13 results on '"Gero-Escapa M"'
Search Results
2. Short-term outcomes after repair treatment (clipping or coiling) in aneurysmal subarachnoid hemorrhage (ASAH): a prospective multicenter study
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Gero Escapa, M, Iglesias Posadilla, D, González Robledo, J, Domínguez Berrot, A, González Salamanca, A, Nogales Martín, L, Ossa Echeverri, S, Diego Calvo, A, Riesco Crespo, M, Olmos Linares, AM, Bueno Sacristán, A, and Ranedo Zaldo, R
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- 2015
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3. Health-related medium term quality of life in intermediate risk pulmonary embolism in a general icu
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Portugal Rodríguez, E, Del Valle Ortiz, M, Badallo Arévalo, O, Ayuela Azcárate, JM, Martínez Barrio, E, Berrazueta Sánchez de Vega, A, Gero Escapa, M, Fernández Ratero, JA, Ossa Echeverri, SA, Perea Rodríguez, ME, and Carbajales Pérez, C
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- 2015
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4. Outcomes of spontaneous subarachnoid hemorrhage (sah) in neurocritical care unit: a multicenter study
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Iglesias Posadilla, D, Gero Escapa, M, González Robledo, J, Domínguez Berrot, A, González Salamanca, A, Nogales Martín, L, Montero Baladía, M, Diego Calvo, A, Riesco Crespo, M, Olmos Linares, AM, Bueno Sacristán, A, and Ranedo Zaldo, R
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- 2015
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5. Evaluation of the degree of adherence to the nutritional recommendations of the critical care patient
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Servia-Goixart L, Lopez-Delgado J, Grau-Carmona T, Trujillano-Cabello J, Escobar-Ortiz J, Montserrat-Ortiz N, Zapata-Rojas A, Bautista-Redondo I, Cruz-Ramos A, Diaz-Castellanos L, Morales-Cifuentes M, Plaza-Bono M, Montejo-Gonzalez J, Temprano-Vazquez S, Arjona-Diaz V, Garcia-Fuentes C, Mudarra-Reche C, Orejana-Martin M, Lores-Obradors A, Anguela-Calvet L, Munoz-Del Rio G, Revelo-Esquibel P, Alanez-Saavedra H, Serra-Paya P, Luna-Solis S, Salinas-Canovas A, De Frutos-Seminario F, Rodriguez-Queraito O, Gonzalez-Iglesias C, Zamora-Elson M, de la Fuente-O'Connor E, Seron-Arbeloa C, Bueno-Vidales N, Iglesias-Rodriguez R, Martin-Luengo A, Sanchez-Miralles A, Marmol-Peis E, Ruiz-Miralles M, Gonzalez-Sanz M, Server-Martinez A, Vila-Garcia B, Lorencio-Cardenas C, Macaya-Redin L, Flecha-Viguera R, Aldunate-Calvo S, Flordelis-Lasierra J, Jimenez-del Rio I, Mampaso-Recio J, Rodriguez-Roldan J, Gastaldo-Simeon R, Gimenez-Castellanos J, Fernandez-Ortega J, Martinez-Carmona J, Lopez-Luque E, Ortega-Ordiales A, Crespo-Gomez M, Ramirez-Montero V, Lopez-Garcia E, Navarro-Lacalle A, Martinez-Garcia P, Dominguez-Fernandez M, Vera-Artazcoz P, Izura-Gomez M, Hernandez-Duran S, Bordeje-Laguna M, Mor-Marco E, Rovira-Valles Y, Philibert V, Alcazar-Espin M, Higon-Canigral A, Calvo-Herranz E, Manzano-Moratinos D, Portugal-Rodriguez E, Andaluz-Ojeda D, Parra-Morais L, Citores-Gonzalez R, Garcia-Gonzalez M, Sanchez-Giron G, Navas-Moya E, Ferrer-Pereto C, Lluch-Candal C, Ruiz-Izquierdo J, Castor-Bekari S, Leon-Cinto C, de Lagran I, Yebenes-Reyes J, Nieto-Martino B, Vaquerizo-Alonso C, Almanza-Lopez S, Perez-Quesada S, Anton-Pascual J, Marin-Corral J, Sistachs-Baquedano M, Hacer-Puig M, Picornell-Noguera M, Mateu-Campos L, Martinez-Valero C, Ortiz-Suner A, Llorente-Ruiz B, Martinez-Diaz M, de la Pena M, Rodriguez-Serrano D, Fernandez-Salvatierra L, Barcelo-Castello M, Millan-Taratiel P, Tejada-Artigas A, Martinez-Arroyo I, Araujo-Aguilar P, Fuster-Cabre M, Andres-Gines L, Soldado-Olmo S, Menor-Fernandez E, Lage-Cendon L, Touceda-Bravo A, Sanchez-Ales L, Almorin-Gonzalvez L, Gero-Escapa M, Martinez-Barrio E, Ossa-Echeverri S, Monge-Donaire D, and Grp Estudio ENPIC
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Background: the application of specialized nutritional support (SNE) is difficult at the organizational level due to the complexity of clinical practice guidelines and we do not know the degree of adherence to the published nutritional recommendations. The aim of this study was to assess the degree of adherence to the recommendations of high impact and "do not do" within our environment, in order to show areas for improvement. Methods: survey of nine questions agreed by experts and carried out in different ICUs of our environment, which reflected the recommendations in SNE. Data related to the organizational characteristics and the healthcare provider that indicated the nutritional support were collected. The differences regarding the degree of adherence between the level of care and the presence of an expert in these units were analyzed. Results: thirty-seven ICUs participated, which corresponded mostly to second level hospitals and polyvalent ICUs with an SNE indicated by intensivists. The adherence to the recommendations was > 80%, with three exceptions associated with issues related to the refeeding syndrome (70.3%), the caloric-protein adjustment of nutrition according to the patient's evolutionary phase (51.4%) and the adjustment of protein intake in patients with renal failure (40.5%). There were no differences according to the level of care or the presence of an expert in these ICUs. Only a greater availability of local nutrition protocols was observed in those ICUs with an expertise. Conclusions: there is a high theoretical adherence to the majority of recommendations in the nutritional field, with exceptions that could correspond to areas where there is an opportunity for improvement.
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- 2019
6. Multi-resistant pseudomonas aeruginosa: study of risk factors for its detection at intensive care unit admission
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Puerto Corrales, S, Vara Arlanzón, R, Callejo-Torre, F, Eiros Bouza, JM, Coma del Corral, MJ, Perea Rodríguez, ME, Martínez Barrios, M, Gero Escapa, M, Ossa Echeverri, S, del Valle Ortíz, M, Calvo Simal, S, Portugal Rodríguez, E, Fernández Ratero, JA, and ENVIN-HELICS Study Group
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- 2015
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7. Benefits of early aggressive immunomodulatory therapy (tocilizumab and methylprednisolone) in COVID-19: Single center cohort study of 685 patients
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Buzon-Martín Luis, Montero-Baladía Miguel, Delgado-López Pedro, Iglesias-Posadilla David, Astigarraga Itziar, Galacho-Harriero Ana, Iglesias-Julián Enrique, López-Veloso María, De La Torre-Ferrera Noelia, Barraza-Bengoechea Julio César, Ubeira- Iglesias Marta, San Llorente- Sebastián Rodrigo, Colazo-Burlato María, Lorenzo-Martín Andrés, Minguito de la Iglesia Javier, García-Muñoz Juan Pablo, Hermida-Fernández Gerardo, Navarro-San Francisco Carolina, Boado-Lama Jorge, Fernández-Regueras María, Callejo-Torre Fernando, Ossa-Echeverri Sergio, Fisac-Cuadrado Lourdes, Gero-Escapa María, Megías-Lobón Gregoria, Simón-Rodríguez Adolfo, and Fernández-Ratero José Antonio
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COVID-19 ,Coronavirus ,SARS-CoV-2 ,Epidemiology ,Diagnosis ,Treatment ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Introduction: A growing evidence suggests that immune dysregulation and thrombotic phenomena are key features in the pathophysiology of COVID-19. Apart from antivirals and respiratory support, anticoagulants, corticoids and immunomodulators are increasingly being prescribed, especially for more severe cases. We describe the clinical outcome of a large cohort of patients preferentially treated with glucocorticoids and interleukin inhibitors. Methods: Single center and retrospective case series. Adult patients admitted with COVID-19 related respiratory insufficiency were included. Patients who died within 2 days after admission and those testing positive but asymptomatic were excluded. We defined two study periods: from March 3rd to March 31 st, 2020 (beginning of epidemic until peak of incidence) and April 1 st to May 7 th, 2020 (second half of epidemic). The majority of patients received respiratory support, combinations of antimicrobials, anticoagulants, corticoids and interleukin inhibitors. Antivirals were preferentially given in the first period. The clinical outcome (death and ventilator dependency) of both periods was compared. Results: From March 3 rd to May 7 th, 685 patients were included for analysis (58.4% males, mean age 68.9 years). Patients in the first period (n = 408) were younger (66.6 vs 71.1 years, p = 0.003), presented lower mean P a O 2/F i O2 ratio at admission (256.5 vs 270.4 mm Hg,p = 0.0563), higher ferritin (1520 vs 1221 ng/ml, p = 0.01), higher IL-6 (679 vs 194 pg/ml, p
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- 2021
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8. "COAGULATION": a mnemonic device for treating coagulation disorders following traumatic brain injury-a narrative-based method in the intensive care unit.
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Quintana-Diaz M, Anania P, Juárez-Vela R, Echaniz-Serrano E, Tejada-Garrido CI, Sanchez-Conde P, Nanwani-Nanwani K, Serrano-Lázaro A, Marcos-Neira P, Gero-Escapa M, García-Criado J, and Godoy DA
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- Humans, Fibrinolytic Agents, Blood Coagulation, Anticoagulants therapeutic use, Intensive Care Units, Blood Coagulation Disorders etiology, Blood Coagulation Disorders therapy, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic therapy
- Abstract
Introduction: Coagulopathy associated with isolated traumatic brain injury (C-iTBI) is a frequent complication associated with poor outcomes, primarily due to its role in the development or progression of haemorrhagic brain lesions. The independent risk factors for its onset are age, severity of traumatic brain injury (TBI), volume of fluids administered during resuscitation, and pre-injury use of antithrombotic drugs. Although the pathophysiology of C-iTBI has not been fully elucidated, two distinct stages have been identified: an initial hypocoagulable phase that begins within the first 24 h, dominated by platelet dysfunction and hyperfibrinolysis, followed by a hypercoagulable state that generally starts 72 h after the trauma. The aim of this study was to design an acronym as a mnemonic device to provide clinicians with an auxiliary tool in the treatment of this complication., Methods: A narrative analysis was performed in which intensive care physicians were asked to list the key factors related to C-iTBI. The initial sample was comprised of 33 respondents. Respondents who were not physicians, not currently working in or with experience in coagulopathy were excluded. Interviews were conducted for a month until the sample was saturated. Each participant was asked a single question: Can you identify a factor associated with coagulopathy in patients with TBI? Factors identified by respondents were then submitted to a quality check based on published studies and proven evidence. Because all the factors identified had strong support in the literature, none was eliminated. An acronym was then developed to create the mnemonic device., Results and Conclusion: Eleven factors were identified: cerebral computed tomography, oral anticoagulant & antiplatelet use, arterial blood pressure (Hypotension), goal-directed haemostatic therapy, use fluids cautiously, low calcium levels, anaemia-transfusion, temperature, international normalised ratio (INR), oral antithrombotic reversal, normal acid-base status, forming the acronym "Coagulation." This acronym is a simple mnemonic device, easy to apply for anyone facing the challenge of treating patients of moderate or severe TBI on a daily basis., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Quintana-Diaz, Anania, Juárez-Vela, Echaniz-Serrano, Tejada-Garrido, Sanchez-Conde, Nanwani-Nanwani, Serrano-Lázaro, Marcos-Neira, Gero-Escapa, García-Criado and Godoy.)
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- 2023
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9. The Patient Blood Management Coordinator, shall we position ourselves?
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Nanwani-Nanwani KL, Gero Escapa M, Serrano Lázaro A, and Quintana Díaz M
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- Humans, Blood Transfusion
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- 2023
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10. Profile and characteristics of the adequacy of blood transfusions in Trauma Intensive Care. A cross sectional multicenter study.
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Juárez-Vela R, Quintana-Diaz M, Rodríguez-Calvo A, Santos-Sánchez JÁ, Gero-Escapa M, Gallego-Curto E, Satústegui-Dordá PJ, Sánchez-González JL, Jericó C, Ruiz de Viñaspre-Hernández R, Gil-Fernández G, and García-Erce JA
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- Humans, Cross-Sectional Studies, Intensive Care Units, Hospitalization, Blood Transfusion, Critical Care
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Introduction: Major trauma is one of the major health care problems facing modern society, trauma systems require careful planning to achieve an ideal level of coverage for the population. The Patient Blood Management Program is an integrated and global strategy to provide patient care that aims to assess and address, when possible, the etiology of blood abnormalities rather than transfuse without treating the underlying cause. We aimed to describe the factors that are associated with the clinical decision to transfuse polytraumatized patients admitted to the Intensive Care Unit (ICU)., Method: We performed a cross sectional multicenter study of patients admitted to ICUs for trauma in 14 Spanish hospitals from September 2020 to December 2021., Results: A total of 69 patients were treated in the emergency room due to polytrauma, 46% of them were considered serious in the initial triage. Thirty were caused by a fall from considerable height (43.47%), followed by 39 patients admitted due to trac accidents (56.52%). The location of the trauma was mainly cranioencephalic, followed by thoracic trauma. Of the 69 patients, 25 received a blood transfusion during their ICU stay (36.23%)., Discussion: No significant differences were observed between transfused and non-transfused patients, except for the severity scales, where transfused patients have a higher score on all the scales assessed in the ICU except for the Revised Trauma Score. As we can see, the incidence of kidney failure was also different between the groups analyzed, reaching 44.00% in transfused patients and 13.64% in the group of patients without blood transfusion, p = 0.005. In this sense, 92.00% of the transfusions performed were inadequate according to the criteria of Hb in blood prior to the decision to transfuse (Hb < 9). Our data support the need to consider clinical practice guidelines regarding blood transfusion and its practices., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Juárez-Vela, Quintana-Diaz, Rodríguez-Calvo, Santos-Sánchez, Gero-Escapa, Gallego-Curto, Satústegui-Dordá, Sánchez-González, Jericó, Ruiz de Viñaspre-Hernández, Gil-Fernández and García-Erce.)
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- 2023
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11. The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?
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Lopez-Delgado JC, Grau-Carmona T, Trujillano-Cabello J, García-Fuentes C, Mor-Marco E, Bordeje-Laguna ML, Portugal-Rodriguez E, Lorencio-Cardenas C, Vera-Artazcoz P, Macaya-Redin L, Martinez-Carmona JF, Mateu-Campos L, Gero-Escapa M, Gastaldo-Simeon R, Vila-García B, Flordelis-Lasierra JL, Montejo-Gonzalez JC, Servia-Goixart L, and The Enpic Study Group
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- Critical Illness therapy, Food, Formulated, Humans, Nutritional Support, Enteral Nutrition, Intensive Care Units
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Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database. Statistical differences were analyzed according to the administration of IMN or other types of enteral formulas. Results: In total, 406 patients were included in the analysis, of whom 15.02% (61) received IMN. Univariate analysis showed that patients treated with IMN formulas received higher mean caloric and protein intake, and better 28-day survival (85.2% vs. 73.3%; p = 0.014. Unadjusted Hazard Ratio (HR): 0.15; 95% CI (Confidence Interval): 0.06−0.36; p < 0.001). Once adjusted for confounding factors, multivariate analysis showed a lower need for vasopressor support (OR: 0.49; 95% CI: 0.26−0.91; p = 0.023) and continuous renal replacement therapies (OR: 0.13; 95% CI: 0.01−0.65; p = 0.049) in those patients who received IMN formulas, independently of the severity of the disease. IMN use was also associated with higher protein intake during the administration of nutritional therapy (OR: 6.23; 95% CI: 2.59−15.54; p < 0.001), regardless of the type of patient. No differences were found in the laboratory parameters, except for a trend toward lower triglyceride levels (HR: 0.97; 95% CI: 0.95−0.99; p = 0.045). Conclusion: The use of IMN formulas may be associated with better outcomes (i.e., lower need for vasopressors and continuous renal replacement), together with a trend toward higher protein enteral delivery during the ICU stay. These findings may ultimately be related to their modulating effect on the inflammatory response in the critically ill. NCT Registry: 03634943.
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- 2022
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12. [Aneurysmal subarachnoid haemorrhage: Results after introducing endovascular therapy in a medium-low volume centre].
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Delgado-López PD, López-Martínez JL, Gero-Escapa M, Martín-Alonso J, Castaño-Blazquez M, Ossa-Echeverri S, Martín-Velasco V, and Castilla-Díez JM
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- Humans, Hydrocephalus, Retrospective Studies, Treatment Outcome, Embolization, Therapeutic, Intracranial Aneurysm therapy, Subarachnoid Hemorrhage therapy
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Objective: To evaluate the impact of introducing endovascular therapy for patients with aneurysmal subarachnoid haemorrhage (aSAH) in a medium-low volume centre., Material and Methods: A retrospective observational study was conducted by comparing the clinical outcome of patients with aSAH before and after introducing endovascular therapy in our centre. The main variables analysed were: type of treatment, hospital and late mortality, intra-procedural morbidity, rate of re-bleeding and vasospasm, and clinical outcome according to the Glasgow Outcome Score (GOS)., Results: Seventy-one patients were treated in two periods: 2010-2011 (32 patients; 19 clipped, 6 coiled, 7 untreated), and 2012-2013 (39 patients, 3 clipped, 34 coiled, 2 untreated). No significant differences were found in age, sex, clinical grade at admission, type and location of aneurysm, Fisher score, or in hospital mortality (28.1% vs 25.6%, P=.35), GOS (except for GOS 5: 43.37% vs 53.8%, P=.045), rate of hydrocephalus and rate of vasospasm. The second cohort obtained better results for aggregated GOS 1+2+3 (36.3% vs 43.75%, P=.034) and for GOS 4+5 (61.5% vs 56.25%, P=.078). The percentage of patients left untreated was significantly lower in the second period (5.1% vs 21.8%, P<.01), as well as the rate of re-bleeding (0% vs 9.4%, P<.01). Patients were treated earlier (2.51 vs 3.95 days), and hospital and total stay were lower (15.2 and 24.6 vs 10.3 and 18 days) in the second period, these differences not reaching statistical significance., Conclusions: Endovascular therapy allowed treating more patients with aSAH, and with a lower re-bleeding rate. This led to a modest reduction in morbidity and mortality., (Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2016
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13. A randomized trial of intravenous glutamine supplementation in trauma ICU patients.
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Pérez-Bárcena J, Marsé P, Zabalegui-Pérez A, Corral E, Herrán-Monge R, Gero-Escapa M, Cervera M, Llompart-Pou JA, Ayestarán I, Raurich JM, Oliver A, Buño A, García de Lorenzo A, and Frontera G
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- Adult, Dietary Supplements, Double-Blind Method, Female, Glutamine blood, Humans, Infections complications, Infusions, Intravenous, Intensive Care Units, Length of Stay, Male, Middle Aged, Prospective Studies, Wounds and Injuries blood, Wounds and Injuries mortality, Glutamine administration & dosage, Wounds and Injuries drug therapy
- Abstract
Purpose: To evaluate the effect of the intravenous (i.v.) L-alanyl-L-glutamine dipeptide supplementation during 5 days on clinical outcome in trauma patients admitted to the intensive care unit (ICU)., Methods: This was a prospective, randomized, double-blind, multicenter trial. Glutamine was not given as a component of nutrition but as an extra infusion. The primary outcome variable was the number of new infections within the first 14 days., Results: We included 142 patients. There were no differences between groups in baseline characteristics. Up to 62 % of the patients in the placebo group and 63 % in the treatment group presented confirmed infections (p = 0.86). ICU length of stay was 14 days in both groups (p = 0.54). Hospital length of stay was 27 days in the placebo group and 29 in the treatment group (p = 0.88). ICU mortality was 4.2 % in both groups (p = 1). Sixty percent of the patients presented low glutamine levels before randomization. At the end of the treatment (6th day), 48 % of the patients maintained low glutamine levels (39 % of treated patients vs. 57 % in the placebo group). Patients with low glutamine levels at day 6 had more number of infections (58.8 vs. 80.9 %; p = 0.032) and longer ICU (9 vs. 20 days; p < 0.01) and hospital length of stay (24 vs. 41 days; p = 0.01)., Conclusions: There was no benefit with i.v. L-alanyl-L-glutamine dipeptide supplementation (0.5 g/kg body weight/day of the dipeptide) during 5 days in trauma patients admitted to the ICU. The i.v. glutamine supplementation was not enough to normalize the plasma glutamine levels in all patients. Low plasma glutamine levels at day 6 were associated with a worse outcome.
- Published
- 2014
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