GONZALEZ SEGUEL, FELIPE ANDRES

Preferred name
GONZALEZ SEGUEL, FELIPE ANDRES
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Email
fgonzalez@udd.cl
ORCID
0000-0001-9099-2389
Scopus Author ID
57209215584
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    Scopus© Citations 6  1
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    Which factors are associated with acquired weakness in the ICU? An overview of systematic reviews and meta-analyses
    (2024)
    Rocío Fuentes-Aspe
    ;
    Ruvistay Gutierrez-Arias
    ;
    GONZALEZ SEGUEL, FELIPE ANDRES  
    ;
    Gabriel Nasri Marzuca-Nassr
    ;
    Rodrigo Torres-Castro
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Rationale</jats:title> <jats:p>Intensive care unit-acquired weakness (ICUAW) is common in critically ill patients, characterized by muscle weakness and physical function loss. Determining risk factors for ICUAW poses challenges due to variations in assessment methods and limited generalizability of results from specific populations, the existing literature on these risk factors lacks a clear and comprehensive synthesis.</jats:p> </jats:sec><jats:sec> <jats:title>Objective</jats:title> <jats:p>This overview aimed to synthesize risk factors for ICUAW, categorizing its modifiable and nonmodifiable factors.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>An overview of systematic reviews was conducted. Six relevant databases were searched for systematic reviews. Two pairs of reviewers selected reviews following predefined criteria, where bias was evaluated. Results were qualitatively summarized and an overlap analysis was performed for meta-analyses.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Eighteen systematic reviews were included, comprising 24 risk factors for ICUAW. Meta-analyses were performed for 15 factors, while remaining reviews provided qualitative syntheses. Twelve reviews had low risk of bias, 4 reviews were unclear, and 2 reviews exhibited high risk of bias. The extent of overlap ranged from 0 to 23% for the corrected covered area index. Nonmodifiable factors, including advanced age, female gender, and multiple organ failure, were consistently associated with ICUAW. Modifiable factors, including neuromuscular blocking agents, hyperglycemia, and corticosteroids, yielded conflicting results. Aminoglycosides, renal replacement therapy, and norepinephrine were associated with ICUAW but with high heterogeneity.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Multiple risk factors associated with ICUAW were identified, warranting consideration in prevention and treatment strategies. Some risk factors have produced conflicting results, and several remain underexplored, emphasizing the ongoing need for personalized studies encompassing all potential contributors to ICUAW development.</jats:p> </jats:sec>
      2Scopus© Citations 30
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    Muscle Dysfunction and Physical Recovery After Critical Illness
    (SAGE Publications, 2025-02-04)
    Matthew F. Mart
    ;
    Joshua I. Gordon
    ;
    GONZALEZ SEGUEL, FELIPE ANDRES  
    ;
    Kirby P. Mayer
    ;
    Nathan Brummel
    During critical illness, patients experience significant and rapid onsets of muscle wasting and dysfunction with loss of strength, mass, and power. These deficits often persist long after the ICU, leading to impairments in physical function including reduced exercise capacity and increased frailty and disability. While there are numerous studies describing the epidemiology of impaired muscle and physical function in the ICU, there are significantly fewer data investigating mechanisms of prolonged and persistent impairments in ICU survivors. Additionally, while several potential clinical risk factors associated with poor physical recovery have been identified, there remains a dearth of interventions that have effectively improved outcomes long-term among survivors. In this article, we aim to provide a thorough, evidence-based review of the current state of knowledge regarding muscle dysfunction and physical function after critical illness with a focus on post-ICU and post-hospitalization phase of recovery.
      2Scopus© Citations 17
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    Femoral Catheter‐Related Adverse Events during Physical Rehabilitation of Patients with Critical Illness: A Systematic Review
    (Wiley, 2026-02-15)
    Camilo Caceres‐Parra
    ;
    Tamara Fenner Martini
    ;
    Diulian Muniz Medeiros
    ;
    Fábio Cangeri Di Naso
    ;
    Aline Felicio Bueno Ingrassia
    <jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Physical rehabilitation is a recommended practice in critical care. However, femoral catheters are commonly viewed as barriers to mobility, extending bed rest.</jats:p> </jats:sec> <jats:sec> <jats:title>Aim</jats:title> <jats:p>To determine the incidence of femoral catheter‐related adverse events during physical rehabilitation sessions of patients with critical illness.</jats:p> </jats:sec> <jats:sec> <jats:title>Study Design</jats:title> <jats:p>Systematic review following PRISMA guidelines. MEDLINE, Web‐of‐Science, LILACS and CINAHL were searched from inception to 27 June 2025. Eligible studies included adults who received physical rehabilitation while a femoral catheter was in place. The primary outcome was the incidence rate (exact Poisson methods) of catheter‐related adverse events occurring during or immediately after rehabilitation sessions. Data were synthesised descriptively, and study‐specific incidence rates were calculated. Risk of bias was assessed using Joanna Briggs Institute tools. The protocol was registered in PROSPERO (CRD42020178029).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Fifteen studies were included, involving 504 patients and 1846 rehabilitation sessions delivered with femoral catheters. Activities ranged from cycling in bed to walking. A total of 19 catheter‐related adverse events were identified across four studies (27%). The overall incidence rate was 3.8 (95% CI 2.3–5.9) per 100 patients and 0.81 (95% CI 0.45–1.34) per 100 sessions. Incidence rates per 100 patients were 1.3 (95% CI 0.4–3.4) for mixed venous/arterial, 0.0 (95% CI 0.0–4.8) for haemodialysis and 11.8 (95% CI 6.6–19.5) for intra‐aortic balloon pump catheters. Incidence rate per 100 rehabilitation sessions solely occurred for intra‐aortic balloon pump catheters (3.5 [95% CI 2.0–5.7]).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Physical rehabilitation in patients with femoral catheters appears to be safe, with a low incidence of adverse events.</jats:p> </jats:sec> <jats:sec> <jats:title>Relevance to Clinical Practice</jats:title> <jats:p>Femoral catheters should not be considered an absolute contraindication to mobilisation, supporting efforts by nursing and rehabilitation professionals to minimise bed rest.</jats:p> </jats:sec> <jats:sec> <jats:title>Review Protocol Registration</jats:title> <jats:p>The review protocol was prospectively registered in PROSPERO (International Prospective Register of Systematic Reviews), registration number CRD42020178029.</jats:p> </jats:sec>
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    Physical Impairments in Survivors of Critical Illness
    (Cambridge University Press, 2026-01-22)
    Sara U. Dorn
    ;
    GONZALEZ SEGUEL, FELIPE ANDRES  
    ;
    Kirby Mayer
    ;
    Selina Parry
    ;
    Hallie Zeleznik
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    Respiratory muscle dysfunction in mechanical ventilation: a systematic review and meta-analysis of biological mechanisms
    (American Physiological Society, 2026-04-01)
    Owen Gustafson
    ;
    GONZALEZ SEGUEL, FELIPE ANDRES  
    ;
    Cayla M. Robinson
    ;
    Cecilia Villablanca
    ;
    Catalina Olave
    <jats:p> Revealing biological mechanisms leading to respiratory muscle dysfunction is essential to improve clinical outcomes in patients with critical illness. The purpose was to identify biological mechanisms associated with respiratory muscle dysfunction in patients with critical illness during mechanical ventilation or sepsis. Six databases were electronically searched from inception to January 2025, examining studies with muscle biopsies. Screening, data collection, and risk-of-bias were conducted in duplicate by two independent assessors. Meta-analysis was performed to determine differences in muscle biological parameters of patients with critical illness requiring mechanical ventilation compared with controls. From 22,036 titles screened, eight studies ( n = 187 patients and n = 161 controls) published between 2000 and 2024 met eligibility criteria. Muscle biopsies were taken between days 1 and 7 in the intensive care unit from the diaphragm ( n = 110; 3 studies), rectus abdominis ( n = 68; 5 studies), external intercostal ( n = 10; 1 study), and latissimus dorsi ( n = 3; 1 study). Diaphragmatic fiber cross-sectional area was 30% smaller (mean difference [95% confidence interval] = −629 [−876, −382] μm <jats:sup>2</jats:sup> ), with lower proportion of type II fibers (−1.94 [−3.40, −0.49]%) compared with controls. Diaphragmatic fiber force of patients was more than two standard deviations lower (standardized mean difference = −2.49 [−3.84, −1.14]), and ubiquitinated protein levels were higher (2.09 [−0.14, 4.32]) than controls. Extramyocellular, mitochondrial, and gene expression parameters were assessed in some studies, but low sample size and high heterogeneity prevented meta-analyses. In conclusion, muscle biopsies from ventilated patients revealed atrophy, contractile weakness, and proteolysis markers. Standardized methodologies assessing respiratory muscles are needed to clarify biological mechanisms leading to muscle dysfunction and to guide respiratory muscle interventions. </jats:p>
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    Building Resilience When Disaster Strikes: Adapting Clinical Trials in Critical Illness Recovery
    (Oxford University Press (OUP), 2026-02-02)
    Anna G Kalema
    ;
    GONZALEZ SEGUEL, FELIPE ANDRES  
    ;
    Louisa A Summers
    ;
    Esther E Dupont-Versteegden
    ;
    Ashley A Montgomery-Yates
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