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1. TEN YEARS OF OUTPATIENT HOMECARE IN TRANSFUSION MEDICINE WITHIN THE HEALTH CARE OF ASSISTANCE OF THE MEDICAL UNION

Author

B Villar, V Siecola, M Irazabal, and M Techera

Subjects
Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Objective: This retrospective study aimed to demonstrate the impact of hometransfusions on the number of patients avoiding admission to the Emergency Room orhospitalization. Methods and materials: The following resources were utilized to achieve theproposed objectives: 1. Blood Bank Computer System (SISSAN). 2. Home Care Area Form (filled out by the physician). 3. Daily Activity FormDuring each visit to the patient, the physician completed the form with the patient's data, theactivities performed at home, vital parameters, blood products used, and the ongoingdisease. These data were then entered into the computer system at the Health Care Centre. We chose a ten-year period to evaluate the activity of the Home Care Area and analyzed thefollowing items: 1. The impact on the number of patients avoiding emergency room visits or hospitaladmissions for blood transfusions. 2. Blood components used. Results: From January 2014 to January 2024:1. 3,171 medical consultations were performed.2. 3,659 transfusion procedures were carried out. 3. Blood components transfused included: 2,881 Desplasmatized Blood units, 393Platelet Concentrate units, and 131 Apheresis Platelets units. 4. Factor VIII was the most commonly used plasma derivative. Discussion: During the chosen period, we observed a significant increase in hometransfusions over the last five years, with a peak during the pandemic years, 2020-2021.During this period, transfusions in the Emergency Room accounted for 22% of the total, 44%in hospital wards, and 19.8% in polyclinics. Home Care Area transfusions represented 14% of the total. Thus, home transfusions significantly reduced the need for Emergency Room orhospital admissions for blood components. Additionally, this approach supports variousareas such as Palliative Care, Geriatrics, Oncology, and Hematology, maintaining patientcomfort and reducing hospitalization costs. Conclusions: From our analysis, we conclude that: Home transfusions representedabout 14% of the total transfusions performed during this period, effectively reducing theneed for institutional visits to receive blood components. These transfusions increased in thelast five years, particularly during the pandemic, demonstrating institutional support and thefeasibility of home therapy during critical moments. The most commonly used BloodComponent was Desplasmatized Blood, and the most commonly used Plasma Derivativewas Factor VIII.

Published
2024
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2. Fever and seizures after a dental procedure

Author

G. Jiménez-Britez, M. Irazabal, and G. Caldentey

Subjects
Text mining, Fever, business.industry, Seizures, Dentistry, Medicine, Humans, Medical emergency, Critical Care and Intensive Care Medicine, business, medicine.disease, Dental Procedure
Published
2019

3. Frailty in patients over 65 years of age admitted to Intensive Care Units (FRAIL-ICU)

Author

S, López Cuenca, L, Oteiza López, N, Lázaro Martín, M M, Irazabal Jaimes, M, Ibarz Villamayor, A, Artigas, and J A, Lorente Balanza

Subjects
Aged, 80 and over, Male, Time Factors, Frailty, Organ Dysfunction Scores, Frail Elderly, Age Factors, Length of Stay, Intensive Care Units, Logistic Models, Spain, Prevalence, Humans, Female, Hospital Mortality, Prospective Studies, Aged
Abstract

To estimate the prevalence of frailty in patients admitted to the Intensive Care Unit (ICU) and its impact upon ICU mortality at 1 and 6 months.A prospective observational cohort study was carried out.Spanish ICU.None.Patients≥65 years of age admitted to the ICU for24hours. Variables were registered upon admission, and functional status was assessed by telephone calls 1 and 6 months after discharge from the ICU.Age, gender, frailty (FRAIL scale), functional status (Barthel, Lawton, Clinical Dementia Rating and NUTRIC score), days of mechanical ventilation (MV), functional score (APACHE II and SOFA), ICU mortality, and mortality 1 and 6 months after ICU discharge.A total of 132 patients were evaluated, of which 46 were frail (34.9%). Age of the frail versus non-frail patients: 78.8±7.2 and 78.6±6.4 years, respectively (P=.43); male gender: 43.8% versus 56.3% (P=.10); SOFA score: 4.7±2.9 versus 4.6±2.9 (P=.75); MV: 33.3% versus 66.7% (P=.75); days of MV: 5.6±15 versus 4.3±8.1 (P=.57); ICU mortality 13% versus 6% (P = .14), mortality at 1 month 24% versus 8% (P = .01), mortality 6 months 32% versus 15% (P = .03). Frailty is associated with mortality at one month (OR = 3.5, P.05, 95% CI (1.22-10.03) and at 6 months after discharge from the ICU (OR = 2.62, P.05, 95% CI (1.04-6.56).Frailty was present in 35% of the patients admitted to the ICU, and was associated with mortality.

Published
2018

4. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)

Author

D. Rob, R. Špunda, J. Lindner, J. Šmalcová, O. Šmíd, T. Kovárník, A. Linhart, J. Bìlohlávek, M. M. Marinoni, G. Cianchi, S. Trapani, M. L. Migliaccio, L. Gucci, M. Bonizzoli, A. Cramaro, M. Cozzolino, S. Valente, A. Peris, E. Grins, E. Kort, M. Weiland, N. Manandhar Shresta, P. Davidson, L. Algotsson, S. Fitch, G. Marco, J. Sturgill, S. Lee, M. Dickinson, T. Boeve, A. Khaghani, P. Wilton, S. Jovinge, A. N. Ahmad, R. Loveridge, S. Vlachos, S. Patel, E. Gelandt, L. Morgan, S. Butt, M. Whitehorne, V. Kakar, C. Park, M. Hayes, C. Willars, T. Hurst, T. Best, A. Vercueil, G. Auzinger, B. Adibelli, N. Akovali, A. Torgay, P. Zeyneloglu, A. Pirat, Z. Kayhan, S. S. Schmidbauer, J. Herlitz, T. Karlsson, H. Friberg, R. Knafelj, P. Radsel, F. Duprez, T. Bonus, G. Cuvelier, S. Mashayekhi, M. Maka, S. Ollieuz, G. Reychler, R. Mosaddegh, S. Abbasi, S. Talaee, V. Z. Zotzmann, D. S. Staudacher, T. W. Wengenmayer, D. D. Dürschmied, C. B. Bode, A. Nelskylä, J. Nurmi, M. Jousi, A. Schramko, E. Mervaala, G. Ristagno, M. Skrifvars, G. Ozsoy, T. Kendirli, E. Azapagasi, O. Perk, U. Gadirova, E. Ozcinar, M. Cakici, C. Baran, S. Durdu, A. Uysalel, M. Dogan, M. Ramoglu, T. Ucar, E. Tutar, S. Atalay, R. Akar, M. Kamps, G. Leeuwerink, J. Hofmeijer, O. Hoiting, J. Van der Hoeven, C. Hoedemaekers, A. Konkayev, V. Kuklin, T. Kondratyev, M. Konkayeva, N. Akhatov, M. Sovershaev, T. Tveita, V. Dahl, L. Wihersaari, M. B. Skrifvars, S. Bendel, K. M. Kaukonen, J. Vaahersalo, J. Romppanen, V. Pettilä, M. Reinikainen, A. Lybeck, T. Cronberg, N. Nielsen, M. Rauber, K. Steblovnik, A. Jazbec, M. Noc, P. Kalasbail, F. Garrett, E. Kulstad, D. J. Bergström, H. R. Olsson, S. Schmidbauer, I. Mandel, S. Mikheev, Y. Podoxenov, I. Suhodolo, A. Podoxenov, J. Svirko, A. Sementsov, L. Maslov, V. Shipulin, L. V. Vammen, S. R. Rahbek, N. S. Secher, J. P. Povlsen, N. J. Jessen, B. L. Løfgren, A. G. Granfeldt, A. Grossestreuer, S. Perman, P. Patel, S. Ganley, J. Portmann, M. Cocchi, M. Donnino, Y. Nassar, S. Fathy, A. Gaber, S. Mokhtar, Y. C. Chia, R. Lewis-Cuthbertson, K. Mustafa, A. Sabra, A. Evans, P. Bennett, W. Eertmans, C. Genbrugge, W. Boer, J. Dens, C. De Deyne, F. Jans, A. Skorko, M. Thomas, M. Casadio, A. Coppo, A. Vargiolu, J. Villa, M. Rota, L. Avalli, G. Citerio, J. B. Moon, J. H. Cho, C. W. Park, T. G. Ohk, M. C. Shin, M. H. Won, P. Papamichalis, V. Zisopoulou, E. Dardiotis, S. Karagiannis, D. Papadopoulos, T. Zafeiridis, D. Babalis, A. Skoura, I. Staikos, A. Komnos, S. Silva Passos, F. Maeda, L. Silva Souza, A. Amato Filho, T. Araújo Guerra Granjeia, M. Schweller, D. Franci, M. De Carvalho Filho, T. Martins Santos, P. De Azevedo, R. Wall, I. Welters, P. Tansuwannarat, P. Sanguanwit, T. Langer, M. Carbonara, A. Caccioppola, C. Ferraris Fusarini, E. Carlesso, E. Paradiso, M. Battistini, E. Cattaneo, F. Zadek, R. Maiavacca, N. Stocchetti, A. Pesenti, A. Ramos, F. Acharta, J. Toledo, M. Perezlindo, L. Lovesio, A. Dogliotti, C. Lovesio, N. Schroten, B. Van der Veen, M. C. De Vries, J. Veenstra, Y. B. Abulhasan, S. Rachel, M. Châtillon-Angle, N. Alabdulraheem, I. Schiller, N. Dendukuri, M. Angle, C. Frenette, S. Lahiri, K. Schlick, S. A. Mayer, P. Lyden, M. Akatsuka, J. Arakawa, M. Yamakage, J. Rubio, J. A. Rubio Mateo-Sidron, R. Sierra, M. Celaya, L. Benitez, S. Alvarez-Ossorio, A. Fernandez, O. Gonzalez, H. Engquist, E. Rostami, P. Enblad, L. Canullo, J. Nallino, M. Perreault, J. Talic, A. J. Frenette, L. Burry, F. Bernard, D. R. Williamson, D. Adukauskiene, J. Cyziute, A. Adukauskaite, L. Malciene, L. Luca, A. Rogobete, O. Bedreag, M. Papurica, M. Sarandan, C. Cradigati, S. Popovici, C. Vernic, D. Sandesc, V. Avakov, I. Shakhova, H. Trimmel, M. Majdan, G. H. Herzer, C. S. Sokoloff, M. Albert, D. Williamson, C. Odier, J. Giguère, E. Charbonney, Z. Husti, T. Kaptás, Z. Fülep, Z. Gaál, M. Tusa, J. Donnelly, M. Aries, M. Czosnyka, C. Robba, M. Liu, A. Ercole, D. Menon, P. Hutchinson, P. Smielewski, R. López, J. Graf, J. M. Montes, M. Kenawi, A. Kandil, K. Husein, A. Samir, J. Heijneman, J. Huijben, F. Abid-Ali, M. Stolk, J. Van Bommel, H. Lingsma, M. Van der Jagt, R. C. Cihlar, G. Mancino, P. Bertini, F. Forfori, F. Guarracino, D. Pavelescu, I. Grintescu, L. Mirea, S. Alamri, M. Tharwat, N. Kono, H. Okamoto, H. Uchino, T. Ikegami, T. Fukuoka, M. Simoes, E. Trigo, P. Coutinho, J. Pimentel, A. Franci, D. Basagni, M. Boddi, V. Anichini, A. Cecchi, D. Markopoulou, K. Venetsanou, I. Papanikolaou, T. Barkouri, D. Chroni, I. Alamanos, E. Cingolani, M. G. Bocci, L. Pisapia, A. Tersali, S. L. Cutuli, V. Fiore, A. Palma, G. Nardi, M. Antonelli, R. Coke, A. Kwong, D. J. Dwivedi, M. Xu, E. McDonald, J. C. Marshall, A. E. Fox-Robichaud, P. C. Liaw, I. Kuchynska, I. R. Malysh, L. V. Zgrzheblovska, L. Mestdagh, E. F. Verhoeven, I. Hubloue, J. Ruel-laliberte, R. Zarychanski, F. Lauzier, P. Lessard Bonaventure, R. Green, D. Griesdale, R. Fowler, A. Kramer, D. Zygun, T. Walsh, S. Stanworth, C. Léger, A. F. Turgeon, D. M. Baron, J. Baron-Stefaniak, G. C. Leitner, R. Ullrich, O. Tarabrin, A. Mazurenko, Y. Potapchuk, D. Sazhyn, P. Tarabrin, A. González Pérez, J. Silva, V. Artemenko, A. Bugaev, I. Tokar, S. Konashevskaya, I. M. Kolesnikova, E. V. Roitman, T. Rengeiné Kiss, Z. Máthé, L. Piros, E. Dinya, E. Tihanyi, A. Smudla, J. Fazakas, R. Ubbink, P. Boekhorst te, E. Mik, L. Caneva, G. Ticozzelli, S. Pirrelli, D. Passador, F. Riccardi, F. Ferrari, E. M. Roldi, M. Di Matteo, I. Bianchi, G. A. Iotti, G. Zurauskaite, A. Voegeli, M. Meier, D. Koch, S. Haubitz, A. Kutz, M. Bargetzi, B. Mueller, P. Schuetz, G. Von Meijenfeldt, M. Van der Laan, C. Zeebregts, K. B. Christopher, P. Vernikos, T. Melissopoulou, G. Kanellopoulou, M. Panoutsopoulou, D. Xanthis, K. Kolovou, T. Kypraiou, J. Floros, H. Broady, C. Pritchett, M. Marshman, N. Jannaway, C. Ralph, C. L. Lehane, C. K. Keyl, E. Z. Zimmer, D. T. Trenk, A. S. Ducloy-Bouthors, M. J. Jonard, F. Fourrier, F. Piza, T. Correa, A. Marra, J. Guerra, R. Rodrigues, A. Vilarinho, V. Aranda, S. Shiramizo, M. R. Lima, E. Kallas, A. B. Cavalcanti, M. Donoso, P. Vargas, J. McCartney, S. Ramsay, K. McDowall, I. Novitzky-Basso, C. Wright, M Grgic Medic, L Bielen, V Radonic, O Zlopasa, N Gubarev Vrdoljak, V Gasparovic, R Radonic, G. Narváez, D. Cabestrero, L. Rey, M. Aroca, S. Gallego, J. Higuera, R. De Pablo, L. Rey González, G. Narváez Chávez, J. Higuera Lucas, D. Cabestrero Alonso, M. Aroca Ruiz, L. Jaramillo Valarezo, R. De Pablo Sánchez, A. Quinza Real, T. W. Wigmore, I. Bendavid, J. Cohen, I. Avisar, I. Serov, I. Kagan, P. Singer, J Hanison, U Mirza, D Conway, A. Takasu, H. Tanaka, N. Otani, S. Ohde, S. Ishimatsu, F Coffey, P Dissmann, K Mirza, M Lomax, P. Dissmann, F. Coffey, K. Mirza, M. Lomax, JR Miner, R Leto, AM Markota, PG Gradišek, VA Aleksejev, AS Sinkovič, S. Romagnoli, C. Chelazzi, G. Zagli, F. Benvenuti, P. Mancinelli, P. Boninsegni, L. Paparella, A. T. Bos, O. Thomas, T. Goslar, A. Martone, P. R. Sandu, V. A. Rosu, A. Capilnean, P. Murgoi, A. Lecavalier, D. Jayaraman, P. Rico, P. Bellemare, C. Gelinas, T. Nishida, T. Kinoshita, N. Iwata, K. Yamakawa, S. Fujimi, L. Maggi, F. Sposato, G. Citterio, C. Bonarrigo, M. Rocco, V. Zani, R. A. De Blasi, D Alcorn, L Barry, M. A. Riedijk, D. M. Milstein, J. Caldas, R. Panerai, L. Camara, G. Ferreira, E. Bor-Seng-Shu, M. Lima, F. Galas, N. Mian, R. Nogueira, G. Queiroz de Oliveira, J. Almeida, J. Jardim, T. G. Robinson, F. Gaioto, L. A. Hajjar, I. Zabolotskikh, T. Musaeva, W. Saasouh, J. Freeman, A. Turan, S. Saseedharan, E. Pathrose, S. Poojary, J. Messika, Y. Martin, N. Maquigneau, M. Henry-Lagarrigue, C. Puechberty, A. Stoclin, L. Martin-Lefevre, F. Blot, D. Dreyfuss, A. Dechanet, D. Hajage, J. Ricard, E. Almeida, G. Landoni, J. Fukushima, E. Fominskiy, C. De Brito, L. Cavichio, L. Almeida, U. Ribeiro, E. Osawa, R. Boltes, L. Battistella, L. Hajjar, P. Fontela, T. Lisboa, L. Forgiarini Junior, G. F. Friedman, F. Abruzzi, J. Azevedo Peixoto Primo, P. Marques Filho, J. Stormorvski de Andrade, K. Matos Brenner, M. Scorsato boeira, C. Leães, C. Rodrigues, A. Vessozi, A. SantAnna Machado, M. Weiler, H. Bryce, A. Hudson, T. Law, R. Reece-Anthony, A. Molokhia, F. Abtahinezhadmoghaddam, E. Cumber, L. Channon, A. Wong, R. Groome, D. Gearon, J. Varley, A. Wilson, J. Reading, F. G. Zampieri, F. A. Bozza, M. Ferez, H. Fernandes, A. Japiassú, J. Verdeal, A. C. Carvalho, M. Knibel, J. I. Salluh, M. Soares, J. Gao, E. Ahmadnia, B. Patel, A. MacKay, S. Binning, R. J. Pugh, C. Battle, C. Hancock, W. Harrison, T. Szakmany, F. Mulders, J. Vandenbrande, J. Dubois, B. Stessel, K. Siborgs, D. Ramaekers, U. V. Silva, W. S. Homena, G. C. Fernandes, A. P. Moraes, L. Brauer, M. F. Lima, F. De Marco, N. Maric, M. Mackovic, N. Udiljak, CE Bosso, RD Caetano, AP Cardoso, OA Souza, R Pena, MM Mescolotte, IA Souza, GM Mescolotte, H. Bangalore, E. Borrows, D. Barnes, V. Ferreira, L. Azevedo, G. Alencar, A. Andrade, A. Bierrenbach, L. Tadini Buoninsegni, L. Cecci, J. Lindskog, K. Rowland, P. Sturgess, A. Ankuli, R Rosa, T Tonietto, A Ascoli, L Madeira, W Rutzen, M Falavigna, C Robinson, J Salluh, A Cavalcanti, L Azevedo, R Cremonese, D Da Silva, A Dornelles, Y Skrobik, J Teles, T Ribeiro, C Eugênio, C Teixeira, M. Zarei, H. Hashemizadeh, M. Eriksson, G. Strandberg, M. Lipcsey, A. Larsson, M. Lignos, E. Crissanthopoulou, K. Flevari, P. Dimopoulos, A. Armaganidis, JG Golub, AS Stožer, H. Rüddel, C. Ehrlich, C. M. Burghold, C. Hohenstein, J. Winning, W. Sellami, Z. Hajjej, M. Bousselmi, H. Gharsallah, I. Labbene, M. Ferjani, J. Sattler, D. Steinbrunner, H. Poppert, G. Schneider, M. Blobner, K. G. Kanz, S. J. Schaller, K. Apap, G. Xuereb, L. Massa, N. Delvau, A Penaloza, G Liistro, F Thys, I. K. Delattre, P. Hantson, P. M. Roy, P. Gianello, L Hadîrcă, A Ghidirimschi, N Catanoi, N Scurtov, M Bagrinovschi, Y. S. Sohn, Y. C. Cho, B. Golovin, O. Creciun, A. Ghidirimschi, M. Bagrinovschi, R. Tabbara, J. Z. Whitgift, A. Ishimaru, A. Yaguchi, N. Akiduki, M. Namiki, M. Takeda, J. N. Tamminen, A. Uusaro, C. G. Taylor, E. D. Mills, A. D. Mackay, C. Ponzoni, R. Rabello, A. Serpa, M. Assunção, A. Pardini, G. Shettino, T. Corrêa, P. V. Vidal-Cortés, L. Álvarez-Rocha, P. Fernández-Ugidos, A. Virgós-Pedreira, M. A. Pérez-Veloso, I. M. Suárez-Paul, L. Del Río-Carbajo, S. Pita Fernández, A. Castro-Iglesias, A. Butt, A. A. Alghabban, S. K. Khurshid, Z. A. Ali, I. N. Nizami, N. S. Salahuddin, M. Alshahrani, A. W. Alsubaie, A. S. Alshamsy, B. A. Alkhiliwi, H. K. Alshammari, M. B. Alshammari, N. K. Telmesani, R. B. Alshammari, L. P. Asonto, L. P. Damiani, F Bozza, A. El Khattate, M. Bizrane, N. Madani, J. Belayachi, R. Abouqal, D. Ramnarain, B. Gouw-Donders, C. Benstoem, A. Moza, P. Meybohm, C. Stoppe, R. Autschbach, D. Devane, A. Goetzenich, L. U. Taniguchi, L. Araujo, G. Salgado, J. M. Vieira, J. Viana, N. Ziviani, I. Pessach, A. Lipsky, A. Nimrod, M. O´Connor, I. Matot, E. Segal, A. Kluzik, A. Gradys, P. Smuszkiewicz, I. Trojanowska, M. Cybulski, A. De Jong, M. Sebbane, G. Chanques, S. Jaber, R. Rosa, C. Robinson, M. Bessel, L. Cavalheiro, L. Madeira, W. Rutzen, R. Oliveira, J. Maccari, M. Falavigna, E. Sanchez, F. Dutra, C. Dietrich, P. Balzano, J. Rezende, C. Teixeira, S. Sinha, K. Majhi, J. G. Gorlicki, F. P. Pousset, J. Kelly, J. Aron, A. Crerar Gilbert, N. Prevec Urankar, M. Irazabal, M. Bosque, J. Manciño, A. Kotsopoulos, N. Jansen, W. Abdo, Ú. M. Casey, B. O’Brien, R. Plant, and B. Doyle

Subjects
Fatal outcome, business.industry, Traumatic brain injury, 030208 emergency & critical care medicine, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, medicine.disease, Outcome (game theory), 03 medical and health sciences, 0302 clinical medicine, Anesthesia, Medicine, business, Acute subdural hematoma
Published
2017
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5. Critical older trauma patients

Author

Santiago Yus, M Irazabal, and L. F. Fernandez

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Public health, Poster Presentation, Emergency medicine, Population, medicine, Critical Care and Intensive Care Medicine, education, business, Cause of death
Abstract

The aim of this study was characterize the older injured patient in our setting and identify risk factors that might predict mortality. Trauma is the fifth leading cause of death over the age of 65. In Spain, it has become a major public health problem as a result of the increase of this population. It represents 30% of the trauma admissions to our ICU. Geriatric patients may have comorbidities, limited physiologic reserve, may be taking chronic medication and the injury pattern is different [1].

Published
2012
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6. Acute respiratory distress syndrome - the Berlin definition: impact on an ICU of a university hospital

Author

L. F. Fernandez, J. López, A Agrifoglio, M Jiménez, M Hernández, M Irazabal, Santiago Yus, and J Figueira

Subjects
Mechanical ventilation, medicine.medical_specialty, ARDS, Respiratory distress, business.industry, medicine.medical_treatment, Apache II score, Acute respiratory distress, Critical Care and Intensive Care Medicine, University hospital, medicine.disease, Emergency medicine, Poster Presentation, medicine, Intensive care medicine, business
Abstract

The current definition of ARDS was established in 1994 by the AECC. In 2011 emerged the Berlin definition. The aim of this study was to find a new approach from the impact of ARDS in an ICU and to analyze APACHE II score, days of mechanical ventilation (MV), duration of ARDS and mortality.

Published
2013

7. Inhalation injury in critical burn patients

Author

M Irazabal, Loreto Fernández, A Agrifoglio, Lucia Cachafeiro, A. García de Lorenzo, Eva Herrero, M Sanchez, M Hernández, and M Lendinez

Subjects
Mechanical ventilation, medicine.medical_specialty, genetic structures, business.industry, medicine.medical_treatment, High mortality, Alternative medicine, Critical Care and Intensive Care Medicine, Demographic data, Inhalation injury, Epidemiology, Emergency medicine, Poster Presentation, Medicine, business
Abstract

The objective is to analyze the epidemiology and mortality of critical burn patients with inhalation injury.

Published
2013

9. [Cavernous hemangiomas of the brain: report of 2 cases]

Author

M, Irazabal and M, Henriquez

Subjects
Adult, Diagnosis, Differential, Male, Hemangioma, Cavernous, Brain Neoplasms, Humans, Female, Telangiectasis, Child, Tomography, X-Ray Computed, Cerebral Angiography, Ultrasonography
Abstract

Two cases of encephalic cavernous hemangiomas successfully surgically treated are described. Neurological clinical picture is not characteristic and it is given by the size, number and location of lesions in addition to the possibility of bleeding. Precise diagnostic done by angiography, gammagraphy and CT scan is of utmost importance to consider surgical approach. Surgery is the best means to treat the lesion although if surgery is contraindicated prognosis is poor due to episodes of hemorrhage that can accompany this pathology.

Published
1984

10. Risk factors for mortality in elderly and very elderly critically ill patients with sepsis: a prospective, observational, multicenter cohort study

Author

Institut Català de la Salut, [Martin-Loeches I] Multidisciplinary Intensive Care Research Organization (MICRO), St James's Hospital/Trinity College Dublin TCD, James's St, Ushers, Dublin, Ireland. Pulmonary Intensive Care Unit, Respiratory Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain. University of Barcelona, Barcelona, Spain. Centro de Investigación Biomédica en Red-Enfermedades Respiratorias Barcelona, Spain. [Guia MC] Critical care Center, Corporacion Sanitaria Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Sabadell, Spain. [Vallecoccia MS] Multidisciplinary Intensive Care Research Organization (MICRO), St James's Hospital/Trinity College Dublin TCD, James's St, Ushers, Dublin, Ireland. Department of Intensive Care and Anaesthesiology, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A.Gemelli, Rome, Italy. [Suarez D] Critical care Center, Corporacion Sanitaria Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Sabadell, Spain. [Ibarz M, Irazabal M] Servicio de Medicina Intensiva, Hospitales Universitarios Sagrado Corazon y General de Cataluña, Barcelona, Spain. [Ferrer R] Servei de cures intensives, Hospital Universitari Vall d'Hebron, Barcelona, Spain. Grup de recerca en Xoc, disfunció orgànica i ressuscitació, Vall d’Hebron Institut de Recerca, Barcelona, Spain., and Hospital Universitari Vall d'Hebron

Subjects
Condiciones Patológicas, Signos y Síntomas::Procesos Patológicos::Inflamación::Síndrome de Respuesta Inflamatoria Sistémica::Sepsis [ENFERMEDADES], Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores], Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings], Persons::Age Groups::Adult::Aged [NAMED GROUPS], personas::Grupos de Edad::adulto::anciano::ancianos de 80 o más años [DENOMINACIONES DE GRUPOS], Persones grans, Septicèmia - Mortalitat, Pathological Conditions, Signs and Symptoms::Pathologic Processes::Inflammation::Systemic Inflammatory Response Syndrome::Sepsis [DISEASES], Persons::Age Groups::Adult::Aged::Aged, 80 and over [NAMED GROUPS], Personas::Grupos de Edad::Adulto::Anciano [DENOMINACIONES DE GRUPOS]
Published
2021

11. Risk factors for mortality in elderly and very elderly critically ill patients with sepsis: a prospective, observational, multicenter cohort study

Author

Mercedes Ibarz, Ricard Ferrer, Maria Sole Vallecoccia, Marian Irazabal, Ignacio Martin-Loeches, David Suarez, Maria Consuelo Guia, Antonio Artigas, Institut Català de la Salut, [Martin-Loeches I] Multidisciplinary Intensive Care Research Organization (MICRO), St James's Hospital/Trinity College Dublin TCD, James's St, Ushers, Dublin, Ireland. Pulmonary Intensive Care Unit, Respiratory Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain. University of Barcelona, Barcelona, Spain. Centro de Investigación Biomédica en Red-Enfermedades Respiratorias Barcelona, Spain. [Guia MC] Critical care Center, Corporacion Sanitaria Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Sabadell, Spain. [Vallecoccia MS] Multidisciplinary Intensive Care Research Organization (MICRO), St James's Hospital/Trinity College Dublin TCD, James's St, Ushers, Dublin, Ireland. Department of Intensive Care and Anaesthesiology, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A.Gemelli, Rome, Italy. [Suarez D] Critical care Center, Corporacion Sanitaria Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Sabadell, Spain. [Ibarz M, Irazabal M] Servicio de Medicina Intensiva, Hospitales Universitarios Sagrado Corazon y General de Cataluña, Barcelona, Spain. [Ferrer R] Servei de cures intensives, Hospital Universitari Vall d'Hebron, Barcelona, Spain. Grup de recerca en Xoc, disfunció orgànica i ressuscitació, Vall d’Hebron Institut de Recerca, Barcelona, Spain., Vall d'Hebron Barcelona Hospital Campus, and Hospital Universitari Vall d'Hebron

Subjects
Personas::Grupos de Edad::Adulto::Anciano::Anciano de 80 o más Años [DENOMINACIONES DE GRUPOS], medicine.medical_specialty, Aging, health care facilities, manpower, and services, Mistake, Critical Care and Intensive Care Medicine, Persones grans, afecciones patológicas, signos y síntomas::procesos patológicos::inflamación::síndrome de respuesta inflamatoria sistémica::sepsis [ENFERMEDADES], Sepsis, 03 medical and health sciences, 0302 clinical medicine, Elderly, Anesthesiology, Septic shock, Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings], Medicine, Intensive care medicine, personas::Grupos de Edad::adulto::anciano [DENOMINACIONES DE GRUPOS], Septicèmia - Mortalitat, Condiciones Patológicas, Signos y Síntomas::Procesos Patológicos::Inflamación::Síndrome de Respuesta Inflamatoria Sistémica::Sepsis [ENFERMEDADES], Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores], business.industry, Critically ill, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, social sciences, medicine.disease, humanities, Persons::Age Groups::Adult::Aged::Aged, 80 and over [NAMED GROUPS], Critical care, 030228 respiratory system, Persons::Age Groups::Adult::Aged [NAMED GROUPS], ICU, Observational study, Bundles, personas::Grupos de Edad::adulto::anciano::ancianos de 80 o más años [DENOMINACIONES DE GRUPOS], business, Cohort study, Pathological Conditions, Signs and Symptoms::Pathologic Processes::Inflammation::Systemic Inflammatory Response Syndrome::Sepsis [DISEASES]
Abstract

Elderly; ICU; Sepsis Ancià; UCI; Sèpsia Anciano; UCI; Sepsis BACKGROUND: Age has been traditionally considered a risk factor for mortality in elderly patients admitted to intensive care units. The aim of this prospective, observational, multicenter cohort study is to determine the risk factors for mortality in elderly and very elderly critically ill patients with sepsis. RESULTS: A total of 1490 patients with ≥ 65 years of age were included in the study; most of them 1231 (82.6%) had a cardiovascular failure. The mean age (± SD) was 74.5 (± 5.6) years, and 876 (58.8%) were male. The patients were divided into two cohorts: (1) elderly: 65-79 years and (2) very elderly: ≥ 80 years. The overall hospital mortality was 48.8% (n = 727) and was significantly higher in very elderly compared to elderly patients (54.2% vs. 47.4%; p = 0.02). Factors independently associated with mortality were APACHE II score of the disease, patient location at sepsis diagnosis, development of acute kidney injury, and thrombocytopenia in the group of elderly patients. On the other hand, in the group of very elderly patients, predictors of hospital mortality were age, APACHE II score, and prompt adherence of the resuscitation bundle. CONCLUSION: This prospective multicenter study found that patients aged 80 or over had higher hospital mortality compared to patients between 65 and 79 years. Age was found to be an independent risk factor only in the very elderly group, and prompt therapy provided within the first 6 h of resuscitation was associated with a reduction in hospital mortality in the very elderly patients.

Published
2019

12. I-DTI, a Second-Opinion Platform Related to Organ Donation and Transplant Between Health Care Professionals.

Author

Arredondo E, Irazabal M, López C, Colomer J, Ballesté C, and Manyalich M

Subjects
Health Personnel, Humans, Pandemics, Treatment Outcome, COVID-19, Organ Transplantation, Tissue and Organ Procurement
Abstract

Objectives: The COVID-19 pandemic led to a decline in donation and transplant programs worldwide. Telehealth was explored as a strategy to continue organ procurement activity. The aim of this project was to develop and test I-DTI, an online medical platform for health care professionals specialized in the field of organ donation and transplant, that provides second-opinion consultancy and instant-messaging services., Materials and Methods: The Donation and Transplantation Institute (DTI Foundation), in collaboration with the developers of an operative communication engine (Medxat/Be-Hit), designed the I-DTI platform, via a web-based application. I-DTI contents were created by the DTI Foundation medical team and international experts in organ donation and transplantation. I-DTI was launched in 2020 in a 6-month pilot phase, in which hospitals from India (Kerala), Philippines, Trinidad and Tobago, and Sri Lanka were included. In the pilot phase, about 60 health care professionals were involved and >20 international experts were enrolled to respond to incoming inquiries. The following topics were considered for this review: organ donation, organ transplantation, transplant follow-up, tissue donation, and COVID-19. Data collected were entered anonymously into an encrypted database for academic purposes. A survey was then conducted for all users to improve its acceptance and feasibility., Results: On average, the second-opinion service was consulted 2 times per week by the participants, and experts' opinions were delivered in <24 hours. An intuitive user interface led participants to use the messaging service daily. Active dissemination contributed to I-DTI growth, achieving 300 users from >20 countries within the first year., Conclusions: I-DTI has proved to be a feasible tool to support health care professionals, for knowledge exchange and communication, ensuring access to international best practices. Nevertheless, it is imperative that medical providers actively encourage the use of innovative solutions available, especially in the areas with restricted access to knowledge.

Published
2022
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14. [ISAR Score (Identification of Seniors At Risk) predicts mortality in patients older than 75 years admitted in Intensive Care].

Author

Lopez Cuenca S, Oteiza L, Lazaro Martín N, Ibarz M, Irazabal M, Artigas A, and Lorente JA

Subjects
Aged, Critical Care, Humans, Prospective Studies, Geriatric Assessment, Hospital Mortality, Hospitalization, Mortality, Patient Discharge
Abstract

Background and Objectives: Currently, the patient's baseline situation is a more important prognostic factor than age. The purpose of this study is to estimate the prognostic value of the ISAR score (Identification of Senior at Risk) in patients ≥75 years admitted to intensive care (ICU)., Patients and Methods: Prospective multicenter study including patients ≥75 years admitted to the ICU > 24hours. On admission, 28 days and 6 months after discharge from the ICU, mortality and baseline were evaluated using the ISAR score, the Lawton and Brody scale (LB) and the Barthel index (BI), the Frail fragility scale. scale (FS), the Charlson comorbidity index (ICC), Dementia rating score (DRC)., Results: 38 of 94 patients (40%) were high risk (ISAR ≥ 3) and were characterized by BI 90 (65-100), LB 4 (3-5), and CDR 1 (0-2), ICC 7.5 (6-10). 58% had FS ≥ 3. In the long term, they were in a situation of dependency [BI 50 (2.5-77.5), LB 3 (0-4), CDR 1 (0-1.5)]. The ICU mortality at 28 days and 6 months was 18.4%, 25.7% and 35.3%, respectively, being statistically significant. The area under the ISAR score ROC curve was 0.749 to 0.797, in all the mortality periods studied, although the difference with other predictive variables was not significant, but the p value was the lowest., Conclusions: The ISAR score predicts mortality in critically elderly patients with a discriminative capacity comparable to other predictive variables., (Copyright © 2020 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2021
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15. Sepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort study.

Author

Ibarz M, Boumendil A, Haas LEM, Irazabal M, Flaatten H, de Lange DW, Morandi A, Andersen FH, Bertolini G, Cecconi M, Christensen S, Faraldi L, Fjølner J, Jung C, Marsh B, Moreno R, Oeyen S, Öhman CA, Bollen Pinto B, Soliman IW, Szczeklik W, Valentin A, Watson X, Zaferidis T, Guidet B, and Artigas A

Abstract

Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival., Results: This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81-86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7, p < 0.0001), required more vasoactive drugs [82.2% vs. 55.1%, p < 0.0001] and renal replacement therapies [17.4% vs. 9.9%; p < 0.0001], and had more life-sustaining treatment limitations [37.3% vs. 32.1%; p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86-1.15), p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87-1.17), p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day survival was similar in both groups [57.2% (95% CI 52.7-60.7) vs. 57.1% (95% CI 53.7-60.1), p = 0.85]., Conclusions: After adjusting for organ dysfunction, sepsis at admission was not independently associated with decreased 30-day survival in this multinational study of 3869 VIPs. Age, frailty, and SOFA score were independently associated with survival.

Published
2020
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19. Risk factors for mortality in elderly and very elderly critically ill patients with sepsis: a prospective, observational, multicenter cohort study.

Author

Martin-Loeches I, Guia MC, Vallecoccia MS, Suarez D, Ibarz M, Irazabal M, Ferrer R, and Artigas A

Abstract

Background: Age has been traditionally considered a risk factor for mortality in elderly patients admitted to intensive care units. The aim of this prospective, observational, multicenter cohort study is to determine the risk factors for mortality in elderly and very elderly critically ill patients with sepsis., Results: A total of 1490 patients with ≥ 65 years of age were included in the study; most of them 1231 (82.6%) had a cardiovascular failure. The mean age (± SD) was 74.5 (± 5.6) years, and 876 (58.8%) were male. The patients were divided into two cohorts: (1) elderly: 65-79 years and (2) very elderly: ≥ 80 years. The overall hospital mortality was 48.8% (n = 727) and was significantly higher in very elderly compared to elderly patients (54.2% vs. 47.4%; p = 0.02). Factors independently associated with mortality were APACHE II score of the disease, patient location at sepsis diagnosis, development of acute kidney injury, and thrombocytopenia in the group of elderly patients. On the other hand, in the group of very elderly patients, predictors of hospital mortality were age, APACHE II score, and prompt adherence of the resuscitation bundle., Conclusion: This prospective multicenter study found that patients aged 80 or over had higher hospital mortality compared to patients between 65 and 79 years. Age was found to be an independent risk factor only in the very elderly group, and prompt therapy provided within the first 6 h of resuscitation was associated with a reduction in hospital mortality in the very elderly patients.

Published
2019
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20. Endocan as an early biomarker of severity in patients with acute respiratory distress syndrome.

Author

Orbegozo D, Rahmania L, Irazabal M, Mendoza M, Annoni F, De Backer D, Creteur J, and Vincent JL

Abstract

Background: Plasma concentrations of endocan, a proteoglycan preferentially expressed in the pulmonary vasculature, may represent a biomarker of lung (dys)function. We sought to determine whether the measurement of plasma endocan levels early in the course of acute respiratory distress syndrome (ARDS) could help predict risk of death or of prolonged ventilation., Methods: All patients present in the department of intensive care during a 150-day period were screened for ARDS (using the Berlin definition). Endocan concentrations were measured at the moment of ARDS diagnosis (T0) and the following morning (T1). We compared data from survivors and non-survivors and data from survivors with less than 10 days of ventilator support (good evolution) and those who died or needed more than 10 days of mechanical ventilation (poor evolution). Results are presented as numbers (percentages), mean ± standard deviation or medians (percentile 25-75)., Results: Ninety-six consecutive patients were included [median APACHE II score of 21 (17-27) and SOFA score of 9 (6-12), PaO 2 /FiO 2 ratio 155 (113-206)]; 64 (67%) had sepsis and 51 (53%) were receiving norepinephrine. Non-survivors were older (66 ± 15 vs. 59 ± 18 years, p = 0.045) and had higher APACHE II scores [27 (22-30) vs. 20 (15-24), p < 0.001] and blood lactate concentrations at study inclusion [2.1 (1.3-4.0) vs. 1.5 (0.9-2.6) mmol/L, p = 0.024] than survivors, but PaO 2 /FiO 2 ratios [150 (116-207) vs. 158 (110-206), p = 0.95] were similar in the two groups. Endocan concentrations on the day after ARDS diagnosis were significantly higher in patients with poor evolution than in those with good evolution [12.0 (6.8-18.6) vs. 7.2 (5.4-12.5), p < 0.01]., Conclusion: Blood endocan concentrations early in the evolution of ARDS may be a useful marker of disease severity.

Published
2017
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21. Microvascular reactivity is altered early in patients with acute respiratory distress syndrome.

Author

Orbegozo Cortés D, Rahmania L, Irazabal M, Santacruz C, Fontana V, De Backer D, Creteur J, and Vincent JL

Subjects
Adult, Aged, Case-Control Studies, Female, Humans, Male, Middle Aged, Prognosis, Respiration, Artificial, Respiratory Distress Syndrome diagnosis, Respiratory Distress Syndrome mortality, Respiratory Distress Syndrome therapy, Severity of Illness Index, Spectroscopy, Near-Infrared, Time Factors, Microcirculation, Microvessels physiopathology, Respiratory Distress Syndrome physiopathology, Upper Extremity blood supply
Abstract

Background: Acute respiratory distress syndrome (ARDS) is associated with vascular endothelial dysfunction. The resultant microvascular reactivity can be assessed non-invasively using near-infrared spectroscopy (NIRS) and a vascular occlusion test (VOT) and changes have been correlated with severity of organ dysfunction and mortality in other critically ill populations. We used NIRS to study the presence of microcirculatory alterations in patients with ARDS., Methods: We studied 27 healthy volunteers and 32 ARDS patients admitted to our intensive care department. NIRS measurements were performed within 24 h after diagnosis (Berlin definition). VOTs were performed by inflating an arm-cuff to a pressure greater than the systolic pressure for 3 min, followed by rapid deflation. The descending (Desc) and ascending (Asc) thenar muscle oxygen saturation (StO2) slopes were calculated. We compared data from volunteers with those from ARDS patients, from ARDS survivors and non-survivors, and from ARDS survivors who required <7 days ventilatory support (good evolution) with those who required >7 days support or died (poor evolution)., Results: ARDS patients had lower StO2 values [75(67-80) vs 79(76-81) %, p = 0.04] and Asc slopes [185(115-233) vs 258(216-306) %/min, p < 0.01] than healthy volunteers, but Desc slopes were similar. The Asc slope was lower in the patients with a poor evolution than in the other patients [121(90-209) vs 222(170-293) %/min, p < 0.01], and in the non-survivors than in the survivors [95(73-120) vs 212(165-252) %/min, p < 0.01]., Conclusions: In ARDS patients, microvascular reactivity is altered early, and the changes are directly related to the severity of the disease. The ascending slope is the best determinant of outcome.

Published
2016
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22. [Cavernous hemangiomas of the brain: report of 2 cases].

Author

Irazabal M and Henriquez M

Subjects
Adult, Brain Neoplasms pathology, Brain Neoplasms surgery, Cerebral Angiography, Child, Diagnosis, Differential, Female, Hemangioma, Cavernous pathology, Hemangioma, Cavernous surgery, Humans, Male, Telangiectasis diagnosis, Tomography, X-Ray Computed, Ultrasonography, Brain Neoplasms diagnosis, Hemangioma, Cavernous diagnosis
Abstract

Two cases of encephalic cavernous hemangiomas successfully surgically treated are described. Neurological clinical picture is not characteristic and it is given by the size, number and location of lesions in addition to the possibility of bleeding. Precise diagnostic done by angiography, gammagraphy and CT scan is of utmost importance to consider surgical approach. Surgery is the best means to treat the lesion although if surgery is contraindicated prognosis is poor due to episodes of hemorrhage that can accompany this pathology.

Published
1984

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