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1. Intravenous Ascorbic Acid for the Prevention of Postreperfusion Syndrome in Orthotopic Liver Transplantation: Protocol for a Randomized Controlled Trial

Author

Luis Gajate, Inés de la Hoz, Mercedes Espiño, Maria del Carmen Martin Gonzalez, Cristina Fernandez Martin, Ascensión Martín-Grande, Diego Parise Roux, Oscar Pastor, Judith Villahoz, Miguel Ángel Rodriguez-Gandía, and Javier Nuño Vazquez

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundLiver transplantation is the last therapeutic option for patients with end-stage liver disease. Postreperfusion syndrome (PRS), defined as a fall in mean arterial pressure of more than 30% within the first 5 minutes after reperfusion of at least 1 minute, can occur in liver transplantation as a deep hemodynamic instability with associated hyperfibrinolysis immediately after reperfusion of the new graft. Its incidence has remained unchanged since it was first described in 1987. PRS is related to ischemia-reperfusion (I/R) injury, whose pathophysiology involves the release of several mediators from both the donor and the recipient. The antioxidant effect of ascorbic acid has been studied in resuscitating patients with septic shock and burns. Even today, there are publications with conflicting results, and there is a need for further studies to confirm or rule out the usefulness of this drug in this group of patients. The addition of ascorbic acid to preservation solutions used in solid organ transplantation is under investigation to harness its antioxidant effect and mitigate I/R injury. Since PRS could be considered a manifestation of I/R injury, we believe that the possible beneficial effect of ascorbic acid on the occurrence of PRS should be investigated. ObjectiveThe aim of this randomized controlled trial is to assess the benefits of ascorbic acid over saline in the development of PRS in adult liver transplantation. MethodsWe plan to conduct a single-center randomized controlled trial at the Hospital Universitario Ramón y Cajal in Spain. A total of 70 participants aged 18 years or older undergoing liver transplantation will be randomized to receive either ascorbic acid or saline. The primary outcome will be the difference between groups in the incidence of PRS. The randomized controlled trial will be conducted under conditions of respect for fundamental human rights and ethical principles governing biomedical research involving human participants and in accordance with the international recommendations contained in the Declaration of Helsinki and its subsequent revisions. ResultsThe enrollment process began in 2020. A total of 35 patients have been recruited so far. Data cleaning and analysis are expected to occur in the first months of 2024. Results are expected around the middle of 2024. ConclusionsWe believe that this study could be particularly relevant because it will be the first to analyze the clinical effect of ascorbic acid in liver transplantation. Moreover, we believe that this study fills an important gap in the knowledge of the potential benefits of ascorbic acid in the field of liver transplantation, particularly in relation to PRS. Trial RegistrationEuropean Union Drug Regulating Authorities Clinical Trials Database 2020-000123-39; https://tinyurl.com/2cfzddw8; ClinicalTrials.gov NCT05754242; https://tinyurl.com/346vw7sm International Registered Report Identifier (IRRID)DERR1-10.2196/50091

Published
2023
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2. EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI): study protocol for a multicentre, observational trial

Author

Melanie Meersch, Mira Küllmar, Carola Wempe, Alexander Zarbock, Ke Peng, Sigismond Lasocki, Thomas Rimmele, Maria Martin, Olivier Desebbe, Michele Rossi, Matthias Heringlake, Christina Massoth, Raphael Weiss, Andreas Höhn, Gael Pradel, Ana Kowark, Ahmed mohamed Ibrahim, Orestis Ioannidis, Andrea Cortegiani, Maxime Leger, Emmanuel Rineau, Pierre-Yves Egreteau, Andrea Russo, Laura Kerschke, Savino Spadaro, Carole Ichai, Vincent Cottenceau, Sebastian Ziemann, Maria Gomez, Julien Nadaud, Olivier Pérus, Philippe Magazzeni, Philippe Montravers, Deniz Karakaya, Christophe Aveline, Alexander Bentley, Tulay Ozkan Seyhan, Jean-François Pittet, Sébastien Ponsonnard, Pierre Garcon, Ana Serrano, Gulay Ok, Pierre Vautier, Jean François Gautier, Sergi Sabaté, Yusuf Tunali, Valérie Cerro, Stephanie Suria, Khaschayar Saadat-Gilani, Hichem Makhloufi, Anis Cherak, Lamine Lakhel Ghanem, Zohier Gouaglia, Dina Nasrine Guadouri, Fayrouz Naouel Hama, Mustafa Kara, Omayma Saadi, Rachida Sakhraoui, Fadila Bourou, Abdelhadi Cherifi, Rahmoune Ghania Sadaoui, Amel Ouyahia, Ilhem Ouahab, Souad Bouaoud, Meriem Abdoun, Anisse Tidjane, Benali Tabeti, Nabil Boudjenan-Serradj, Carlos Jose Pérez Rivera, Paulo Cabrer, Julián Corso, Juan Pablo García, Sharon Idarraga, Christopher Montoya, Rafael Figueroa, Eduar Aldana, María Alejandra Torrado, Zheng-min Ma, Yu-fan Yang, Ya-juan Zhu, Peter Sklienka, Michal Frelich, Vojtech Jarkulis, Pavel Sevcik, Vojtech Vodicka, Mohamed Gamal Elbahnasawy, Shady Elsalhawy, Sara Motawea, Zeinab Othman, Mohamed Sahma, Ahmed Mahmoud Nafea, Nermin Ahmed, Doaa Ali Attia, Moataz Maher Emara, Mohamed Mamdouh Bonna, Mohamed Ahmed Gabr, Amany Ismail Tarbay, Ibrahim Abdelmonaem Abdehaleem, Esraa Elsayed Mohamed, Amr Mahmoud Eldeeb, Ahmed Mohamed Abbas, John Ashraf Magdy, Zyad Hassan Hamed, Hany Mostafa Esmaeil Osman, Mostafa Samy Abbas, Oliver Joannes-Boyau, Nicolas Barraud, Corentin Berthelot, Thibault Camus, Anissa Dahmi, Mylène Defaye, Sébastien Derville, Younes El-Boustani, Elsa Deloge, Hélène Jacob, Simon Monziols, Fred Priem, Jean-Jacques Robin, Vincent Legros, Therry Floch, Salvatore Muccio, Claire Geneve, Marie Lim Legouge, Stéphanie Tao Mauny, Willy Mfam, Léa Pascot, Mireille Chartier, Benjamin Duteurtre, Aidren Le Cousin, Nathalie Begel, Claire-Annissa Chekirine, Vincent Derlon, Elodie Grein, Marie-Annick Lehair, Laurent Magazzeni, Carsten Potter, Catherine Roth, Florence Voivret, Jamil Elmawieh, Annabelle Stoclin, Cédric Cirenei, Gregoire Andrieu, Sven Couloumy, Jeremy Falcone, Marion Fajardy, Arsène Gagneuil, Emeline Girardet, Agnès Mazereeuw, Mélanie Bertel, Simon Bocher, Vanessa Carn, Lenaïg Le Guen, Guillaume Le Loup, Montaine Lefevre, Amanita Diop, Vanessa Jean-Michel, Sylvie Devlieger, Juliette Duthoit, Mohamed El Kadiri, Viviane Cassisa, Charline Masson, Pierre Verrier, Axel Coquerel, Enora Atchade, Charles-Edouard Rochon, Céline Delerue, Vidal Quentin, Vanessa Latry, Nina Queixalos, Thierry Braun, Saad Bouzoubaa, Basile Christ, Audrey Geiger, Joachim Gomille, Vianney Kieffer, Simone Mangeant, Christelle Prochilo, Christian Schmitt, Stefan Skwirba, Hubert Grand, Frédérique Boury, Nicolas Mayeur, Marie Pasquie, Vincent Bruckert, Vincent Arnould, Mona Bonciu, Thibault Chapelle, Luc Facchino, Florence Fagot-Gandet, Andrea Iachim, Elena Mannu, Rémi Plattier, Romain Rozier, Michel Boudinaud, Marie-Hélène Hausermann, My Hue Nguyen, Andersen Ramorasata, Amélie Barreau, Anne-Hélène Boivin, Céline Ravry, Nicolas Mottard, Johanne Beuvelot, Florence Prunier Bossion, Christian Dörr, Thilo Caspar von Groote, Linda Grüßer, Pia Wittig, Timo Brandenburger, Thomas Dimski, Niklas Döhmen, Laura Huthmann, Daniela Kaierle, Claude Pelletier, Manon Schleß, Sebastian Cleophas, Stephanie Haunhorst, Marina Jansen, Alexandra Schmitt, Julia Soisch, Kilian Sturm, Peter Rosenberger, Alexander Bendig, Lena Flohr, Helene Häberle, Pascal Hofmann, Jonathan Kuhle, Nora Michaela Leser, Kathrin Pfister, Stefanie Prohaska, Franziska Sennholz, Lena Stetz, Kathrin Weber, Sebastian Stehr, Stephan Klaus, Marco Sadlo, Matthias Boschin, Christian Sengelhoff, Ulrich Michael Göbel, Jan Gerrit Haaker, Carina-Kristin Göttker, Matthias Gründel, Romina Baumgärtel, Astrid Berggren, Madeleine Gülzow, Lennart Muras, Hauke Paarmann, Serge Thal, Dschamil El-Masri, Eleni Arnaoutoglou, Maria Ntalouka, Paula Stratigopoulou, Anastasia Analytis, Efthymios Mavrommatis, Petros Tzimas, Agathi Karakosta, Danai Pantazi, Antonia Dimakopoulou, Katerina Dimitropoulou, Humam Jalaawiy, Aeshah Anwar, Hashim Talib Hashim, Hogir Imad Rasheed Aldawoody, Giulia Catalisano, Gilia Ingoglia, Mariachiara Ippolito, Silvia De Rosa, Lucia Cattin, Andrea Bianchin, Marisa Barone, Gianluca Paternoster, Salvatore Lucio Cutuli, Liliana Sollazzi, Laura Cascarano, Massimo Antonelli, Paola Aceto, Bruno Romanò, Vincenzo Francesco Tripodi, Rosamaria Scappatura, Maria Cristina Vadalà, Diego Fiume, Maria Teresa Strano, Giulia Oddo, Clemente Santorsola, Bilal Abu Hussain, Adnan Raed Alnaser, Anas Hassouneh Ghassan, Khaled Hasanein, Mohammed Theab, Seokyung Shin, Seungho Jung, Kyuho Lee, Sung Mee Jung, Jongyoon Baek, Muhammed K. Elhadi, Issa Abuzeid, Mohammed Albaraesi, Sarah Aldressi, Wegdan Khalel, Eman Abdulwahed, Akram Abdulhamid Ashur Abujrad, Amer Almaghrabi, Muhand Mohammed Alteleeb, Entisar Ahmed Ali Alshareea, Marwa Isa Biala, Abdulqudus Deeknah, Dooua Ali Gheddim, Reem Ghmagh, Nawras Salih Ali AbuIkhrays, Marwa Sinan, Enas Soula, Sumayyah Ghayth Bahroun, Khawla Derwish, Aya Munir Mohamed, Eman Sayed Younes, Rayet Al Islam Benjouira, Mohamed Aliwa, Najwa Abdullah Altashani, Mohammed Omar Alteb, Ahmed Msherghi, Fatima Alagelli, Sufyan Albarouni, Ahmed Albishti, Sarah Aljamal, Mohamed Alsori, Taha Ekhuja, Suha Elzwai, Mohammed Ghula, Tahani Mustafa, Ahmed Tuwaib, Haifa Zriba, Hamza Mahmoud Agilla, Toky Andriamahefa Rafanomezantsoa, Anne Marie Camilleri Podesta, Denise Mifsud Bonnici, Tiziana Pirotta, Gilberto Adrián Gasca López, Maja Mojsova Mijovska, Tatjana Davitkovska, Aleksandra Gavrilovska, Sanja Lukikj, Marija Vesova, Dina Zafirova, Sarah Amro, Baraa N. F. Hajjaj, Muawia Alkhazendar, Yousuf Barakat, Sewar Abdulaziz Elejla, Ahmed Elhissi, Ahmed Khader, Ali Salem, Rita de Freitas Regufe, André Filipe de Oliveira Eloy, Lisbete Marisa Neto Cordeiro Perdigão, Evgeny Grigoriev, Artem Ivkin, Roman Kornelyuk, Michael Yaroustovsky, Marina Abramyan, Ekaterina Komardina, Nataliya Lesteva, Medina Aybazova, Elmira Kumykova, Svetlana Lesina, Gennady Rybakov, Alexey Shestov, Abdulnaser Ahmad Ahmad Barmou, Bushra Lotfi Altayeb Ahmed, Aisha Mohammad Eliyas, Yousra Emadeldin, Alexander Kaserer, Clara Castellucci, Julian Rössler, Samira Akbas, Andreja Möller Petrun, Irena Gregorcic, Vesna Sok, Roman Čičak, Elizabeth Bárcena, Antonio Guisado, Ismail Wi, Javier Ripollés Melchor, Ángel Becerra-Bolaños, Sergio Cabrera-Doreste, Ancor Domínguez-Arbelo, María Candelaria Delgado-Alonso, Virginia Muiño-Palomar, Aurelio Rodríguez-Pérez, Javier Mata Estévez, Maria Begona Covas Munoz, Juan Mulet Matas, Sara Perez Palao, Maria Dolores Mira Quirós, Alisia Cezara Teslev, Mercedes Garcia Alvarez, Marga Argilaga, María Campos, Albert Bainac, Astrid Batalla, Marta Giné, Gracia Herránz, Ignacio Hinojal, Margarita Logroño Ejea, Noelia de la Rosa Ruiz, María Gastaca Abasolo, Carla Rosario Houhton Acuna, Ibai Iriarte Zaranton, Ana Mendigurenmurua, María José Munoz Sanz, Erika Olea de la Fuente, María Pilar Pérez Vaquero, Ana Soto Iglesias, Ana Ugarte Mieres, Alaitz Urtiaga Urrestizala, Lourdes Ferreira, Félix Lobato, Marta Aguado Sevilla, Andres Erazo, Pere Miró, Diana Vernetta, Berta Castellano Paulis, Anabel Adell Perez, Marta Aseguinolaza Pagola, Elena delVal Peciña, Ainhoa Garmendia Odriozola, Amaia Lopetegi Aizpurua, Olatz Pavón Piquer, Pilar Plou Garcia, Paula Ortega Rezola, Antia Osorio Lopez, Isabel de la Calle Gil, Rosalía Navarro Casado, Peter Adamove, Roser Bayona Domenge, Francho Miguel Blasco Blasco, Adriana Alexandra Rueda Villamizar, Maria Antonia Perelló Llaneras, Jose Ignacio García-Sánchez, Laura Fernandez Téllez, Sara García Zamorano, Natalia Gijón Herreros, Andrea Rodriguez Esteve, Pablo Monedero Rodríguez, Isabel García Trigo, Agustín Alcaraz, Andrea Lara Jiménez, Iñigo Rubio, Nuria García, Raquel Callejas, Angel Manuel Candela Toha, Eli Claros, Pilar Cobeta, Pascual Crespo, Trini Dorado, Elena Elías, Javier Felices, Diego Gil, Nuria Mané, Adolfo Martínez, Lucía Pereira, Alberto Balvis Noemí Samaranch, Carlos Tiscar, Judith VillaHoz, Patricia Galán Menéndez, Elena Cardona, Anna Conesa, Veronica Estepa, Laura Llinares Espí, Yuri Loaiza Aldeán, Susana Manrique, Víctor Morales Ariza, Laura Villarino Villa, Elfayadh Saidahmed Mohamed Amed Suliman, Hytham Hamid, Modather Mohamed Saeed, Orhan Sungur Mukadder, Demet Altun, Nur Canbolat, Müşerref Beril Dinçer, Serap Aktaş Yıldırım, Müzeyyen İyigün, Davut Yapıcı, Levent Özdemir, Aslinur Sagun, Neval Boztug, Yesim Cetintas, Bora Dinc, Emel Gündüz, Hakkı Ünlügenç, Demet Lafli Tunay, Ozgur Komurcu, Özlem Korkmaz Dilmen, Eren Fatma Akcil, Eda Tok Alsina, Özge Hakli, Cengiz Polat, Namigar Turgut, Nurcan Kızılcık, Özge Köner, Öznur Şen, Nurdan Aydin, Burcu Basaran, Emre Sertac Bingul, Kamil Darcin, Semra Ugur, Kemal Tolga Saracoglu, Asli Demir, Özgök Aysegül, Eda Balci, Behic Girgin, Aygun Guler, Ümit Karadeniz, Nihal Özaslan, Yigit Özay Hülya, Namik Ozcan, Aysun Postaci, Mehmet Sahap, Nevriye Salman, Özlem Sağır, Bulent Atik, Murat Bicakcioglu, Hafize Fisun Demir, Ugün Fatih, Nazan Kocaoglu, Hüseyin ilksen Toprak, Duygu Demiröz Aslan, Yusuf Ziya Colak, Mustafa Soner Ozcan, Mehmet Yilmaz, Umran Karaca, Sevtap Hekimoglu Sahin, Özlem Ersoy Karka, Gizem Demir Şenoğlu, Süheyla Erkoç Karadağ, Neslihan Alkis, Volkan Baytaş, Engin Erturk, Ali Akdogan, Ahmet Besir, Dilek Kutanis, Sedat Saylan, Ersagun Tugcugil, Pinar Ayvat, Berrin Günaydın, Beyza Mehri Büyükgebiz, Omer Faruk Boran, Feyza Calisir, Yavuz Orak, Bahar Kuvaki Balkan, Sibel Büyükcoban, Erol Gökel, Sakize Ferim Günenc, Sule Özbilgin, Suna Göre, Selcan Akesen, Seda Cansabuncu, Natalia Momot, Anna Panchenko, and Kristen Rutledge

Subjects
Medicine
Abstract

Introduction More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI.Methods and analysis EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI.Ethics and dissemination EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials.Trial registration number NCT04165369.

Published
2021
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3. 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

4. Institutional factors associated with adherence to enhanced recovery protocols for colorectal surgery: Secondary analysis of a multicenter study

Author

Andres Zorrilla-Vaca, Alexander B. Stone, Javier Ripolles-Melchor, Ane Abad-Motos, Jose M. Ramirez-Rodriguez, Patricia Galan-Menendez, Gabriel E. Mena, Michael C. Grant, Cristina Garcia-Perez, Eva Higuera-Míguelez, José M. Marcos-Vidal, María Merino-García, Ana B. Rubio-López, María E. Pascual-Diez, Francisco J. García-Miguel, Luis R. Cabezudo-Sanjose, Ruth Martínez-Díaz, Sara Alegría-Rebollo, José L. González-Rodríguez, María S. Vega-Cruz, Gema Martínez-Ragüés, Manuel A. Gómez-Ríos, Eva Mosquera-Rodríguez, Sara Del-Río-Regueira, Domingo Bustos-García, María P. Sánchez-Conde, Antonio Rodríguez-Calvo, María A. Hernández-Valero, María Angoso-Clavijo, Luis M. González-Fernández, Miguel A. Bravo-Riaño, María V. Arnes-Muñoz, José R. Perez-Valdivieso, Marta Martin-Vizcaino, Susana Hernandez-Garcia, Francisco J. Yoldi-Murillo, Miguel Salvador-Bravo, Manuela Rubial-Alvarez, Fabiola Oteiza-Martinez, Enrique Balen-Rivera, José A. Garcia-Erce, Ana Zugasti-Murillo, María E. Petrina-Jáuregui, Filadelfo Bustos-Molina, Daniel Paz-Martín, Bárbara Vázquez-Vicente, Lourdes González-López, Conrado Mínguez-Marín, Susana Diz-Jueguen, Jaime Seoane-Antelo, Julio Ballinas-Miranda, Ester Carrera-Dacosta, Erica Barreiro-Domínguez, Alexandra Piñeiro-Teijeiro, Raquel Sanchez-Santos, Marina Varela-Duran, Pilar Diaz-Parada, Aránzazu Calero-Lillo, Manuel Ángel López-Lara, Salvador Muñoz-Collado, Juan Valverde-Sintas, Silvia Aznar-Puig, Daniel Troyano-Escribano, Sandra Marmaña-Mezquita, Jesús Fernanz-Antón, Lucia Catot-Alemany, Jaume Balust, Marta Ubré, Carlos Ferrando-Ortolá, Graciela Martínez-Pallí, Ainitze Ibarzabal, Antonio M. Lacy, Rubén Sánchez-Martín, Karina Martins-Cruz, Paula Pérez-Jiménez, Rubén Casans-Francés, Javier Longás, José M. Ramírez Rodríguez, Ana Mugarra-Llopis, Cristina Crisan, Estefanía Gracia-Ferrándiz, Esther Romero-Vargas, Marina Soro-Domingo, Rita Rodríguez-Jiménez, Blanca Prada-Martin, Henar Muñoz-Hernández, José I. Gómez Herrera, Sara Cocho-Crespo, Sandra Fernández-Caballero, Miguel Flores-Crespo, Andrea Vázquez-Fernández, Carlo Brugiotti, Estefanía Ollé-Sese, Carla R. Houghton-Acuña, Marta López-Doucil, Ernesto A. Tarazona-López, Iván BEL-Marcobal, Sonia González-Cogollor, Manuel Llácer-Pérez, Alberto Arias-Romano, María C. Arrabal-Taborda, Mercedes Caballero-Domínguez, Rafael García-López, Julio Ontoria-Muriel, Antonio Vivó-Blasco, Francisco J. Blanco, Enrique DEL-Cojo-Peces, Jose M. Tena-Guerrero, Aitor Landaluce-Olavarria, Izaskun Badiola, Marta Calvo, Unai DE-Andres, Vicente Portugal-Porras, Bakarne Ugarte-Sierra, Ana Pedregosa-Sanz, Laura Perelló-Cerdà, Yobanys Rodríguez-Téllez, Joanna Grössl-Meleán, Xavier Viñas-Truñén, Enrique Alday-Muñoz, Elena Bermejo-Marcos, Pedro A. Alonso-Casado, Francisco A. Gimeno-Calvo, Ana Rodriguez-Sánchez, Carmen Montes-López, Laura Álvarez-Llano, María J. FAS-Vicent, Juan M. Ortega-Monzó, Gustavo Flores-Flores, José L. Tristancho, Montserrat Bayo-Sans, María C. Deiros-Garcia, María L. GIL-Gómez, Lourdes Parra, Vanesa Tejedor-DE-LA-Fuente, Carlos Jericó-Alba, Núria Borrell-Brau, David Camacho-Martín, Jose L. Ortiz-DE-Zarate, Daniel López-Ruiz, Vicens Rodriguez-Bustamante, M. Martinez-Vilalta, Daniel Amoros-Ruiz, Marc Sadurni-Sarda, Fernando A.L.C.A.L.D.E. Matas, Hernán Giordano, Jose M. Perez Peña, Luis Olmedilla-Arnal, Pilar Benito-SAZ, Elena López-GIL, Adela Ruiz-Ortega, Sara Zapatero-García, Emilio DEL-Valle-García, Víctor Soria-Aledo, Carmen V. Pérez-Guarinos, Enrique Pellicer-Franco, Graciela Valero-Navarro, Mónica Mengual-Ballester, José Andrés García-Marín, Manuel Romero-Simó, Ibán Caravaca-García, Teresa Blasco-Segura, Carlos F. Campo-Betancourth, Rafael David Costa-Navarro, Laura Jordá-Sanz, María I. DE-Miguel-Cabrera, José M. España-Pamplona, Silvia GIL-Trujillo, Francisco J. Redondo-Calvo, Víctor Baladrón-Gónzalez, Remedios Moreno-Ballesteros, José L. Muñoz-Rodes, Elena Miranda, Marta Roselló-Chornet, Lourdes Alós-Zaragoza, Juan Catalá-Bauset, María A. Pallardo-López, Noemí Almenara-Almenara, Lorena Muñoz-Devesa, Benito Alcaide-Pardo, Pablo Gimeno-Fernández, José L. Gómez-Agraz, Carla Iglesias-Morales, Paola B. Ordoñez-Enireb, Ana M. Ríos-Villalba, Joselvy Rodríguez-Pinto, Sergio Sánchez-Cortés, María J. Montoya-Tabares, Vicente Ruiz, Francisco González-Sánchez, Víctor Soriano-Giménez, José M. Muñoz-Camarena, Jorge Benavides-Buleje, Juan C. Estupiñán-Jiménez, Irene Portero-Larragueta, David Alias, María J. Alberola-Estellés, Óscar Díaz-Cambronero, María S. Matoses-Jaén, María D. Ruiz-Boluda, Carlos Maristany-Bienert, José A. Pardo-López, Álvaro Ramiro-Ruiz, Pablo García, Arantza Martínez-DE-Guereñu, Belinda Montalbán, Claudia Olea, David Benguría, Javier Silva, Adriana Calderón, Jordi Escoll-Rufino, Carlos Cerdan-Santacruz, José E. Sierra-Grañón, María Rufas-Acín, Nuria Mestres-Petit, Ingrid C. Penagos-Saavedra, Cristina Moreno-Castilla, Jordi Riera-RIU, Ana Cuellar-Martínez, R.C. González-Álvarez, Míriam Sánchez-Merchante, Santiago García-DEL-Valle-Y-Manzano, Sara García-Zamorano, Natalia Gijón-Herreros, Patricia Robles-Ángel, Margarita Logroño-Ejea, Rodrigo Sanllorente-Sebastian, Maria C. Villalain-Perez, Mihaela Siclama-Stroe, Judith Benítez-Villar, Alberto Sánchez-Campos, Alberto Martínez-Ruiz, Patricia Alonso-Carnicero, Francisco J. DE-LA-Torre-González, Carolina Naranjo-Checa, Fernando Pereira-Pérez, Elena Ruiz-Ucar, Alfredo Rivera, Cristina GIL-Lapetra, Enrique Roca-Castillo, María L. Mariscal-Flores, Mario Morales-Cayuela, Irene Alonso-Ramos, Virginia Jiménez-Carneros, Lucas Casalduero-Garcia, Javier Jimenez-Miramón, L. José, Eva M. Nogués-Ramia, Yolanda Sosa-Quesada, Alonso Gómez, Laura M. Martínez-Meco-Ortiz, Mercedes Cabellos-Olivares, José R. Rodríguez-Fraile, María Labalde-Martínez, null Ramos-Rodríguez, Beatriz Nacarino-Alcorta, Raquel Fernández-García, Borja DE-LA-Quintana-Gordon, Justyna Drewniak, Fátima Senra-L, Pablo Galindo-Jara, Ana B. Gallardo-Herrera, Cesar García-Llorente, Laura Colao-García, Luz-Divina Rellan-Álvarez, Miguel Miro-Murillo, Sahely-CLARET Flores-Risco, Jordi Serrat-Puyol, Adrian Medina-Gallardo, Yuhami Mitsahid-Curbelo-Peña, null Orenzana, Alfredo Abad-Gurumeta, Norma Aracil-Escoda, Eugenio Martínez-Hurtado, Beatriz Nozal-Mateo, Elena Sáez-Ruiz, Rut Salvachua-Fernández, Javier Ripollés-Melchor, María L. DE-Fuenmayor-Valera, Elena Sánchez, Begoña Toribio, Antonio Navarro-Sánchez, José López-Fernández, Dácil Montesdeoca-Cabrera, Francisco J. Alcalá-Serrano, Azahara Sancho-DE-Avila, Sofia Diaz-Carrasco, Almudena Martín-Martín, Alejandro Suarez-DE-LA-Rica, Rafael UÑA-Orejón, Emilio Maseda, Guillermo Tejón-Pérez, María V. Alfaro-Martínez, Marta Alonso-Fernández, María A. Álvarez-Cebrián, María J. Álvarez-DEL-Vayo-Rodríguez, Mariana Carrillo-Rivas, María Fernández-Rodríguez, Sonia Trabanco-Morán, José L. Rábago-Morán, Javier Martínez-Ubieto, Ana M. Pascual-Bellosta, Sonia M. Ortega-Lucea, Maria P. Santero-Ramirez, Maria V. Duque-Mallen, Cristian Aragon-Benedi, Andrea Vallejo-Tarrat, Carmen Colillas-Calvet, Maria J. Laso, Javier Martinez-Cabañero, Javier Hernández-Salván, Beatriz Ledesma-Muñoz, Carolina Ochoa-Osorio, Máximo Sanz-García, Begoña Herrero-Garrote, Alma Blázquez-Martin, Manuel Díez-Alonso, Pilar Hernández-Juara, José M. Muguerza-Huguet, Macarena Barbero-Mielgo, Belén SAN-Antonio-SAN-Román, Laura Alonso-Aguilar, Viktoria Molnar, María C. Delgado-Naviero, Encarnación Meléndez-Leal, Virginia Cavero-García, África Fernández-Sánchez, Daniela A. Cubek-Quevedo, Rocío D.Í.E.Z. Munar, Francisco J. Blázquez-Fernández-DE-LA Pradilla, Ana B. Serrano, Alberto Balvís, Alberto Berruezo, Elena Esparza, Inés D.E.L.A. HOZ, Ana Palavicini, Lucia Pereira, Ximena Vega, Judith Villahoz, Gema Villanueva, José I. Alonso-Fernández, César Aldecoa, Clara Bolaño-Pérez, Teresa Villán-González, Astrid Batalla, G. Azparren, M. Basttita, M. Felipe, L. Cueva, Marta Gine, A.M. Gómez-Caro, I. India, S. Piñol, Neus Esteve-Pérez, Carlos Mora-Fernández, Ana Ferrer-Robles, Juan J. Segura-Sampedro, Natalia Alonso-Hernández, Angels Camps-Cervantes, Ivette Chocrón-DA-Prat, Carolina C. Coronado-Silva, Héctor Duque-Santos, Elena Esclapez-Sempere, Patricia Galan-Menéndez, Silvia Matarín-Olmo, M.P. Tormos-Pérez, Laura Villarino-Villa, Héctor Bergés-Gutiérrez, Miguel Aisa-Gasca, Verónica Arbona-Camillero, José D. Bautista-González, Francisco J. Carballido-Pascual, Mercedes Gutiérrez-Moreno, Ana Muñoz-Durán, Jesús Cañete-Gómez, Esther Cáceres-Fabrega, José M. Lorente-Herce, Octavio Mulet-Zayas, Rocío Gómez-Pérez, Cristina Monje-Salazar, Luis Lobato-Bancalero, Carmelo Torres-Moreno, Elena Sanchez-Cárdenas, Juan J. Daza-González, Teresa Sanchez-Viguera, Antonio DEL-Fresno-Asensio, Laura Bermudez-Román, José L. Jover-Pinillos, Francisco J. Orts-Micó, Coral Cózar-Lozano, Olga Blasco-Delgado, Andrea Nonnemacher-SAN-Julián, José A. Pérez, Laura D.U.R.Á.N. Cruces, and Pablo Renedo-Corcóstegui

Subjects
medicine.medical_specialty, Perioperative medicine, Quality management, business.industry, Colorectal surgery, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, Patient satisfaction, Enhanced recovery, 030202 anesthesiology, Multidisciplinary approach, Spain, Anesthesiology, Anesthesia, Secondary analysis, Emergency medicine, Medicine, Humans, Multicenter Studies as Topic, 030212 general & internal medicine, business, Colorectal Surgery
Abstract

Adherence to Enhanced Recovery Protocols (ERPs) is associated with faster functional recovery, better patient satisfaction, lower complication rates and reduced length of hospital stay. Understanding institutional barriers and facilitators is essential for improving adherence to ERPs. The purpose of this study was to identify institutional factors associated with adherence to an ERP for colorectal surgery.A secondary analysis of a nationwide study was conducted including 686 patients who underwent colorectal surgery across twenty-one institutions in Spain. Adherence to ERPs was calculated based upon the components recommended by the Enhanced Recovery After Surgery (ERAS®) Society. Institutional characteristics (i.e., case volume, ERP duration, anesthesia staff size, multidisciplinary meetings, leadership discipline) were captured from each participating program. Multivariable regression was performed to determine characteristics associated with adherence.The median adherence to ERAS was 68.2% (IQR 59.1%-81.8%). Multivariable linear regression revealed that anesthesiologist leadership (+5.49%, 95%CI +2.81% to +8.18%, P 0.01), duration of ERAS implementation (+0.46% per year, 95%CI +0.06% to +0.86%, P 0.01) and the use of regular multidisciplinary meetings (+4.66%, 95%CI +0.06 to +7.74%, P 0.01) were independently associated with greater adherence. Case volume (-2.38% per 4 cases weekly, 95%CI -3.03 to -1.74, P 0.01) and number of anesthesia providers (-1.19% per 10 providers, 95%CI +2.23 to -8.18%, P 0.01) were negatively associated with adherence.Adherence to ERPs is strongly associated with anesthesiology leadership, regular multidisciplinary meetings, and program duration, whereas case volume and the size of the anesthesia staff were potential barriers. These findings highlight the importance of strong leadership, experience and establishing a multidisciplinary team when developing an ERP for colorectal surgery.

Published
2021

5. EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI): study protocol for a multicentre, observational trial

Author

Weiss, Raphael, Saadat-Gilani, Khaschayar, Kerschke, Laura, Wempe, Carola, Meersch, Melanie, Zarbock, Alexander Hichem Makhloufi, Anis, Cherak, Lamine Lakhel Ghanem, Zohier, Gouaglia, Dina Nasrine Guadouri, Fayrouz Naouel Hama, Mustafa, Kara, Omayma, Saadi, Rachida, Sakhraoui, Fadila, Bourou, Abdelhadi, Cherifi, Rahmoune Ghania Sadaoui, Amel, Ouyahia, Ilhem, Ouahab, Souad, Bouaoud, Meriem, Abdoun, Anisse, Tidjane, Benali, Tabeti, Nabil, Boudjenan-Serradj, Carlos Jose Pérez Rivera, Paulo, Cabrer, Julián, Corso, Juan Pablo García, Sharon, Idarraga, Christopher, Montoya, Rafael, Figueroa, Eduar, Aldana, María Alejandra Torrado, Peng, Ke, Zheng-Min, Ma, Yu-Fan, Yang, Ya-Juan, Zhu, Peter, Sklienka, Michal, Frelich, Vojtech, Jarkulis, Pavel, Sevcik, Vojtech, Vodicka, Mohamed Gamal Elbahnasawy, Shady, Elsalhawy, Sara, Motawea, Zeinab, Othman, Mohamed, Sahma, Ahmed Mahmoud Nafea, Nermin, Ahmed, Doaa Ali Attia, Moataz Maher Emara, Mohamed Mamdouh Bonna, Mohamed Ahmed Gabr, Amany Ismail Tarbay, Ibrahim Abdelmonaem Abdehaleem, Esraa Elsayed Mohamed, Amr Mahmoud Eldeeb, Ahmed Mohamed Abbas, John Ashraf Magdy, Zyad Hassan Hamed, Hany Mostafa Esmaeil Osman, Mostafa Samy Abbas, Oliver, Joannes-Boyau, Nicolas, Barraud, Corentin, Berthelot, Thibault, Camus, Anissa, Dahmi, Mylène, Defaye, Sébastien, Derville, Younes, El-Boustani, Elsa, Deloge, Hélène, Jacob, Simon, Monziols, Fred, Priem, Jean-Jacques, Robin, Vincent, Legros, Therry, Floch, Salvatore, Muccio, Claire, Geneve, Marie Lim Legouge, Stéphanie Tao Mauny, Willy, Mfam, Léa, Pascot, Christophe, Aveline, Mireille, Chartier, Benjamin, Duteurtre, Jean Francois Gautier, Aidren Le Cousin, Pierre, Vautier, Julien, Nadaud, Nathalie, Begel, Claire-Annissa, Chekirine, Vincent, Derlon, Elodie, Grein, Marie-Annick, Lehair, Laurent, Magazzeni, Philippe, Magazzeni, Carsten, Potter, Catherine, Roth, Florence, Voivret, Thomas, Rimmelé, Valérie, Cerro, Stéphanie, Suria, Jamil, Elmawieh, Annabelle, Stoclin, Cédric, Cirenei, Gregoire, Andrieu, Sven, Couloumy, Jeremy, Falcone, Marion, Fajardy, Arsène, Gagneuil, Emeline, Girardet, Agnès, Mazereeuw, Sébastien, Ponsonnard, Pierre-Yves, Egreteau, Mélanie, Bertel, Simon, Bocher, Vanessa, Carn, Lenaïg Le Guen, Guillaume Le Loup, Montaine, Lefevre, Carole, Ichai, Amanita, Diop, Vanessa, Jean-Michel, Sylvie, Devlieger, Juliette, Duthoit, Mohamed El Kadiri, Maxime, Léger, Viviane, Cassisa, Sigismond, Lasocki, Charline, Masson, Emmanuel, Rineau, Pierre, Verrier, Axel, Coquerel, Philippe, Montravers, Enora, Atchade, Charles-Edouard, Rochon, Céline, Delerue, Vidal, Quentin, Vanessa, Latry, Nina, Queixalos, Vincent, Cottenceau, Thierry, Braun, Saad, Bouzoubaa, Basile, Christ, Audrey, Geiger, Joachim, Gomille, Vianney, Kieffer, Simone, Mangeant, Christelle, Prochilo, Christian, Schmitt, Stefan, Skwirba, Hubert, Grand, Frédérique, Boury, Nicolas, Mayeur, Marie, Pasquie, Pierre, Garçon, Vincent, Bruckert, Vincent, Arnould, Mona, Bonciu, Thibault, Chapelle, Luc, Facchino, Florence, Fagot-Gandet, Andrea, Iachim, Elena, Mannu, Olivier, Perus, Rémi, Plattier, Romain, Rozier, Gaël, Pradel, Michel, Boudinaud, Marie-Hélène, Hausermann, My Hue Nguyen, Andersen, Ramorasata, Amélie, Barreau, Anne-Hélène, Boivin, Céline, Ravry, Nicolas, Mottard, Johanne, Beuvelot, Florence Prunier Bossion, Olivier, Desebbe, Alexander, Zarbock, Christian, Dörr, Thilo Caspar von Groote, Mira, Küllmar, Christina, Massoth, Melanie, Meersch, Khaschayar, Saadat-Gilani, Raphael, Weiss, Carola, Wempe, Sebastian, Ziemann, Linda, Grüßer, Ana, Kowark, Pia, Wittig, Timo, Brandenburger, Thomas, Dimski, Niklas, Döhmen, Laura, Huthmann, Daniela, Kaierle, Claude, Pelletier, Manon, Schleß, Andreas, Hohn, Sebastian, Cleophas, Stephanie, Haunhorst, Marina, Jansen, Alexandra, Schmitt, Julia, Soisch, Kilian, Sturm, Peter, Rosenberger, Alexander, Bendig, Lena, Flohr, Helene, Häberle, Pascal, Hofmann, Jonathan, Kuhle, Nora Michaela Leser, Kathrin, Pfister, Stefanie, Prohaska, Franziska, Sennholz, Lena, Stetz, Kathrin, Weber, Sebastian, Stehr, Stephan, Klaus, Marco, Sadlo, Matthias, Boschin, Christian, Sengelhoff, Ulrich Michael Göbel, Jan Gerrit Haaker, Carina-Kristin, Göttker, Matthias, Gründel, Matthias, Heringlake, Romina, Baumgärtel, Astrid, Berggren, Madeleine, Gülzow, Lennart, Muras, Hauke, Paarmann, Serge, Thal, Alexander, Bentley, Dschamil, El-Masri, Anne, Sebastiani, Eleni, Arnaoutoglou, Maria, Ntalouka, Paula, Stratigopoulou, Anastasia, Analytis, Efthymios, Mavrommatis, Petros, Tzimas, Agathi, Karakosta, Danai, Pantazi, Antonia, Dimakopoulou, Katerina, Dimitropoulou, Orestis, Ioannidis, Humam, Jalaawiy, Aeshah, Anwar, Hashim Talib Hashim, Hogir Imad Rasheed Aldawoody, Andrea, Cortegiani, Giulia, Catalisano, Gilia, Ingoglia, Mariachiara, Ippolito, De Rosa, Silvia, Lucia, Cattin, Andrea, Bianchin, Marisa, Barone, Gianluca, Paternoster, Salvatore Lucio Cutuli, Andrea, Russo, Liliana, Sollazzi, Laura, Cascarano, Massimo, Antonelli, Paola, Aceto, Bruno, Romanò, Savino, Spadaro, 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Susana, Manrique, Víctor Morales Ariza, Laura Villarino Villa, Elfayadh Saidahmed Mohamed Amed Suliman, Hytham, Hamid, Ahmed Mohamed Ibrahim, Modather Mohamed Saeed, Orhan Sungur Mukadder, Demet, Altun, Nur, Canbolat, Müşerref Beril Dinçer, Tulay Özkan Seyhan, Serap Aktaş Yıldırım, Müzeyyen, İyigün, Davut, Yapıcı, Levent, Özdemir, Aslinur, Sagun, Neval, Boztug, Yesim, Cetintas, Bora, Dinc, Emel, Gündüz, Hakkı, Ünlügenç, Demet Lafli Tunay, Deniz, Karakaya, Burhan, Dost, Ozgur, Komurcu, Özlem Korkmaz Dilmen, Eren Fatma Akcil, Yusuf, Tunali, Gülay, Ok, Eda Tok Alsina, Özge, Hakli, Cengiz, Polat, Namigar, Turgut, Nurcan, Kızılcık, Özge, Köner, Öznur, Şen, Nurdan, Aydin, Burcu, Basaran, Emre Sertac Bingul, Yavuz, Gürkan, Kamil, Darcin, Semra, Ugur, Kemal Tolga Saracoglu, Asli, Demir, Özgök, Aysegül, Eda, Balci, Behic, Girgin, Aygun, Guler, Ümit, Karadeniz, Nihal, Özaslan, Yigit Özay Hülya, Namik, Ozcan, Aysun, Postaci, Mehmet, Sahap, Nevriye, Salman, Özlem, Sağır, Bulent, Atik, Murat, Bicakcioglu, Hafize Fisun Demir, Ugün, Fatih, Nazan, Kocaoglu, Hüseyin Ilksen Toprak, Duygu Demiröz Aslan, Yusuf Ziya Colak, Mustafa Soner Ozcan, Mehmet, Yilmaz, Umran, Karaca, Sevtap Hekimoglu Sahin, Özlem Ersoy Karka, Gizem Demir Şenoğlu, Süheyla Erkoç Karadağ, Neslihan, Alkis, Volkan, Baytaş, Engin, Erturk, Ali, Akdogan, Ahmet, Besir, Dilek, Kutanis, Sedat, Saylan, Ersagun, Tugcugil, Pinar, Ayvat, Berrin, Günaydın, Beyza Mehri Büyükgebiz, Omer Faruk Boran, Feyza, Calisir, Yavuz, Orak, Bahar Kuvaki Balkan, Sibel, Büyükcoban, Erol, Gökel, Sakize Ferim Günenc, Sule, Özbilgin, Suna, Göre, Selcan, Akesen, Seda, Cansabuncu, Natalia, Momot, Anna, Panchenko, Jean-Francois, Pittet, Kristen, Rutledge, Tıp Fakültesi, Weiss, R, Saadat-Gilani, K, Kerschke,L, Wempe,C, Meersch, M, Zarbock, A, Cortegiani, A, and Ippolito, M

Subjects
Epidemiology, urologic and male genital diseases, acute renal failure, Adult Intensive & Critical Care, Anaesthesia, Cohort Studies, surgery, chronic renal failure, Humans, Multicenter Studies as Topic, Prospective Studies, adult intensive & critical care, urogenital system, Incidence, General Medicine, Acute Kidney Injury, female genital diseases and pregnancy complications, critical care, Renal Replacement Therapy, Observational Studies as Topic, epidemiology, Acute Renal Failure, Surgery, adult intensive &amp, Chronic Renal Failure
Abstract

Sağır, Özlem (Balikesir Author), Introduction More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. Methods and analysis EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. Ethics and dissemination EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369. ©

Published
2021

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