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2. A retrospective case-control study to evaluate the use of beta-lactam desensitization in the management of penicillin-allergic patients: a potential strategy for Antimicrobial Stewardship Programs

Author

Rodríguez-Alarcón, Alicia, primary, Sanz de Mena, Manuela, additional, Alanti, Soukaina Sara, additional, Echeverría-Esnal, Daniel, additional, Sorli, Luisa, additional, Sendra, Elena, additional, Benítez-Cano, Adela, additional, Membrilla, Estela, additional, Cots, Francesc, additional, Güerri-Fernández, Robert, additional, Adalia, Ramón, additional, Horcajada, Juan Pablo, additional, Escolano, Fernando, additional, Grau, Santiago, additional, and Gómez-Zorrilla, Silvia, additional

Published
2023
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7. Antibiotic desensitization as a potential tool in antimicrobial stewardship programs: retrospective data analysis and systematic literature review

Author

Rodríguez-Alarcón, Alicia, primary, Barceló-Vidal, Jaime, additional, Echeverría-Esnal, Daniel, additional, Sorli, Luisa, additional, Güerri-Fernández, Roberto, additional, Ramis Fernández, Sofía Martina, additional, Benitez-Cano, Adela, additional, Sendra, Elena, additional, López Montesinos, Inmaculada, additional, Membrilla-Fernández, Estela, additional, Ferrández, Olivia, additional, Adalia, Ramón, additional, Horcajada, Juan Pablo, additional, Escolano, Fernando, additional, Gómez-Zorrilla, Silvia, additional, and Grau, Santiago, additional

Published
2022
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8. Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS

Author

Ferrando, Carlos, Suarez-Sipmann, Fernando, Mellado-Artigas, Ricard, Hernández, María, Gea, Alfredo, Arruti, Egoitz, Aldecoa, César, Martínez-Pallí, Graciela, Martínez-González, Miguel A., Slutsky, Arthur S., Villar, Jesús, Graciela, Martínez-Pallí, Mercadal, Jordi, Muñoz, Guido, Mellado, Ricard, Jacas, Adriana, Vendrell, Marina, Sánchez-Etayo, Gerard, Alcón, Amalia, Belda, Isabel, Agustí, Mercé, Carramiñana, Albert, Gracia, Isabel, Panzeri, Miriam, León, Irene, Balust, Jaume, Navarro, Ricard, Arguís, María José, Carretero, Maria José, Ibáñez, Cristina, Perdomo, Juan, López, Antonio, López, Manuel, Cuñat, Tomás, Ubré, Marta, Ojeda, Antonio, Calvo, Andrea, Rivas, Eva, Hurtado, Paola, Pujol, Roger, Martín, Nuria, Tercero, Javier, Sanahuja, Pepe, Magaldi, Marta, Coca, Miquel, del Rio, Elena, Martínez-Ocon, Julia, Masgoret, Paula, Caballero, Angel, Risco, Raquel, Gómez, Lidia, de Riva, Nicolás, Ruiz, Ana, Beatriz, Tena, Jaramillo, Sebastián, Balibrea, Jose María, de Lacy, Francisco Borja, Otero, Ana, Ibarzabal, Ainitze, Bravo, Raquel, Carreras, Anna, Martín-Barreda, Daniel, Alias, Alfonso Jesús, Balaguer, Mariano, Aliaga, Jorge, Almuedo, Alex, Alonso, Joan Ramón, Andrea, Rut, Angelès, Gerard Sergi, Arias, Marilyn, Aziz, Fátima, Badía, Joan Ramon, Barbeta, Enric, Torres, Toni, Batiste, Guillem, Benet, Pau, Borrat, Xavi, Borrell, María, Bragulat, Ernest, Carmona, Inmaculada, Castellà, Manuel, Castro, Pedro, Ceravalls, Joan, Comino, Oscar, Cucciniello, Claudia, De Deray, Clàudia, De Diego, Oriol, De la Matta, Paula, Farrero, Marta, Fernández, Javier, Fernández, Sara, Fernández, Anna, Ferrer, Miquel, Fervienza, Ana, Forga, María Tallo, Forné, Daniel, Galán, Clàudia, Gomez, Andrea, Guasch, Eduard, Tejero, Maria Hernández, Jiménez, Beltrán, Leyes, Pere, López, Teresa, Martínez, José Antonio, Muñoz, Jose, Nicolás, Josep Maria, Ortiz, José Tomás, Peiró, Anna, Pérez, Manuel, Poch, Esteban, Pujol, Margarida, Quintana, Eduard, Ramis, Bartomeu, Reverter, Enric, Rovira, Irene, Ruiz, Pablo, Sandoval, Elena, Schneider, Stefan, Sibila, Oriol, Solé, Carla, Soriano, Alex, Soy, Dolors, Suárez, M., Téllez, Adrián, Toapanta, Néstor David, Torres, Antoni, Urra, Xavier, Bordell, Alicia, Martín, Silvia, Andrés, Judith, Ruiz, Alberto Martínez, Medel, Gonzalo Tamayo, Villasante, Iñaki Bilbao, Clavero, Fernando Iturri, Álvarez, Covadonga Peralta, Herrera, Julia T., Trancho, Andrea García, Mandiola, Iñaki Sainz, Suarez, Carmen Ruano, Bocos, Angela Ruiz, Izagirre, Eneritz Urrutia, de Urbina Fernández, Pablo Ortiz, Apodaka, Naiara, Molano, Leire Prieto, Ganuza, Eunate, Vallinas, Iratxe, de Orte, Karmele, Paniagua, Celia González, Ortiz, Gemma, Pérez, Mireia, López, Marta, Bárcena, Estíbaliz, Urutxurtu, Erik, Maroño, Maria Jesús, Escontrela, Blanca, Ereñozaga, Aitziber, Lasuen, Deiene, Zabal, Ainhoa, Guereca, Ane, Adalia, Ramón, Zattera, Luigi, Hernandez, Irina Adalid, Altuna, Leire Larrañaga, Castells, Aina Serrallonga, Garcia, Adriana Vilchez, Núñez, María, Román, Lorena, Calvo, Francisco Javier Redondo, González, Ruben Villazala, González, Victor Baladron, Faba, Patricia, Montenegro, Omar, Ramírez, Natalia Bejarano, Contreras, Sergio Marcos, Rodríguez, Alejandro Garcia, Vázquez, Saleta Rey, Pérez, Cristina Garcia, Miguelez, Eva Higuera, Blanco, Irene Pérez, Rivera, David García, de la Fuente, Ane Martín, Pardo, Marta, Rodriguez, Vanessa, Bengoetxea, Unai, Ramasco, Fernando, Bernal, Sheila Olga Santidrián, Hernando, Alvar Santa Cruz, Domínguez, Beatriz, Lima, Ana Vázquez, Candela, Ángel, Bambaren, Ismael A. Acevedo, Blanco, Maria Isabel Albala, Montoiro, Paloma Alonso, Utrera, Fernando Álvarez, Esteruelas, Juan Avellanosa, López, Amal Azzam, Balvis, Alberto José Balvis, Martín, María Beltrán, Haserfaty, Jacobo Benatar, Camacho, Alberto Berruezo, Weimer, Laura Betolaza, del Mar Carbonell Soto, Maria, Seral, Cristina Carrasco, Zaballos, Cristina Cerro, Llamas, Elizabeth Claros, Orduna, Pilar Coleta, Forero, Ingrid P. Cortes, Agustín, Pascual, Aliseda, Crespo, de Pablo Pajares, María Angélica, Remesal, Yolanda Díez, Díaz, Trinidad Dorado, Blasco, Noemí Echevarría, Martín, María Elena Elías, Triviño, Javier Felices, López, Natalia Fernández, Martín, Cristina Fernández, Pozuelo, Natalia Ferreiro, Martín, Luis Gajate, Santos, Clara Gallego, Mayo, Diego Gil, Rojo, María Gómez, Cibrián, Claudia González, López, Elena Herrera, Olmedillo, Borja Hinojal, Gallego, Berta Iglesias, Khonsari, Sassan, Ruiz, María Nuria Mane, Arroyo, María Manzanero, Ortega, Ana María Mariscal, Burcio, Sara Martín, del Carmen Martín González, María, Grande, Ascensión Martín, López, Jose Juan Martín, Rabes, Cecilia Martín, Borja, Marcos Martínez, Castro, Nilda Martínez, Pérez, Adolfo Martínez, Matcan, Snejana, Viñas, Cristina Medrano, Herrera, Lisset Miguel, Betancur, Adrián Mira, Carbajo, María Montiel, Moradas, Javier Moya, Pérez, Lorena Muñoz, Murias, Mónica Nuñez, González, Eva Ordiales, Recio, Óscar Ordoñez, Rodriguez, Miguel Ángel Palomero, Roux, Diego Parise, Torres, Lucia Pereira, Lagunas, David Pestaña, Corraliza, Juana María Pinto, Rodrigo, Marian Prieto, Diaz-Regaño, Inmaculada Rodriguez, Esteban, David Rodriguez, Pernia, Víctor Rojas, Saiz, Álvaro Ruigómez, Villarino, Bárbara Saavedra, Palero, Noemí Samaranch, Pérez, Gloria Santos, Pérez, Jaume Serna, Romero, Ana Belén Serrano, López, Jesús Tercero, García, Carlos Tiscar, de la Torre Concostrina, Marta, Mesa, Eva María Ureta, Olarte, Eva Velasco, Martínez, Judith Villahoz, Palacios, Raúl Villalaba, García, Gema Villanueva, de Medeiros, Cristina Vogel, Ovejero, Soraya Gholamian, Orgaz, Marta Vicente, Herradon, Patricia Lloreda, Gómez, Cristina Crespo, Sarmiento-Trujillo, Tatiana, Medina, Noemí García, García, María Martínez, Ramírez, Carles Espinós, Rivero, Nabil Mouhaffel, Gil, Jose Antonio Bernia, Martín, Sonsoles, Moral, María Victoria, Galán, Josefina, Paniagua, Pilar, Pérez, Sergio, Bainac, Albert, Arias, Ana, Ramil, Elsa, Escudero, Jorge, Monedero, Pablo, Cara, Carmen, Lara, Andrea, Mendez Martínez, E., Mendoza, Jorge, Baines, Íñigo Rubio, Montero, Alejandro, Ibañez, Rocío Armero, Pitarch, Juan Vicente Llau, Alcover, Fernando Rauer, Herreros, Cristina Álvarez, Martín, Cyntia Sánchez, Olmos, Lucía López Ocáriz, Moruno, Marta Navas, Montoto, Fernando García, Rodriguez, M. F. Mirón, Gamito, Cristina Hernández, Orejudo, Antonio Barba, Vielma, Luis Gerardo Smith, Marín, Yasmina González, de Borja Amador Penco, Francisco, Domínguez, Marta Donoso, Ramírez, Silvia Esquivel, Carbonell, José Antonio, López, Berta Monleón, Martínez-Castro, Sara, Aguilar, Gerardo, Gestal, María, Casas, Pablo, Rosato, Angel Outeiro, Pan, Andrea Naveiro, Portela, María Alonso, Romar, Adrián García, Rodríguez, Eva Mosquera, Seijo, Diego Ruanova, Maceiras, Pablo Rama, Castro-Ceoane, Francisco, López, Esther Moreno, Gil, Sergio, Antón, Julia Guillén, Tirado, Patricia García-Consuegra, Calvo, Aurora Callau, Lisbona, Laura Forés, Romero, María Carbonell, Gil, Belén Albericio, Jarne, Laura Pradal, Lozano, María Soria, López, Diego Loscos, Abarca, Andrea Patiño, Pérez-Asenjo, Jordi Serrano Javier, Díez-Domínguez, Ángel, Zubizarreta, Ion, Ramos, Jon, Fernández, Iosu, Maseda, Emilio, de la Rica, Alejandro Suárez, Veganzones, Javier, Insausti, Itziar, Sagra, Javier, Carrasco, Sofía Díaz, Feijoo, Ana Montero, Garutti, Julio Yagüe. Ignacio, Parga, Eva Bassas, Garcia, Carmen Deiros, Rosa, Elisenda Pujol, Navarro, Ana Tejedor, Gabernet, Roser Font, Bernat, Maria José, Valls, Meritxell Serra, Garcia-Bernalt, Cristina Cobaleda, Anton, Jesus Fernanz, Sierra, Adriana Aponte, Gomez, Lucia Gil, Vaqueiro, Olaia Guenaga, Marin, Susana Hernandez, Pinzon, Laura Pardo, Aranda, Sira Garcia, Orejuela, Carlos Briones, Sanchez, Edgar Cortes, Fernandez, Alejandro Romero, Sanjosé, Esther Fernández, Garsabal, Patricia Iglesias, Lopez, Guillermo Isidro, Vicol, Ana, Malagon, Sara Espejo, Loewe, Maria Sanabra, Torradeflo, Laura Grau, Alcaide, Lourdes Blanco, Sanclemente, Gloria Buenaventura, Serra Pujol, Pere, Mendoza, Gustavo Cuadros, Konarska, Miroslawa, Almenara, Fedra Bachs, Golska, Agnieszka, Blesa, Aleix Carmona, Serra, Arantxa Mas, Melchor, Javier Ripollés, Moreno, Ana Nieto, Novo, Káteri Chao, López, Sandra Gadín, Moreno, Elena Nieto, Tonal, Bérénice Gutiérrez, de Pablo, Elena Lucena, Yañez, Barbara Algar, Rivero, Beatriz Vázquez, Mateo, Beatriz Nozal, de Retes, Marina, Escoda, Norma Aracil, Mayo, Cristina Gallardo, González, Rosa Sanz, Escobar, Alicia Ruiz, López, Maria Laura Pelegrina, Peña, Marina Valenzuela, Dueñas, David Stolle, Motos, Ane Abad, Abad-Gurumeta, Alfredo, Errazquin, Ana Tirado, Ruiz, Elena Sáez, Perez, Nerea Gómez, de Francisco, González, Borja Bau, Serra, Cesar Morcillo, Higueras, Jessica Souto, Vicente, Rosario, Ferrandis, Raquel, Martín, Silvia Polo, Moncho, Azucena Pajares, Puigdollers, Ignacio Moreno, Cortés, Juan Pérez Artacho, Calvo, Ana Moret, Peña, Ana Pi, Fernández, María Catalán, Varela, Marina, Diaz, Pilar, Chiva, María Isabel Forés, Agulló, A. Javier, Pérez, Antonio, Barrionuevo, María, Medrano, Paloma, Sanz, Cristina, Ortega, Manuel, Galiana, Maria, Margarit, Antoni, del Rio, Válerie Mourre, Muxella, Eva Heras, and Vidal, Anna

Subjects
Mechanical ventilation, ARDS, Acute respiratory distress syndrome, business.industry, Original, medicine.medical_treatment, Hazard ratio, 030208 emergency & critical care medicine, medicine.disease, Critical Care and Intensive Care Medicine, 3. Good health, Coronavirus, 03 medical and health sciences, Plateau pressure, Prone position, 0302 clinical medicine, 030228 respiratory system, Anesthesia, Intensive care, Breathing, Medicine, business, Tidal volume, Outcome
Abstract

Purpose The main characteristics of mechanically ventilated ARDS patients affected with COVID-19, and the adherence to lung-protective ventilation strategies are not well known. We describe characteristics and outcomes of confirmed ARDS in COVID-19 patients managed with invasive mechanical ventilation (MV). Methods This is a multicenter, prospective, observational study in consecutive, mechanically ventilated patients with ARDS (as defined by the Berlin criteria) affected with with COVID-19 (confirmed SARS-CoV-2 infection in nasal or pharyngeal swab specimens), admitted to a network of 36 Spanish and Andorran intensive care units (ICUs) between March 12 and June 1, 2020. We examined the clinical features, ventilatory management, and clinical outcomes of COVID-19 ARDS patients, and compared some results with other relevant studies in non-COVID-19 ARDS patients. Results A total of 742 patients were analysed with complete 28-day outcome data: 128 (17.1%) with mild, 331 (44.6%) with moderate, and 283 (38.1%) with severe ARDS. At baseline, defined as the first day on invasive MV, median (IQR) values were: tidal volume 6.9 (6.3–7.8) ml/kg predicted body weight, positive end-expiratory pressure 12 (11–14) cmH2O. Values of respiratory system compliance 35 (27–45) ml/cmH2O, plateau pressure 25 (22–29) cmH2O, and driving pressure 12 (10–16) cmH2O were similar cto values from non-COVID-19 ARDS observed in other studies. Recruitment maneuvers, prone position and neuromuscular blocking agents were used in 79%, 76% and 72% of patients, respectively. The risk of 28-day mortality was lower in mild ARDS [hazard ratio (RR) 0.56 (95% CI 0.33–0.93), p = 0.026] and moderate ARDS [hazard ratio (RR) 0.69 (95% CI 0.47–0.97), p = 0.035] when compared to severe ARDS. The 28-day mortality was similar to other observational studies in non-COVID-19 ARDS patients. Conclusions In this large series, COVID-19 ARDS patients have features similar to other causes of ARDS, compliance with lung-protective ventilation was high, and the risk of 28-day mortality increased with the degree of ARDS severity. Electronic supplementary material The online version of this article (10.1007/s00134-020-06192-2) contains supplementary material, which is available to authorized users.

Published
2020

15. Recommendations for antibiotic selection for severe nosocomial infections

Author

Mensa, Josep, primary, Barberán, José, additional, Ferrer, Ricard, additional, Borges, Marcio, additional, Rascado, Pedro, additional, Maseda, Emilio, additional, Oliver, Antonio, additional, Marco, Francesc, additional, Adalia, Ramón, additional, Aguilar, Gerardo, additional, Estella, Ángel, additional, León López, Rafael, additional, Robles Marcos, Manuel Santiago, additional, González de Molina, Francisco Javier, additional, Serrano García, Ricardo, additional, Salavert, Miguel, additional, Fernández Gómez, Javier, additional, Poliakova, Yuliya, additional, Pasquau, Juan, additional, Azanza, José Ramón, additional, Bou Arévalo, Germán, additional, Llinares Mondéjar, Pedro, additional, Cardinal-Fernández, Pablo, additional, and Soriano, Alex, additional

Published
2021
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17. Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with High-Flow Nasal Oxygen therapy. A multicenter, adjusted cohort study

Author

Ferrando, Carlos, primary, Mellado-Artigas, Ricard, additional, Gea, Alfredo, additional, Arruti, Egoitz, additional, Aldecoa, César, additional, Adalia, Ramón, additional, Ramasco, Fernando, additional, Monedero, Pablo, additional, Maseda, Emilio, additional, Tamayo, Gonzalo, additional, Hernández-Sanz, María L., additional, Mercadal, Jordi, additional, Martín-Grande, Ascensión, additional, Kacmarek, Robert M., additional, Villar, Jesús, additional, and Suárez-Sipmann, Fernando, additional

Published
2020
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18. Additional file 1 of Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy: a multicenter, adjusted cohort study

Author

Ferrando, Carlos, Mellado-Artigas, Ricard, Gea, Alfredo, Arruti, Egoitz, Aldecoa, César, Adalia, Ramón, Ramasco, Fernando, Monedero, Pablo, Maseda, Emilio, Tamayo, Gonzalo, Hernández-Sanz, María L., Mercadal, Jordi, Ascensión Martín-Grande, Kacmarek, Robert M., Villar, Jesús, and Suárez-Sipmann, Fernando

Abstract

Additional file 1: Table 1. Baseline characteristics of patients with HFNO before and after adjustment. Table 2. Clinical evolution of patients with HFNO (maximum or minimum values) before and after adjustment. Table 3. Baseline characteristics of patients with HFNO plus awake prone positioning before and after adjustment. Table 4. Clinical evolution (maximum or minimum values) of patients with HFNO plus awake prone position before and after adjustment. Table 5. Outcomes of the original-eligible population and weighted population. Figure 1. Peripheral oxyhemoglobin saturation (%) over time in the adjusted population. Figure 2. Respiratory rate (breath per minute) over time in the adjusted population. Figure 3. ROX Index [(SpO2/FiO2) / Respiratory rate] over time in the adjusted population. Figure 4. Probability of being intubated in patients stratified by PaO2/FiO2. Figure 5. Probability of 28-day mortality in patients stratified by PaO2/FiO2.

Published
2020
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19. Clinical and biological markers for predicting ARDS and outcome in septic patients.

Author

Villar, Jesús, Herrán-Monge, Rubén, González-Higueras, Elena, Prieto-González, Miryam, Ambrós, Alfonso, Rodríguez-Pérez, Aurelio, Muriel-Bombín, Arturo, Solano, Rosario, Cuenca-Rubio, Cristina, Vidal, Anxela, Flores, Carlos, González-Martín, Jesús M., García-Laorden, M. Isabel, Genetics of Sepsis (GEN-SEP) Network, Adalia, Ramón, Sánchez-Etayo, Gerard, Martín-Rodríguez, Carmen, Martínez-García, Laura, Becerra, Ángel, and Valencia, Lucía

Subjects
SEPSIS, ADULT respiratory distress syndrome, TREATMENT effectiveness, BIOMARKERS
Abstract

Sepsis is a common cause of acute respiratory distress syndrome (ARDS) associated with a high mortality. A panel of biomarkers (BMs) to identify septic patients at risk for developing ARDS, or at high risk of death, would be of interest for selecting patients for therapeutic trials, which could improve ARDS diagnosis and treatment, and survival chances in sepsis and ARDS. We measured nine protein BMs by ELISA in serum from 232 adult septic patients at diagnosis (152 required invasive mechanical ventilation and 72 had ARDS). A panel including the BMs RAGE, CXCL16 and Ang-2, plus PaO2/FiO2, was good in predicting ARDS (area under the curve = 0.88 in total septic patients). Best performing panels for ICU death are related to the presence of ARDS, need for invasive mechanical ventilation, and pulmonary/extrapulmonary origin of sepsis. In all cases, the use of BMs improved the prediction by clinical markers. Our study confirms the relevance of RAGE, Ang-2, IL-1RA and SP-D, and is novel supporting the inclusion of CXCL16, in BMs panels for predicting ARDS diagnosis and ARDS and sepsis outcome. [ABSTRACT FROM AUTHOR]

Published
2021
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21. Autores

Author

Adalia, Ramón, Agustí, Mercè, Aibar, Jesús A., Almela, Manel, Alsina, M.ª Mercè, Ambrosioni, Juan, Annane, Djillali, Antón, Juan M., Argudo, Eduard, Arguís, M.ª José, Armero, Georgina, Badia, Joan R., Báez, Alejandro, Ballester, Eugeni, Balust, Jaume, Bañeras, Jordi, Barberà, Joan A., Barreiro, Jaime, Barros, Antonio, Belarte, Laia Carla, Bellart, Jordi, Benito, Sergio, Benito, Sofía, Berne, Paola, Blanch, Lluís, Blanco, Isabel, Blasco, Miquel, Bodro, Marta, Borrat, Xavier, Bové, Albert, Burgos, Felip, Cabañas, Jesús, Cambra, Francisco J., Cano, Esteban, Carmona, Francesc, Carreño, Mar, Carreras, Enric, Carrero, Enrique, Cartañà, Ramon, Casals, Francesc, Castro, Pedro, Cereza, Ramón, Cerezo, Salvador, Coca, Antonio, Cofán, Frederic, Corcuera, Rosa, de la Calle, Cristina, de Lecuona, Itziar, del Río, Ana, Díaz-Prieto, Antonio, Doménech, Mónica, Doti, Pamela I., Dueñas, Antonio, Dueñas, Carmelo, Durán, Albert, Enseñat, Joaquim, Escalada, Xavier, Escorsell, Àngels, Espinosa, Gerard, Esteve, Jordi, Esteve, M.ª Jesús, Falces, Carlos, Fernández, Javier, Fernández, Rafael, Fernández, Sara, Ferrer, Miquel, Feu, Faust, Fontanals, Jaume, Forga, María, Fuster, David, Gaínza, Francisco J., Gallardo, Jacinto, García, Covadonga, García, Samuel, Garofalo, Antonio M.G., Gascón, Joaquim, Gatell, Josep M.ª, Gómez, Elisenda, Gómez, Vicente, González, Mercè, Gratacós, Laura, Grau, Josep M.ª, Guerra, José, Heering, Cristian, Heras, Gabriel, Hernández-Meneses, Marta, Herrero, Ignacio, Iranzo, Pilar, Jiménez, Xavier, Leyes, Pere, Lombardo, Julissa, López, Esther, López, Xavier, López-Boado, Miguel A., López-Góngora, Mariana, López-Soto, Alfonso, Lorente, José A., Lozano, Miquel, Lynam, Barry, Magaldi, Marta, Marcos, M.ª Ángeles, Martí, Julio, Martín, Beatriz, Martín, Mari C., Martínez, Fernando, Martínez, Gemma, Martínez, José A., Martínez, Julia, Mas, Antoni, Masip, Josep, Maxime, Virginie, Mensa, Josep, Mercadal, Jordi, Milisenda, José, Miró, José M., Mont, Lluís, Montero, Santiago R., Morales, Luis, Morán, Indalecio, Moreno, Asunción, Moreno, José R., Moreno, Pedro, Muñoz, Carlos, Muñoz, José, Natal, Judith, Navarro, Gonzalo, Navasa, Miquel, Nicolás, José M.ª, Nieto, Juan A., Nogué, Santiago, Obach, Víctor, Olivé, Marta, Ortiz, Guillermo, Palma, Pilar, Parada, Manel, Paredes, David, Peguero, Anna, Pereira, Arturo, Pérez-Villa, Félix, Pericás, Juan M., Plasín, Miguel A., Poca, María A., Poch, Esteban, Prado, Verónica, Prieto, Antonio, Prieto, Sergio, Quintana, Eduard, Recasens, Lluís, Regueiro, Ander, Reverter, Joan C., Ricart, Assumpta, Rinaudo, Mariano, Ríos, Joaquín, Risco, Laura, Rivas, Eva, Rovira, Montserrat, Ruiz, Javier, Sacanella, Emilio, Sahuquillo, Juan, Salgado, Emilio, Sánchez, Miquel, Sánchez-Etayo, Gerard, Sánchez-Guerrero, Ángela, Sanclemente, Gemma, Sandoval, Elena, Sans-Roselló, Jordi, Santamaría, Joan, Sanz, Miquel, Segura, Susana, Sionis, Alessandro, Sitges, Marta, Soriano, Álex, Soto, Josep M., Soy, Dolors, Subirats, Enric, Suy, Anna, Téllez, Adrián, Tercero, Javier, Trigo, Laura, Trucco, Emilce, Ubré, Marta, Valencia, Mauricio, Velasco, José Manuel, Vera, Paula, Via, Gemma, Vidal, Bàrbara, Vidal, Joan, Vidal, Miquel, Vilella, Ana, Vollmer, Ivan, Zapata, Lluís, and Zavala, Elizabeth

Published
2021
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23. Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy: a multicenter, adjusted cohort study.

Author

Ferrando, Carlos, Mellado-Artigas, Ricard, Gea, Alfredo, Arruti, Egoitz, Aldecoa, César, Adalia, Ramón, Ramasco, Fernando, Monedero, Pablo, Maseda, Emilio, Tamayo, Gonzalo, Hernández-Sanz, María L., Mercadal, Jordi, Martín-Grande, Ascensión, Kacmarek, Robert M., Villar, Jesús, Suárez-Sipmann, Fernando, for the COVID-19 Spanish ICU Network, Vendrell, Marina, Sánchez-Etayo, Gerard, and Alcón, Amalia

Abstract

Background: Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether the combination of high-flow nasal oxygen therapy (HFNO) with awake-PP prevents the need for intubation when compared to HFNO alone.Methods: Prospective, multicenter, adjusted observational cohort study in consecutive COVID-19 patients with acute respiratory failure (ARF) receiving respiratory support with HFNO from 12 March to 9 June 2020. Patients were classified as HFNO with or without awake-PP. Logistic models were fitted to predict treatment at baseline using the following variables: age, sex, obesity, non-respiratory Sequential Organ Failure Assessment score, APACHE-II, C-reactive protein, days from symptoms onset to HFNO initiation, respiratory rate, and peripheral oxyhemoglobin saturation. We compared data on demographics, vital signs, laboratory markers, need for invasive mechanical ventilation, days to intubation, ICU length of stay, and ICU mortality between HFNO patients with and without awake-PP.Results: A total of 1076 patients with COVID-19 ARF were admitted, of which 199 patients received HFNO and were analyzed. Fifty-five (27.6%) were pronated during HFNO; 60 (41%) and 22 (40%) patients from the HFNO and HFNO + awake-PP groups were intubated. The use of awake-PP as an adjunctive therapy to HFNO did not reduce the risk of intubation [RR 0.87 (95% CI 0.53-1.43), p = 0.60]. Patients treated with HFNO + awake-PP showed a trend for delay in intubation compared to HFNO alone [median 1 (interquartile range, IQR 1.0-2.5) vs 2 IQR 1.0-3.0] days (p = 0.055), but awake-PP did not affect 28-day mortality [RR 1.04 (95% CI 0.40-2.72), p = 0.92].Conclusion: In patients with COVID-19 ARF treated with HFNO, the use of awake-PP did not reduce the need for intubation or affect mortality. [ABSTRACT FROM AUTHOR]

Published
2020
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24. Autores

Author

Abizanda, Ricardo, Acevedo, Juan, Adalia, Ramón, Agustí, Mercè, A. Aibar, Jesús, Alsina, M. Mercè, Annane, Djillali, Antón, Juan M., Arguís, María José, Ayats, Carmen, R. Badia, Joan, Báez, Alejandro, Ballester, Eugeni, Balust, Jaume, A. Barberà, Joan, Bataller, Ramón, Bayés-Genís, Antonio, Bellart, Jordi, Benito, Sofía, Berne, Paola, Bisbal, Felipe, Blanco, Isabel, Borrat, Xavier, Bosch, Xavier, Bové, Albert, Burgos, Felip, Cabañas, Jesús, Cabré, Lluís, Cano, Esteban, Carmona, Francesc, Carreño, Mar, Carreras, Enric, Carrero, Enrique, Cartañà, Ramón, Casals, Francesc, Castro, Pedro, Cereza, Ramón, Cerezo, Salvador, Cervera, Carlos, Cofán, Frederic, Corcuera, Rosa, Cortés, Irene, Río, Ana del, Díaz-Prieto, Antonio, Domínguez, Rosa, Dueñas, Antonio, Enseñat, Joaquim, Escalada, Xavier, Escartín, Antonio, Escorsell, Àngels, Espinosa, Gerard, Esteve, Jordi, Jesús Esteve, M. <ce:sup loc='post">a</ce:sup>, Falces, Carlos, Fernández, Javier, Fernández, Rafael, Ferrer, Miquel, Fontanals, Jaume, Forga, María, J. Gaínza, Francisco, Gallardo, Jacinto, García, Covadonga, García, Samuel, Gascón, Joaquim, Gatell, Josep M, González, Juan, González, Mercè, Gratacós, Laura, M. Grau, Josep, M. Guilemany, Josep, Gutiérrez, Montserrat, Heras, Magda, Heering, Cristian, Herrero, Ignacio, Jiménez-Fábrega, Xavier, Josa, Miquel, Lafforgue, Patrick, Leyes, Pere, Linares, Laura, López, Xavier, López-Boado, Miguel A., López-Góngora, Mariana, López-Soto, Alfonso, A. Lorente, José, Lozano, Miguel, Marco, Francesc, Martí, Julio, Martín, Mari C., Martínez, Carlos, Martínez, Fernando, Martínez, Gemma, A. Martínez, José, Mas, Antoni, Mas-Font, Sonia, Maxime, Virginie, Mensa, Josep, Mercadal, Jordi, A. Merino, María, Mestres, Carlos, M. Miró, José, Morales, Luis, Morán, Indalecio, Moreno, Asunción, R. Moreno, José, Navasa, Miquel, M. <ce:sup loc='post">a</ce:sup> Nicolás, José, A. Nieto, Juan, Nogué, Santiago, Obach, Víctor, Olivé, Marta, Ortiz, Jessica, Palma, Pilar, Palomeque, Antonio, Parada, Manel, Pardo, Montserrat, Paré, Carles, Paredes, David, Parés, Albert, Pereira, Arturo, Pérez-Villa, Félix, Pizarro, Sandra, Plasín, Miguel A, Poca, Maria A, Poch, Esteban, Prieto, Sergio, Pumarola, Tomás, Recasens, Lluís, Reverter, Joan C, Ricart, Assumpta, Rinaudo, Mariano, Ríos, Joaquín, Rivas, Eva, Rovira, Montserrat, Ruiz, Javier, Sacanella, Emilio, Sahuquillo, Juan, Sánchez, Miquel, Sánchez-Etayo, Gerard, Santamaría, Joan, Sanz, Miquel, Segura, Susana, Sionis, Alessandro, Sitges, Marta, Soriano, Alex, M. Soto, José, Soy, Dolors, Subirats, Enric, Suy, Anna, Tercero, Javier, Tomàs, Carles, Torrabadella, Pablo, Ubré, Marta, Valencia, Mauricio, Vera, Paula, Vía, Gemma, Vidal, Joan, Xaubet, Antoni, Zapata, Lluís, and Zavala, Elizabeth

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31. Anesthetic management of a patient in prone position with a drill bit penetrating the spinal canal at C1-C2, using a laryngeal mask.

Author

Valero R, Serrano S, Adalia R, Tercero J, Blasi A, Sánchez-Etayo G, Martínez G, Caral L, and Ibáñez G

Subjects
Accidents, Adult, Cerebral Angiography, Humans, Male, Neck Injuries complications, Neck Injuries diagnostic imaging, Prone Position, Spinal Canal diagnostic imaging, Tomography, X-Ray Computed, Wounds, Penetrating complications, Wounds, Penetrating diagnostic imaging, Wounds, Penetrating surgery, Anesthesia, Inhalation, Laryngeal Masks, Neck Injuries surgery, Spinal Canal injuries
Abstract

Unlabelled: Airway management in patients with penetrating neck trauma must guarantee cervical spine stability. Moreover, the prone position increases the risk of difficult ventilation and cervical spine injury. A 19-yr-old patient was brought to the emergency room in prone position with a drill bit protruding from the posterolateral aspect of his neck. The bit had entered the spinal canal below the first cervical vertebra, and placed near the odontoid peg. He was referred for surgical removal of the drill. The use of an inhaled induction of anesthesia, avoiding muscle relaxants, and ventilation through a laryngeal mask airway inserted in the prone position seemed to offer a satisfactory approach., Implications: Management of patients with penetrating neck trauma must guarantee cervical spine stability. Moreover, the prone position increases the risk of difficult ventilation and cervical spine injury. Anesthesia may be induced and the airway can be managed with the patient already in the prone position for surgery.

Published
2004
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