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Avila-Hilari A, Tinoco-Solórzano A, Vélez-Páez J, Molano Franco D, Montelongo FDJ, Avellanas-Chavala ML. Acute respiratory distress syndrome at high altitude: Considerations for diagnosis and treatment. Med Intensiva 2024:S2173-5727(24)00197-8. [PMID: 39048472 DOI: 10.1016/j.medine.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 07/27/2024]
Affiliation(s)
- Adrián Avila-Hilari
- Unidad de Terapia Intensiva, Hospital Municipal Boliviano Holandés, El Alto, Bolivia; Comité de Expertos de Medicina Crítica en la Altitud, Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva (FEPIMCTI), Panama City, Panama
| | - Amilcar Tinoco-Solórzano
- Centro de Investigación de Medicina en la Altura, Facultad de Medicina Humana, Universidad de San Martín de Porres, Huanyaco, Peru; Comité de Expertos de Medicina Crítica en la Altitud, Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva (FEPIMCTI), Panama City, Panama
| | - Jorge Vélez-Páez
- Unidad de Terapia Intensiva, Hospital Pablo Arturo Suárez, Quito, Ecuador; Comité de Expertos de Medicina Crítica en la Altitud, Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva (FEPIMCTI), Panama City, Panama
| | - Daniel Molano Franco
- Unidad de Cuidados Intensivos, Hospital San José, Bogotá, Colombia; Comité de Expertos de Medicina Crítica en la Altitud, Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva (FEPIMCTI), Panama City, Panama
| | - Felipe de Jesús Montelongo
- Áreas Críticas, Hospital General Las Americas, Instituto de Salud del Estado de México, Ecatepec de Morelos, Mexico; Comité de Expertos de Medicina Crítica en la Altitud, Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva (FEPIMCTI), Panama City, Panama
| | - Manuel Luis Avellanas-Chavala
- Médico Especialista en Medicina Intensiva, Huesca, Spain; Comité de Expertos de Medicina Crítica en la Altitud, Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva (FEPIMCTI), Panama City, Panama.
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Tu D, Ji L, Cao Q, Ley T, Duo S, Cheng N, Lin W, Zhang J, Yu W, Pan Z, Wang X. Incidence, mortality, and predictive factors associated with acute respiratory distress syndrome in multiple trauma patients living in high-altitude areas: a retrospective study in Shigatse. PeerJ 2024; 12:e17521. [PMID: 38903881 PMCID: PMC11188934 DOI: 10.7717/peerj.17521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/15/2024] [Indexed: 06/22/2024] Open
Abstract
Background Acute respiratory distress syndrome (ARDS) is a severe complication that can lead to fatalities in multiple trauma patients. Nevertheless, the incidence rate and early prediction of ARDS among multiple trauma patients residing in high-altitude areas remain unknown. Methods This study included a total of 168 multiple trauma patients who received treatment at Shigatse People's Hospital Intensive Care Unit (ICU) between January 1, 2019 and December 31, 2021. The clinical characteristics of the patients and the incidence rate of ARDS were assessed. Univariable and multivariable logistic regression models were employed to identify potential risk factors for ARDS, and the predictive effects of these risk factors were analyzed. Results In the high-altitude area, the incidence of ARDS among multiple trauma patients was 37.5% (63/168), with a hospital mortality rate of 16.1% (27/168). Injury Severity Score (ISS) and thoracic injuries were identified as significant predictors for ARDS using the logistic regression model, with an area under the curve (AUC) of 0.75 and 0.75, respectively. Furthermore, a novel predictive risk score combining ISS and thoracic injuries demonstrated improved predictive ability, achieving an AUC of 0.82. Conclusions This study presents the incidence of ARDS in multiple trauma patients residing in the Tibetan region, and identifies two critical predictive factors along with a risk score for early prediction of ARDS. These findings have the potential to enhance clinicians' ability to accurately assess the risk of ARDS and proactively prevent its onset.
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Affiliation(s)
- Dan Tu
- Department of Intensive Care Unit, Shigatse People’s Hospital, Shigatse, Xizang, China
| | - Lv Ji
- Department of Intensive Care Unit, Shigatse People’s Hospital, Shigatse, Xizang, China
| | - Qiang Cao
- Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, Shanghai, China
| | - Tin Ley
- Department of Anesthesiology, Shigatse People’s Hospital, Shigatse, Xizang, China
| | - Suolangpian Duo
- Department of Emergency, Shigatse People’s Hospital, Shigatse, Xizang, China
| | - Ningbo Cheng
- Department of Anesthesiology, Shigatse People’s Hospital, Shigatse, Xizang, China
| | - Wenjing Lin
- Department of Anesthesiology, Shigatse People’s Hospital, Shigatse, Xizang, China
| | - Jianlei Zhang
- Department of Anesthesiology, Shigatse People’s Hospital, Shigatse, Xizang, China
| | - Weifeng Yu
- Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, Shanghai, China
- Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China
| | - Zhiying Pan
- Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, Shanghai, China
- Department of Anesthesiology, Shigatse People’s Hospital, Shigatse, Xizang, China
| | - Xiaoqiang Wang
- Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, Shanghai, China
- Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China
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Belenguer-Muncharaz A, Bernal-Julián F, Hernández-Garcés H, Hermosilla-Semikina I, Tormo-Rodriguez L, Viana-Marco C. Correlation and concordance of SaO 2/FiO 2 and paO 2/FiO 2 ratios in patients with COVID-19 pneumonia who received non-invasive ventilation in two intensive care units⋆. Med Intensiva 2024; 48:298-300. [PMID: 38503678 DOI: 10.1016/j.medine.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
| | | | | | | | - Lluís Tormo-Rodriguez
- Servicio de Medicina Intensiva, Hospital General Universitari Castelló, Castellón, Spain
| | - Clara Viana-Marco
- Servicio de Medicina Intensiva, Hospital General Universitari Castelló, Castellón, Spain
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Martín-Rodríguez F, López-Izquierdo R, Sanz-García A, Ortega GJ, Del Pozo Vegas C, Delgado-Benito JF, Castro Villamor MA, Soriano JB. Prehospital Respiratory Early Warning Score for airway management in-ambulance: A score comparison. Eur J Clin Invest 2023; 53:e13875. [PMID: 36121346 DOI: 10.1111/eci.13875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/30/2022] [Accepted: 09/15/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Prehospital Respiratory Early Warning Scores to estimate the requirement for advanced respiratory support is needed. To develop a prehospital Respiratory Early Warning Score to estimate the requirement for advanced respiratory support. METHODS Multicentre, prospective, emergency medical services (EMS)-delivered, longitudinal cohort derivationvalidation study carried out in 59 ambulances and five hospitals across five Spanish provinces. Adults with acute diseases evaluated, supported and discharged to the Emergency Department with high priority were eligible. The primary outcome was the need for invasive or non-invasive respiratory support (NIRS or IRS) in the prehospital scope at the first contact with the patient. The measures included the following: epidemiological endpoints, prehospital vital signs (respiratory rate, pulse oximetry saturation, fraction of inspired oxygen, systolic and diastolic mean blood pressure, heart rate, tympanic temperature and consciousness level by the GCS). RESULTS Between 26 Oct 2018 and 26 Oct 2021, we enrolled 5793 cases. For NIRS prediction, the final model of the logistic regression included respiratory rate and pulse oximetry saturation/fraction of inspired oxygen ratio. For the IRS case, the motor response from the Glasgow Coma Scale was also included. The REWS showed an AUC of 0.938 (95% CI: 0.918-0.958), a calibration-in-large of 0.026 and a higher net benefit as compared with the other scores. CONCLUSIONS Our results showed that REWS is a remarkably aid for the decision-making process in the management of advanced respiratory support in prehospital care. Including this score in the prehospital scenario could improve patients' care and optimise the resources' management.
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Affiliation(s)
- Francisco Martín-Rodríguez
- Faculty of Medicine, Valladolid University, Valladolid, Spain.,Advanced Life Support, Emergency Medical Services (SACYL), Valladolid, Spain
| | - Raúl López-Izquierdo
- Faculty of Medicine, Valladolid University, Valladolid, Spain.,Emergency Department, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Ancor Sanz-García
- Data Analysis Unit, Health Research Institute, Hospital de la Princesa, Madrid, Spain
| | - Guillermo J Ortega
- Data Analysis Unit, Health Research Institute, Hospital de la Princesa, Madrid, Spain.,CONICET, Buenos Aires, Argentina
| | - Carlos Del Pozo Vegas
- Faculty of Medicine, Valladolid University, Valladolid, Spain.,Emergency Department, Hospital Clínico Universitario, Valladolid, Spain
| | | | | | - Joan B Soriano
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.,Servicio de Neumología, Hospital Universitario de La Princesa, Madrid, Spain.,Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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