CRIS

Permanent URI for this communityhttps://investigadores.udd.cl/handle/123456789/1

Browse

Search Results

Now showing 1 - 10 of 12

Some of the metrics are blocked by your
consent settings
Concurrent nutrition and physical rehabilitation interventions for patients with critical illness
(Ovid Technologies (Wolters Kluwer Health), 2024-12-16)
GONZALEZ SEGUEL, FELIPE ANDRES
;
Kirby P. Mayer
;
Renee D. Stapleton
The effects of either physical rehabilitation or nutrition on outcomes in patients with critical illness are variable and remain unclear. The potential for the combination of exercise and nutritional delivered concurrently to provide benefit is provocative, but data are only emerging. Herein, we provide a summary of evidence from 2023 and 2024 on combined physical rehabilitation and nutrition during and following critical illness. Recent findings While latest trials on physical rehabilitation alone reported conflicting findings, recent nutrition trials found no difference between higher and lower protein delivery and even suggested harm in patients with acute kidney injury. In 2023 and 2024, we identified four studies (one randomized controlled trial) combining physical rehabilitation and nutrition (mainly protein supplementation) within the ICU setting. Overall, these suggested benefits, including reduction of muscle size loss, ICU acquired weakness, delirium, and improved mobility levels, although these benefits did not extend to mortality and hospital length of stay. No recent trials combining physical rehabilitation and nutrition for patients after ICU were identified.</jats:p>
Scopus© Citations 6 1
Some of the metrics are blocked by your
consent settings
Impact of insufflator/aspirator versus exclusive insufflator during robotic radical prostatectomy: a comparative prospective cohort study
(2023)
Hugo Otaola-Arca
;
Orlando Mejías
;
Juan Cristóbal Bravo
;
Rodrigo Pinochet
;
Pablo Bernier
<jats:sec> <jats:title>Background:</jats:title> <jats:p>New generation devices that combine high-flow insufflation with smoke aspiration using continuous gas recirculation ]so-called Insufflator/aspirator systems (IAS)] have recently been developed to generate pneumoperitoneum. The use of an IAS could have an impact on surgical compared to conventional insufflation systems (CIS). The present study aimed to compare the clinical effectiveness/safety, healthorganizational, and pathological/oncological outcomes of the CIS versus IAS during robot-assisted radical prostatectomy (RARP).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>Comparative retrospective cohort study including patients with non-metastatic prostate cancer treated with RARP by four expert surgeons at a robotic referral centre between January 2020 and December 2021. A CIS was used until 15 March 2021, and the IAS thereafter. Data were extracted from the Institutional Review Board-approved (#1064) retro and prospective institutional database.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>The final analysis included 299 patients (143 CIS; 156 IAS). We found no statistically significant differences in demographic data and preoperative results, allowing adequate group comparison. The rate of complications of any degree (9.1% and 1.9%, <jats:italic toggle="yes">P</jats:italic><0.05) and major complications (4.2% and 0.6%, <jats:italic toggle="yes">P</jats:italic><0.05) were lower in the IAS group. Accordingly, the hospital stay was shorter in the IAS group (<jats:italic toggle="yes">P</jats:italic><0.05); however, the small size of this statistically significant difference probably lacks clinical value (1.9±1.6 vs. 1.6±0.8 days). There was no significant difference in surgical time, bleeding, pathological findings, or oncological results.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Data from this large group of patients showed that the rate of overall complications, the rate of major complications, and the length of stay were lower in the IAS group. Implementing the IAS in RARP patients increased the occurrence of SCE and affected our daily practice of transversus abdominis plane block. Interpretation of the results should be made with caution since the design of this study did not allow for the identification of a causal relationship.</jats:p> </jats:sec>
8Scopus© Citations 3
Some of the metrics are blocked by your
consent settings
Clinical and functional outcomes of primary total knee arthroplasty: a South American perspective
(2019)
FIGUEROA POBLETE, DAVID HUMBERTO
;
Carolina Avilés
;
CALVO RODRIGUEZ, RAFAEL
;
FIGUEROA BERRIOS, FRANCISCO JAVIER
;
Alan Garín
4Scopus© Citations 4
Some of the metrics are blocked by your
consent settings
Outcomes of Sepsis and Septic Shock in Cancer Patients: Focus on Lactate
(2021)
LOPEZ HERNANDEZ, RENE RAMON
;
Rodrigo Pérez-Araos
;
Fernanda Baus
;
Camila Moscoso
;
Álvaro Salazar
<jats:p>The number of oncological patients (OP) admitted to intensive care units (ICU) for sepsis/septic shock has dramatically increased in recent years. The definition of septic shock has been modified, adding hyperlactatemia as a severity biomarker for mortality. However, it remains poorly reported in septic OP. We performed a retrospective analysis from a prospective database of sepsis/septic shock patients admitted to our ICU between September 2017 and September 2019 and followed until day 90. We identified 251 patients and 31.9% had active oncological comorbidity, mainly solid tumor (81.3%). Septic shock criteria were met for 112 (44.6%). Hyperlactatemia was observed in 136 (54.2%) patients and this was associated with a lower survival rate. Overall 90-day mortality was 15.1%. In OP vs. non-OP, hyperlactatemia was more frequent (65% vs. 49.1%, <jats:italic>p</jats:italic> = 0.013) and associated with lower survival (65.4% vs. 85.7%, <jats:italic>p</jats:italic> = 0.046). In OP, poor performance status was also associated with lower survival (HR 7.029 [1.998–24.731], <jats:italic>p</jats:italic> = 0.002) In an adjusted analysis, cancer was associated with lower 90-day survival (HR 2.690 [1.402–5.160], <jats:italic>p</jats:italic> = 0.003). In conclusion, septic OP remains a high mortality risk group in whom lactate levels and performance status could help with better risk stratification.</jats:p>
Scopus© Citations 18 1
Some of the metrics are blocked by your
consent settings
Intensive Care Unit–Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review
(2023)
J. Pedro Teixeira
;
Kirby P. Mayer
;
Benjamin R. Griffin
;
Naomi George
;
Nathaniel Jenkins
Scopus© Citations 11 6
Some of the metrics are blocked by your
consent settings
Critical illness myopathy and trajectory of recovery in acute kidney injury requiring continuous renal replacement therapy: a prospective observational trial protocol
(2023)
J Pedro Teixeira
;
Benjamin R Griffin
;
Chaitanya Anil Pal
;
David Felipe Márquez González
;
Nathanial Jenkins
<jats:sec><jats:title>Introduction</jats:title><jats:p>Acute kidney injury requiring renal replacement therapy (AKI-RRT) is common in the intensive care unit (ICU) and is associated with significant morbidity and mortality. Continuous RRT (CRRT) non-selectively removes large amounts of amino acids from plasma, lowering serum amino acid concentrations and potentially depleting total-body amino acid stores. Therefore, the morbidity and mortality associated with AKI-RRT may be partly mediated through accelerated skeletal muscle atrophy and resulting muscle weakness. However, the impact of AKI-RRT on skeletal muscle mass and function during and following critical illness remains unknown. We hypothesise that patients with AKI-RRT have higher degrees of acute muscle loss than patients without AKI-RRT and that AKI-RRT survivors are less likely to recover muscle mass and function when compared with other ICU survivors.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>This protocol describes a prospective, multicentre, observational trial assessing skeletal muscle size, quality and function in ICU patients with AKI-RRT. We will perform musculoskeletal ultrasound to longitudinally evaluate rectus femoris size and quality at baseline (within 48 hours of CRRT initiation), day 3, day 7 or at ICU discharge, at hospital discharge, and 1–3 months postdischarge. Additional skeletal muscle and physical function tests will be performed at hospital discharge and postdischarge follow-up. We will analyse the effect of AKI-RRT by comparing the findings in enrolled subjects to historical controls of critically ill patients without AKI-RRT using multivariable modelling.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>We anticipate our study will reveal that AKI-RRT is associated with greater degrees of muscle loss and dysfunction along with impaired postdischarge recovery of physical function. These findings could impact the in-hospital and postdischarge treatment plan for these patients to include focused attention on muscle strength and function. We intend to disseminate findings to participants, healthcare professionals, the public and other relevant groups via conference presentation and publication without any publication restrictions.</jats:p></jats:sec><jats:sec><jats:title>Trial registration number</jats:title><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" xlink:href="NCT05287204">NCT05287204</jats:ext-link>.</jats:p></jats:sec>
4Scopus© Citations 5
Some of the metrics are blocked by your
consent settings
Pediatric Inflammatory Multisystem Syndrome Associated With SARS-CoV-2
(2020)
Raúl Bustos B
;
Juan Camilo Jaramillo-Bustamante
;
Pablo Vasquez-Hoyos
;
Pablo Cruces
;
Franco Díaz
13Scopus© Citations 24
Some of the metrics are blocked by your
consent settings
Hypertensive Nephropathy: Unveiling the Possible Involvement of Hemichannels and Pannexons
(2022)
Claudia M. Lucero
;
Juan Prieto-Villalobos
;
Lucas Marambio-Ruiz
;
Javiera Balmazabal
;
Tanhia F. Alvear
<jats:p>Hypertension is one of the most common risk factors for developing chronic cardiovascular diseases, including hypertensive nephropathy. Within the glomerulus, hypertension causes damage and activation of mesangial cells (MCs), eliciting the production of large amounts of vasoactive and proinflammatory agents. Accordingly, the activation of AT1 receptors by the vasoactive molecule angiotensin II (AngII) contributes to the pathogenesis of renal damage, which is mediated mostly by the dysfunction of intracellular Ca2+ ([Ca2+]i) signaling. Similarly, inflammation entails complex processes, where [Ca2+]i also play crucial roles. Deregulation of this second messenger increases cell damage and promotes fibrosis, reduces renal blood flow, and impairs the glomerular filtration barrier. In vertebrates, [Ca2+]i signaling depends, in part, on the activity of two families of large-pore channels: hemichannels and pannexons. Interestingly, the opening of these channels depends on [Ca2+]i signaling. In this review, we propose that the opening of channels formed by connexins and/or pannexins mediated by AngII induces the ATP release to the extracellular media, with the subsequent activation of purinergic receptors. This process could elicit Ca2+ overload and constitute a feed-forward mechanism, leading to kidney damage.</jats:p>
5Scopus© Citations 18
Some of the metrics are blocked by your
consent settings
Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 Treated with Tocilizumab
(2020)
Carmen Niño-Taravilla
;
Yazmín P. Espinosa-Vielma
;
Hugo Otaola-Arca
;
POLI HARLOWE, MARIA CECILIA BERTA
;
Lorena I. Tapia
<jats:p>We describe a case of Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in an 8-year-old child. The patient developed multiorgan dysfunction, including mixed shock, cardiac dysfunction with myocarditis, pneumonia, acute kidney failure, and gastrointestinal involvement characterized by inflammation of the wall of the bowel and pancreatitis. After treatment with Tocilizumab and corticoid therapy, he presented clinical improvement and normalization of inflammatory markers. PIMS-TS is a new disease developed in a small percentage of patients, so a high degree of suspicion is necessary to establish the diagnosis. Supportive care is of paramount importance. The use of Tocilizumab to control the inflammatory response is likely to be beneficial, but the best immunotherapeutic agent has not yet been established. Randomized clinical studies should be run to determine the best treatment.</jats:p>
14Scopus© Citations 20
Some of the metrics are blocked by your
consent settings
Compromiso renal agudo en COVID-19
(2020)
Felipe Cavagnaro SM.
7Scopus© Citations 1

CRIS

Browse

Filters

Settings

Sort By

Results per page

Search Results