You searched for:"Manuel Colmenero"
We found (4) results for your search.Abstract
Rev Bras Ter Intensiva. 2019;31(2):156-163
DOI 10.5935/0103-507X.20190026
To assess the efficacy and safety of high-flow nasal cannula oxygen therapy in treating moderate hypercapnic respiratory failure in patients who cannot tolerate or have contraindications to noninvasive mechanical ventilation.
A prospective observational 13-month study involving subjects admitted to an intensive care unit with or developing moderate hypercapnic respiratory failure. Clinical and gas exchange parameters were recorded at regular intervals during the first 24 hours. The endpoints were a oxygen saturation between 88 and 92% along with a reduction in breathing effort (respiratory rate) and pH normalization (≥ 7.35). Subjects were considered nonresponders if they required ventilatory support.
Thirty subjects were treated with high-flow nasal cannula oxygen therapy. They consisted of a mixed population with chronic obstructive pulmonary disease exacerbation, acute cardiogenic pulmonary edema, and postoperative and postextubation respiratory failure. A nonsignificant improvement was observed in respiratory rate (28.0 ± 0.9 versus 24.3 ± 1.5, p = 0.22), which was apparent in the first four hours of treatment. The pH improved, although normal levels were only reached after 24 hours on high-flow nasal cannula therapy (7.28 ± 0.02 versus 7.37 ± 0.01, p = 0.02). The rate of nonresponders was 13.3% (4 subjects), of whom one needed and accepted noninvasive mechanical ventilation and three required intubation. Intensive care unit mortality was 3.3% (1 subject), and a patient died after discharge to the ward (hospital mortality of 6.6%).
High-flow nasal cannula oxygen therapy is effective for moderate hypercapnic respiratory failure as it helps normalize clinical and gas exchange levels with an acceptable rate of nonresponders who require ventilatory support.
Abstract
Rev Bras Ter Intensiva. 2022;34(3):380-385
DOI 10.5935/0103-507X.20220224-en
To determine the incidence of postintensive care syndrome in a cohort of critically ill patients admitted to the intensive care unit and to identify risk factors related to its development in the physical, cognitive and mental health areas.
This was a prospective observational cohort study developed in the intensive care unit of a university hospital. Patients with intensive care unit stays equal to or longer than one week and the need for mechanical ventilation for more than 3 days, shock or delirium were included in the study. Demographic variables, reasons for admission, diagnoses, sedation, type of mechanical ventilation used, complications and length of stay were recorded. A univariate analysis was performed to identify risk factors related to postintensive care syndrome. The scales used for the assessment of the different spheres were Barthel, Pfeiffer, Hospital Anxiety and Depression Scale and Impact of Event Scale-6. The main variables of interest were postintensive care syndrome incidence overall and by domains. Risk factors were examined in each of the health domains (physical, cognitive and mental health).
Eighty-seven patients were included. The mean Acute Physiology and Chronic Health Evaluation II score was 16.5. The mean number of intensive care unit days was 17. The incidence of global postintensive care syndrome was 56.3% (n = 49, 95%CI 45.8 - 66.2%). The incidence of postintensive care syndrome in each of the spheres was 32.1% (physical), 11.5% (cognitive), and 36.6% (mental health).
The incidence of postintensive care syndrome is 56.3%. The mental health sphere is the most frequently involved. The risk factors are different depending on the area considered.
Abstract
Crit Care Sci. 2023;35(4):423-426
DOI 10.5935/2965-2774.20230161-pt