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1. Sumario de recomendaciones y puntos clave del Consenso de las Sociedades Científicas Españolas (SEPAR, SEMICYUC, SEMES; SECIP, SENeo, SEDAR, SENP) para la utilización de la ventilación no invasiva y terapia de alto flujo con cánulas nasales en el paciente adulto, pediátrico y neonatal con insuficiencia respiratoria aguda grave

Author

José Manuel Carratalá Perales, Mirella Gaboli, Carlos Ferrando Ortola, Gemma Rialp Cervera, Juan Fernando Masa Jiménez, Manel Luján, Iñaki Gutiérrez Ibarluzea, Gonzalo Hernández, Javier García Fernández, César Cinesi Gómez, Julio Parrilla Parrilla, Mónica González, Miquel Ferrer Monreal, Julio Moreno Hernando, María Angeles Sánchez Quiroga, Oscar Peñuelas, Ana Sánchez Torres, Carlos Egea Santaolalla, Ana Concheiro Guisán, Arantxa Mas, Antonio Romero Berrocal, Rafael Uña, Alberto García-Salido, Sarah Heili-Frades, Joaquín Escámez, and Eva Farrero Muñoz

Subjects
Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, business.industry, Medicine, business, Humanities
Abstract

Resumen El soporte respiratorio no invasivo (SRNI) comprende 2 modalidades de tratamiento, la ventilacion mecanica no invasiva (VMNI) y la terapia de alto flujo con canulas nasales (TAFCN) que se aplican en pacientes adultos, pediatricos y neonatales con insuficiencia respiratoria aguda (IRA). Sin embargo, el grado de acuerdo entre las distintas especialidades sobre el beneficio de estas tecnicas en diferentes escenarios clinicos es controvertido. El objetivo del presente consenso fue elaborar una serie de recomendaciones de buena practica clinica para la aplicacion de soporte no invasivo en pacientes con IRA, avaladas por todas las sociedades cientificas involucradas en el manejo del paciente adulto y pediatrico/neonatal con IRA. Para ello se contacto con las diferentes sociedades implicadas, quienes designaron a su vez a un grupo de 26 profesionales con suficiente experiencia en su aplicacion. Se realizaron 3 reuniones presenciales para consensuar las recomendaciones (hasta un total de 71) fundamentadas en la revision de la literatura y en la actualizacion de la evidencia disponible en relacion con 3 categorias: indicaciones, monitorizacion y seguimiento del SRNI. Finalmente, se procedio a votacion telematica de cada una de las recomendaciones, por parte de los expertos de cada sociedad cientifica implicada. Para la clasificacion del grado de acuerdo se opto por un sistema analogico de clasificacion facil e intuitivo de usar, y que expresara con claridad si el procedimiento relacionado con el SRNI debia hacerse, podia hacerse o no debia hacerse.

Published
2021
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2. Summary of Recommendations and Key Points of the Consensus of Spanish Scientific Societies (SEPAR, SEMICYUC, SEMES; SECIP, SENEO, SEDAR, SENP) on the Use of Non-Invasive Ventilation and High-Flow Oxygen Therapy with Nasal Cannulas in Adult, Pediatric, and Neonatal Patients with Severe Acute Respiratory Failure

Author

Iñaki Gutiérrez Ibarluzea, Ana Sánchez Torres, María Angeles Sánchez Quiroga, Arantxa Mas, Rafael Uña, Miquel Ferrer Monreal, Óscar Peñuelas, Joaquín Escámez, Manel Luján, José Manuel Carratalá Perales, Sarah Heili-Frades, César Cinesi Gómez, Eva Farrero Muñoz, Carlos Ferrando Ortola, Antonio Romero Berrocal, Ana Concheiro Guisán, Mónica González, Mirella Gaboli, Gonzalo Hernández, Julio Parrilla Parrilla, Carlos Egea Santaolalla, Julio Moreno Hernando, Juan Fernando Masa Jiménez, Javier García Fernández, Gemma Rialp Cervera, and Alberto García-Salido

Subjects
medicine.medical_specialty, Consensus, medicine.medical_treatment, Ventilación no invasiva, Recommendations, medicine.disease_cause, Acute respiratory failure, Insuficiencia respiratoria aguda, medicine, In patient, Intensive care medicine, Scientific society, Mechanical ventilation, business.industry, High flow oxygen, General Medicine, Respiratory support, Consenso, High-flow therapy with nasal cannulas, Good clinical practice, Recomendaciones, Non-invasive ventilation, Terapia de alto flujo con cánulas nasales, business, Nasal cannula
Abstract

Non-invasive respiratory support (NIRS) in adult, pediatric, and neonatal patients with acute respiratory failure (ARF) comprises two treatment modalities, non-invasive mechanical ventilation (NIMV) and high-flow nasal cannula (HFNC) therapy. However, experts from different specialties disagree on the benefit of these techniques in different clinical settings. The objective of this consensus was to develop a series of good clinical practice recommendations for the application of non-invasive support in patients with ARF, endorsed by all scientific societies involved in the management of adult and pediatric/neonatal patients with ARF. To this end, the different societies involved were contacted, and they in turn appointed a group of 26 professionals with sufficient experience in the use of these techniques. Three face-to-face meetings were held to agree on recommendations (up to a total of 71) based on a literature review and the latest evidence associated with 3 categories: indications, monitoring and follow-up of NIRS. Finally, the experts from each scientific society involved voted telematically on each of the recommendations. To classify the degree of agreement, an analogue classification system was chosen that was easy and intuitive to use and that clearly stated whether the each NIRS intervention should be applied, could be applied, or should not be applied. (C) 2020 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.

Published
2021

4. Severe community-acquired pneumonia: Characteristics and prognostic factors in ventilated and non-ventilated patients

Author

Adamantia Liapikou, Chiara Travierso, Antoni Torres, Catia Cilloniz, Albert Gabarrus, Francesco Blasi, Miquel Ferrer Monreal, and Eva Polverino

Subjects
Mechanical ventilation, medicine.medical_specialty, education.field_of_study, business.industry, Septic shock, medicine.medical_treatment, Population, medicine.disease, Confidence interval, Clinical trial, Pneumonia, Community-acquired pneumonia, Internal medicine, Breathing, medicine, education, business
Abstract

Background : Severe community-acquired pneumonia (SCAP) is associated with significant morbidity and mortality. Patients with SCAP and life-threatening acute respiratory failure may require invasive mechanical ventilation (IMV); however, there is limited information on these patients. Methods : We prospectively studied consecutive patients with SCAP. We assessed the characteristics and outcomes of patients on IMV, compared with those who needed non-invasive ventilation (NIV) and no ventilatory support, and determined predictors for mortality and evolution of mortality over time in this population. Results : Among 3,719 patients diagnosed of CAP during 12 years, 664 (18%) had criteria for SCAP; 154 (23%) were allocated to the IMV group, 94 (14%) to the NIV group, and 416 (63%) did not require any ventilatory support; 198 (30%) presented septic shock. In 370 (56%) cases the diagnosis of SCAP was based solely on the presence of 3 or more IDSA/ATS minor criteria. Streptococcus pneumoniae was the main pathogen in all groups. The 30-day mortality was higher in the IMV, compared to the NIV and non-ventilated groups (51, 33%, vs. 17, 18% and 77, 19%, respectively, p=0·001). IMV, but neither NIV nor shock, independently predicted 30-day mortality in multivariate analysis (adjusted odds-ratio 2.18, 95% confidence interval 1·12-4·24, p=0·022). The 30-day mortality did not significantly change over time during the study period. Conclusion: The need for IMV independently predicted 30-day mortality in patients with SCAP. Patients needing IMV should be a target population for future clinical trials on new interventions addressed to improve mortality of SCAP.

Published
2016
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7. Colaboradores

Author

Ramón Agüero Balbín, Alvar Agustí García-Navarro, Carlos Agustí García-Navarro, José Joaquín Alfaro Abreu, Carlos Almonacid Sánchez, Carlos José Álvarez Martínez, José Luis Álvarez-Sala Walther, Rodolfo Álvarez-Sala Walther, Julio Ancochea Bermúdez, Antonio Antón Albisu, María Belén Arnalich Jiménez, Aurelio Arnedillo Muñoz, Francisco Javier Aspa Marco, Manuel Avellanas Chavala, Adolfo Baloira Villar, Joan Albert Barberà Mir, Emilia Barrot Cortés, José Belda Ramírez, José Belda Sanchis, Salvador Bello Dronda, Isabel Blanco Vich, José Blanquer Olivas, Luis Borderías Clau, Cristina Cabrera Lacalzada, Pedro Cabrera Navarro, Joaquín Calatayud Gastardi, Myriam Calle Rubio, José Antonio Caminero Luna, José Luis Campo-Cañaveral de la Cruz, Esteban Cano Jiménez, Alberto Capelastegui Saiz, José Luis Carreras Delgado, Teresa Carrillo Díaz, Pere Casan Clarà, Ciro Casanova Macario, Enrique Cases Viedma, Ana Córdoba Izquierdo, Jaime Corral Peñafiel, Andrés Cosano Povedano, María Jesús Cruz Carmona, Alfredo de Diego Damiá, Javier de Gracia Roldán, José Ignacio de Granda Orive, Pilar de Lucas Ramos, Javier de Miguel Díez, Eduardo de Miguel Poch, Juan Pablo de Torres Tajes, Salvador Díaz Lobato, Carlos Disdier Vicente, José Antonio Domingo Morera, Jordi Dorca Sargatal, José Luis Duque Medina, Joaquín Durán Cantolla, José María Echave-Sustaeta María-Tomé, Mikel Egurrola Izquierdo, Teresa Elías Hernández, Raúl Embún Flor, Isabel Fernández Navarro, Jaime Fernández-Bujarrabal Villoslada, Miquel Ferrer Monreal, José Ferreres Franco, Tomás Franquet Casas, Jorge Freixinet Gilart, Marta Fuentes Alonso, Juan Bautista Gáldiz Iturri, Miguel Gallego Díaz, Antonio Pablo Gámez García, Borja García-Cosío Piqueras, José María García García, Ricardo García Luján, Ignasi Garcia Olivé, Francisco García Río, Mariano García-Yuste Martín, Javier Gaudó Navarro, Rosa María Girón Moreno, Rosa Gómez García, Ana María Gómez Martínez, María Jesús Gómez Nebreda, Nicolás González Mangado, Amaia Gorostiza Manterola, Begoña Gregorio Crespo, María Rosa Güell i Rous, José Antonio Gutiérrez Lara, Luis Hernández Blasco, Michele Hernández Cabrera, Jesús Hernández Hernández, Rosana Hernando Salvador, Gemma Iruin Irulegui, José Ramón Jarabo Sarceda, Luis Lapeña Gutiérrez, Montserrat León Fábregas, José Antonio López García-Asenjo, Raquel López Reyes, Antolín López Viña, Hugo Loureiro Koechlin, Eduardo Márquez Martín, Francisca Lourdes Márquez Pérez, María del Rocío Martín López, Concepción Martín Serrano, Miguel Ángel Martínez García, Cristina Martínez González, Graciella Martínez Pallí, Juan Fernando Masa Jiménez, José María Matilla González, Mercè Mayos Pérez, Rosario Menéndez Villanueva, José Carlos Meneses Pardo, Mercedes Merino Sánchez, Marc Miravitlles Fernández, Luis Molinos Martín, José María Montserrat Canal, Ferran Morell Brotad, José Antonio Mosquera Pestaña, Joaquim Mullol i Miret, Xavier Muñoz Gall, Dolores Nauffal Manzur, Isabel Nerín de la Puerta, María Asunción Nieto Barbero, Remedios Otero Candelera, Isabel Otero González, Juan José Palacios Gutiérrez, Germán Peces-Barba Romero, José Luis Pérez Arellano, Esteban Pérez Rodríguez, Miguel Perpiñá Tordera, José María Pino García, Vicente Plaza Moral, José Manuel Porcel Pérez, Luis Puente Maestu, María Carme Puy Rión, Carmen Puzo Ardanuy, Olga Rajas Naranjo, Ramón Rami Porta, Juan José Ríos Blanco, Juan José Rivas de Andrés, Eulogio Rodríguez Becerra, Felipe Rodríguez de Castro, José Miguel Rodríguez González-Moro, Juan Luis Rodríguez Hermosa, Francisco Rodríguez Panadero, José Antonio Rodríguez Portal, Robert Rodríguez Roisin, Pedro Rodríguez Suárez, Gema Rodríguez Trigo, Jordi Roig Cutillas, Santiago Romero Candeira, Juan Ruiz Manzano, José Miguel Sahuquillo Arce, Antonio Salcedo Posadas, Neus Salord Oleo, Julio Sánchez de Cos Escuín, Juan José Soler Cataluña, Antonio Sueiro Bendito, Julia Tárrega Camarasa, Alfons Torrego Fernández, Antonio José Torres García, Antoni Torres Martí, Fernando Uresandi Romero, María Piedad Ussetti Gil, Antonio Valero Santiago, Andrés Varela de Ugarte, Montserrat Vendrell Relat, Héctor Verea Hernando, Rafael Vidal Pla, José Luis Viejo Bañuelos, Santiago José Villanueva Serrano, Felipe Villar Álvarez, Carlos Villasante Fernández-Montes, Victoria Villena Garrido, Antoni Xaubet Mir, and Rafael Zalacaín Jorge

Published
2010
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