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Pedrosa L, Hoyos J, Reyes L, Mosteiro A, Zattera L, Topczewski T, Rodríguez-Hernández A, Amaro S, Torné R, Enseñat J. Brain metabolism response to intrahospital transfers in neurocritical ill patients and the impact of microdialysis probe location. Sci Rep 2024; 14:7388. [PMID: 38548829 PMCID: PMC10978944 DOI: 10.1038/s41598-024-57217-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 03/15/2024] [Indexed: 04/01/2024] Open
Abstract
Intrahospital transfer (IHT), a routine in the management of neurocritical patients requiring imaging or interventions, might affect brain metabolism. Studies about IHT effects using microdialysis (MD) have produced conflicting results. In these studies, only the most damaged hemisphere was monitored, and those may not reflect the impact of IHT on overall brain metabolism, nor do they address differences between the hemispheres. Herein we aimed to quantify the effect of IHT on brain metabolism by monitoring both hemispheres with bilateral MD. In this study, 27 patients with severe brain injury (10 traumatic brain injury and 17 subarachnoid hemorrhage patients) were included, with a total of 67 IHT. Glucose, glycerol, pyruvate and lactate were measured by MD in both hemispheres for 10 h pre- and post-IHT. Alterations in metabolite levels after IHT were observed on both hemispheres; although these changes were more marked in hemisphere A (most damaged) than B (less damaged). Our results suggest that brain metabolism is altered after an IHT of neurocritical ill patients particularly but not limited to the damaged hemisphere. Bilateral monitorization may be more sensitive than unilateral monitorization for detecting metabolic disturbances not directly related to the course of the disease.
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Affiliation(s)
- Leire Pedrosa
- Department of Neurosurgery, Hospital Clinic of Barcelona, 08036, Barcelona, Spain
- IDIBAPS Biomedical Research Institute, 08036, Barcelona, Spain
| | - Jhon Hoyos
- Department of Neurosurgery, Hospital Clinic of Barcelona, 08036, Barcelona, Spain
| | - Luis Reyes
- Department of Neurosurgery, Hospital Clinic of Barcelona, 08036, Barcelona, Spain
| | - Alejandra Mosteiro
- Department of Neurosurgery, Hospital Clinic of Barcelona, 08036, Barcelona, Spain
| | - Luigi Zattera
- Department of Anesthesiology and Critical Care, Hospital Clinic of Barcelona, 08036, Barcelona, Spain
| | - Thomaz Topczewski
- Department of Neurosurgery, Hospital Clinic of Barcelona, 08036, Barcelona, Spain
| | - Ana Rodríguez-Hernández
- Department of Neurosurgery, Germans Trias i Pujol University Hospital, 08916, Badalona, Spain
| | - Sergio Amaro
- IDIBAPS Biomedical Research Institute, 08036, Barcelona, Spain
- Comprehensive Stroke Unit, Neurology, Hospital Clinic of Barcelona, 08036, Barcelona, Spain
| | - Ramon Torné
- Department of Neurosurgery, Hospital Clinic of Barcelona, 08036, Barcelona, Spain.
- IDIBAPS Biomedical Research Institute, 08036, Barcelona, Spain.
- Comprehensive Stroke Unit, Neurology, Hospital Clinic of Barcelona, 08036, Barcelona, Spain.
| | - Joaquim Enseñat
- Department of Neurosurgery, Hospital Clinic of Barcelona, 08036, Barcelona, Spain
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Santana D, Mosteiro A, Llull L, Massons M, Zattera L, Pujol-Fontrodona G, Werner M, Torné R, Amaro S, Chamorro A. Stroke Unit as an alternative to Intensive Care Unit for initial hospital admission of low-grade non-aneurysmal subarachnoid haemorrhage: A safety and cost-minimisation analysis. Eur Stroke J 2024; 9:180-188. [PMID: 37746931 PMCID: PMC10916811 DOI: 10.1177/23969873231202361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION Stroke Units (SU) have been suggested as an alternative to Intensive Care units (ICU) for initial admission of low-grade non-aneurysmal spontaneous subarachnoid haemorrhage (naSAH). We hypothesised that the incidence of in-hospital complications and long-term clinical outcomes in low-grade naSAH patients would be comparable in both settings, and that a cost-minimisation analysis would favour the use of SU. PATIENTS AND METHODS Retrospective, single-centre study at a third-level stroke-referral hospital, including low-grade spontaneous naSAH patients with WFNS 1-2. Primary outcomes were death and functional status at 3 months. Secondary outcomes were incidence of in-hospital major neurological and systemic complications. Additionally, a cost-minimisation analysis was conducted to estimate the average cost savings that could be achieved with the most efficient approach. RESULTS Out of 96 naSAH patients, 30 (31%) were initially admitted to ICU and 66 (69%) to SU. Both groups had similar demographic and radiological features except for a higher proportion of WFNS 2 in ICU subgroup. There were no statistically significant differences between ICU and SU-managed subgroups in death rate (2 (7%) and 1 (2%), respectively), functional outcome at 90 days (28 (93%) and 61 (92%) modified Rankin Scale 0-2) or neurological and systemic in-hospital complications. Cost-minimisation analysis demonstrated significant monetary savings favouring the SU strategy. DISCUSSION AND CONCLUSION Initial admission to the SU appears to be a safe and cost-effective alternative to the ICU for low-grade naSAH patients, with comparable clinical outcomes and a reduction of hospitalisation-related costs. Prospective multicenter randomised studies are encouraged to further evaluate this approach.
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Affiliation(s)
- Daniel Santana
- Institute of Neuroscience, Comprehensive Stroke Center, Hospital Clínic of Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Alejandra Mosteiro
- Universitat de Barcelona, Barcelona, Spain
- Institute of Neuroscience, Neurosurgery Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Laura Llull
- Institute of Neuroscience, Comprehensive Stroke Center, Hospital Clínic of Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Miquel Massons
- Institute of Neuroscience, Comprehensive Stroke Center, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Luigi Zattera
- Universitat de Barcelona, Barcelona, Spain
- Anesthesiology Department, Neurocritical Care Division, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Gabriel Pujol-Fontrodona
- Universitat de Barcelona, Barcelona, Spain
- Anesthesiology Department, Neurocritical Care Division, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Mariano Werner
- Institute of Diagnostic Imaging, Neurointerventional Radiology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Ramón Torné
- Universitat de Barcelona, Barcelona, Spain
- Institute of Neuroscience, Neurosurgery Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Sergio Amaro
- Institute of Neuroscience, Comprehensive Stroke Center, Hospital Clínic of Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Angel Chamorro
- Institute of Neuroscience, Comprehensive Stroke Center, Hospital Clínic of Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
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Mellado-Artigas R, Zattera L, Barbeta E, Ferrando C. Comment to “Very late intubation in COVID-19 patients: A forgotten prognosis factor?”. Crit Care 2022; 26:212. [PMID: 35818055 PMCID: PMC9272866 DOI: 10.1186/s13054-022-04033-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
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Zattera L, Veliziotis I, Benitez-Cano A, Ramos I, Larrañaga L, Nuñez M, Román L, Adalid I, Ferrando C, Muñoz G, Arruti E, Minini A, Bassas E, Hernández M, Taccone FS, Peluso L, Adalia R. Early procalcitonin to predict mortality in critically ill COVID-19 patients: a multicentric cohort study. Minerva Anestesiol 2022; 88:259-271. [PMID: 35072432 DOI: 10.23736/s0375-9393.22.15942-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND High levels of procalcitonin (PCT) have been associated with a higher risk of mortality in COVID-19 patients. We explored the prognostic role of early PCT assessment in critically ill COVID-19 patients and whether PCT predictive performance would be influenced by immunosuppression. METHODS Retrospective multicentric analysis of prospective collected data in COVID-19 patients consecutively admitted to 36 intensive care units (ICUs) in Spain and Andorra from March to June 2020. Adult (>18 years) patients with confirmed COVID-19 and available PCT values (<72 hours from ICU admission) were included. Patients were considered as "No Immunosuppression" (NI), "Chronic Immunosuppression" (CI) and "Acute Immunosuppression" (AIT if only tocilizumab; AIS if only steroids, AITS if both). The primary outcome was the ability of PCT to predict ICU mortality. RESULTS Of the 1079 eligible patients, 777 patients were included in the analysis. Mortality occurred in 227 (28%) patients. In the NI group 144 (19%) patients were included, 67 (9%) in the CI group, 66 (8%) in the AIT group, 262 (34%) in the AIS group and 238 (31%) in the AITS group; PCT was significantly higher in non-survivors when compared with survivors (0.64 [0.17-1.44] vs. 0.23 [0.11-0.60] ng/mL; p<0.01); however, in the multivariable analysis, PCT values was not independently associated with ICU mortality. PCT values and ICU mortality were significantly higher in patients in the NI and CI groups. CONCLUSIONS PCT values are not independent predictors of ICU mortality in COVID-19 patients. Acute immunosuppression significantly reduced PCT values, although not influencing its predictive value.
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Affiliation(s)
- Luigi Zattera
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain - .,Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium -
| | - Ioannis Veliziotis
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Adela Benitez-Cano
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Isabel Ramos
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Leire Larrañaga
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Maria Nuñez
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Lorena Román
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Irina Adalid
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Carlos Ferrando
- Department of Anesthesiology and Critical Care, Hospital Clinic, Barcelona, Spain.,Institut D'investigació August Pi i Sunyer, Barcelona, Spain
| | - Guido Muñoz
- Department of Anesthesiology and Critical Care, Hospital Clinic, Barcelona, Spain
| | | | - Andrea Minini
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Eva Bassas
- Department of Anesthesiology and Critical Care, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | - Maria Hernández
- Department of Anesthesiology and Critical Care, Hospital Universitario Cruces, Barakaldo, Spain
| | - Fabio S Taccone
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Lorenzo Peluso
- Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Ramon Adalia
- Department of Anesthesiology and Critical Care, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
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Ferrando C, Mellado-Artigas R, Gea A, Arruti E, Aldecoa C, Bordell A, Adalia R, Zattera L, Ramasco F, Monedero P, Maseda E, Martínez A, Tamayo G, Mercadal J, Muñoz G, Jacas A, Ángeles G, Castro P, Hernández-Tejero M, Fernandez J, Gómez-Rojo M, Candela Á, Ripollés J, Nieto A, Bassas E, Deiros C, Margarit A, Redondo F, Martín A, García N, Casas P, Morcillo C, Hernández-Sanz M. Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: A prospective, cohort, multicentre study. Revista Española de Anestesiología y Reanimación (English Edition) 2020. [PMCID: PMC7833676 DOI: 10.1016/j.redare.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background The clinical course of COVID-19 critically ill patients, during their admission in the intensive care unit (UCI), including medical and infectious complications and support therapies, as well as their association with in-ICU mortality has not been fully reported. Objective This study aimed to describe clinical characteristics and clinical course of ICU COVID-19 patients, and to determine risk factors for ICU mortality of COVID-19 patients. Methods Prospective, multicentre, cohort study that enrolled critically ill COVID-19 patients admitted into 30 ICUs from Spain and Andorra. Consecutive patients from March 12th to May 26th, 2020 were enrolled if they had died or were discharged from ICU during the study period. Demographics, symptoms, vital signs, laboratory markers, supportive therapies, pharmacological treatments, medical and infectious complications were reported and compared between deceased and discharged patients. Results A total of 663 patients were included. Overall ICU mortality was 31% (203 patients). At ICU admission non-survivors were more hypoxemic [SpO2 with non-rebreather mask, 90 (IQR 83–93) vs 91 (IQR 87–94); p < 0.001] and with higher sequential organ failure assessment score [SOFA, 7 (IQR 5–9) vs 4 (IQR 3–7); p < 0.001]. Complications were more frequent in non-survivors: acute respiratory distress syndrome (ARDS) (95% vs 89%; p = 0.009), acute kidney injury (AKI) (58% vs 24%; p < 10−16), shock (42% vs 14%; p < 10−13), and arrhythmias (24% vs 11%; p < 10−4). Respiratory super-infection, bloodstream infection and septic shock were higher in non-survivors (33% vs 25%; p = 0.03, 33% vs 23%; p = 0.01 and 15% vs 3%, p = 10−7), respectively. The multivariable regression model showed that age was associated with mortality, with every year increasing risk-of-death by 1% (95%CI: 1–10, p = 0.014). Each 5-point increase in APACHE II independently predicted mortality [OR: 1.508 (1.081, 2.104), p = 0.015]. Patients with AKI [OR: 2.468 (1.628, 3.741), p < 10−4)], cardiac arrest [OR: 11.099 (3.389, 36.353), p = 0.0001], and septic shock [OR: 3.224 (1.486, 6.994), p = 0.002] had an increased risk-of-death. Conclusions Older COVID-19 patients with higher APACHE II scores on admission, those who developed AKI grades II or III and/or septic shock during ICU stay had an increased risk-of-death. ICU mortality was 31%.
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Ferrando C, Mellado-Artigas R, Gea A, Arruti E, Aldecoa C, Bordell A, Adalia R, Zattera L, Ramasco F, Monedero P, Maseda E, Martínez A, Tamayo G, Mercadal J, Muñoz G, Jacas A, Ángeles G, Castro P, Hernández-Tejero M, Fernandez J, Gómez-Rojo M, Candela Á, Ripollés J, Nieto A, Bassas E, Deiros C, Margarit A, Redondo FJ, Martín A, García N, Casas P, Morcillo C, Hernández-Sanz ML. Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: A prospective, cohort, multicentre study. ACTA ACUST UNITED AC 2020; 67:425-437. [PMID: 32800622 PMCID: PMC7357496 DOI: 10.1016/j.redar.2020.07.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Antecedentes No se ha reportado plenamente la evolución clínica de los pacientes críticos de COVID-19 durante su ingreso en la unidad de cuidados intensivos (UCI), incluyendo las complicaciones médicas e infecciosas y terapias de soporte, así como su asociación con la mortalidad en UCI. Objetivo El objetivo de este estudio es describir las características clínicas y la evolución de los pacientes ingresados en UCI por COVID-19 y determinar los factores de riesgo de la mortalidad en UCI de dichos pacientes. Métodos Estudio prospectivo, multicéntrico y de cohorte, que incluyó a los pacientes críticos de COVID-19 ingresados en 30 UCI de España y Andorra. Se incluyó a los pacientes consecutivos del 12 de marzo al 26 de mayo del 2020 si habían fallecido o habían recibido el alta de la UCI durante el periodo de estudio. Se reportaron los datos demográficos, los síntomas, los signos vitales, los marcadores de laboratorio, las terapias de soporte, terapias farmacológicas y las complicaciones médicas e infecciosas, realizándose una comparación entre los pacientes fallecidos y los pacientes dados de alta. Resultados Se incluyó a un total de 663 pacientes. La mortalidad general en UCI fue del 31% (203 pacientes). Al ingreso en UCI los no supervivientes eran más hipoxémicos (SpO2 con mascarilla de no reinhalación, de 90 [RIC 83-93] vs. 91 [RIC 87-94]; p < 0,001] y con mayor puntuación en la escala SOFA-Evaluación de daño orgánico secuencial (SOFA, 7 [RIC 5-9] vs. 4 [RIC 3-7]; p <0,001]). Las complicaciones fueron más frecuentes en los no supervivientes: síndrome de distrés respiratorio agudo (SDRA) (95% vs. 89%; p = 0,009), insuficiencia renal aguda (IRA) (58% vs. 24%; p < 10–6), shock (42% vs. 14%; p < 10–13) y arritmias (24% vs. 11%; p < 10–4). Las superinfecciones respiratorias, infecciones del torrente sanguíneo y los shock sépticos fueron más frecuentes en los no supervivientes (33% vs. 25%; p = 0,03, 33% vs. 23%; p = 0,01 y 15% vs. 3%, p = 10–7, respectivamente). El modelo de regresión multivariable reflejó que la edad estaba asociada a la mortalidad y que cada año incrementaba el riesgo de muerte en un 1% (IC del 95%: 1-10, p = 0,014). Cada incremento de 5 puntos en la escala APACHE II predijo de manera independiente la mortalidad (odds ratio [OR]: 1,508 [1,081, 2,104], p = 0,015). Los pacientes con IRA (OR: 2,468 [1,628, 3,741], p < 10–4)], paro cardiaco (OR: 11,099 [3,389, 36,353], p = 0,0001] y shock séptico [OR: 3,224 [1,486, 6,994], p= 0,002) tuvieron un riesgo de muerte incrementado. Conclusiones Los pacientes mayores de COVID-19 con puntuaciones APACHE II más altas al ingreso, que desarrollaron IRA en grados ii o iii o shock séptico durante la estancia en UCI tuvieron un riesgo de muerte incrementado. La mortalidad en UCI fue del 31%.
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Affiliation(s)
- C Ferrando
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España.
| | - R Mellado-Artigas
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - A Gea
- Departamento de Medicina Preventiva y Salud Pública, Escuela Médica, Universidad de Navarra, Pamplona, España
| | - E Arruti
- Tecnología Ubikare, Bilbao, Vizcaya, España
| | - C Aldecoa
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario Río Hortega, Valladolid, España
| | - A Bordell
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario Río Hortega, Valladolid, España
| | - R Adalia
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - L Zattera
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - F Ramasco
- Departamento de Anestesiología y Cuidados Críticos, Hospital La Princesa, Madrid, España
| | - P Monedero
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - E Maseda
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario La Paz, Madrid, España
| | - A Martínez
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Cruces, Barakaldo, Vizcaya, España
| | - G Tamayo
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Cruces, Barakaldo, Vizcaya, España
| | - J Mercadal
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - G Muñoz
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - A Jacas
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - G Ángeles
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - P Castro
- Unidad de Cuidados Intensivos Médicos, Hospital Clínic, Institut D'investigació August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, España
| | - M Hernández-Tejero
- Unidad Hepática, Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - J Fernandez
- Unidad Hepática, Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - M Gómez-Rojo
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Ramón y Cajal, Madrid, España
| | - Á Candela
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Ramón y Cajal, Madrid, España
| | - J Ripollés
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Universitario Infanta Leonor, Madrid, España
| | - A Nieto
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Universitario Infanta Leonor, Madrid, España
| | - E Bassas
- Departamento de Anestesiología y Cuidados Críticos, Hospital San Joan Despí Moises Broggi, Barcelona, España
| | - C Deiros
- Departamento de Anestesiología y Cuidados Críticos, Hospital San Joan Despí Moises Broggi, Barcelona, España
| | - A Margarit
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - F J Redondo
- Departamento de Anestesiología y Cuidados Críticos, Hospital Nostra Senyora de Meritxell SAAS, Andorra, Andorra
| | - A Martín
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Ciudad Real, Ciudad Real, España
| | - N García
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Urdúliz, Urdúliz, Vizcaya, España
| | - P Casas
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Terrasa, Terrasa, Barcelona, España
| | - C Morcillo
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario a Coruña, A Coruña, España
| | - M L Hernández-Sanz
- Departamento de Anestesiología y Cuidados Críticos, Hospital Sanitas CIMA, Barcelona, España
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Zattera L, Errasti J, Supervía A. Intoxicación por el cannabinoide sintético 5-fluoro-ABD, adquirido como ketamina. Med Clin (Barc) 2018; 151:168. [DOI: 10.1016/j.medcli.2018.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 12/14/2022]
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Zattera L, Errasti J, Supervía A. Intoxication by the synthetic cannabinoid 5-fluoro-ABD, acquired as ketamine. Medicina Clínica (English Edition) 2018; 151:168. [DOI: 10.1016/j.medcle.2018.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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