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Fragilidad: en busca de herramientas de evaluación preoperatoria

2020 , Javiera Vargas , María de Los Ángeles Gálvez , Mariana Rojas , Macarena Honorato , Maricarmen Andrade , Patricio Leyton , Gabriela Mardones , Julián Morales , Daniela Pérsico , Fernanda Rojas , Duby Moreno , Erika Becker , Gabriel Cavada , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL

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Post-COVID-19 condition: a sex-based analysis of clinical and laboratory trends

2024 , Carlos Delfino , POLI HARLOWE, MARIA CECILIA BERTA , VIAL COX, MARIA CECILIA , VIAL CLARO, PABLO AGUSTIN , Gonzalo Martínez , Amy Riviotta , Catalina Arbat , Nicole Mac-Guire , Josefina Hoppe , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , MUÑOZ VENTURELLI, PAULA ANDREA

Background and aimPost-COVID-19 condition (PCC) encompasses long-lasting symptoms in individuals with COVID-19 and is estimated to affect between 31–67% of patients, with women being more commonly affected. No definitive biomarkers have emerged in the acute stage that can help predict the onset of PCC, therefore we aimed at describing sex-disaggregated data of PCC patients from a local cohort and explore potential acute predictors of PCC and neurologic PCC.MethodsA local cohort of consecutive patients admitted with COVID-19 diagnosis between June 2020 and July 2021 were registered, and clinical and laboratory data were recorded. Only those <65 years, discharged alive and followed up at 6 and 12 months after admission were considered in these analyses. Multivariable logistic regression analysis was performed to explore variables associated with PCC (STATA v 18.0).ResultsFrom 130 patients in the cohort, 104 were contacted: 30% were women, median age of 42 years. At 6 months, 71 (68%) reported PCC symptoms. Women exhibited a higher prevalence of any PCC symptom (87 vs. 60%, p = 0.007), lower ferritin (p = 0.001) and procalcitonin (p = 0.021) and higher TNF levels (p = 0.042) in the acute phase compared to men. Being women was independently associated to 7.60 (95% CI 1.27–45.18, p = 0.026) higher risk for PCC. Moreover, women had lower return to normal activities 6 and 12 months.ConclusionOur findings highlight the lasting impact of COVID-19, particularly in young women, emphasising the need for tailored post-COVID care. The lower ferritin levels in women are an intriguing observation, warranting further research. The study argues for comprehensive strategies that address sex-specific challenges in recovery from COVID-19.

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Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model

2015 , Benjamín Erranz , Franco Díaz , Alejandro Donoso , Tatiana Salomón , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , María Fernanda Torres , Pablo Cruces

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Reduced PICU respiratory admissions during COVID-19

2020 , Pablo Vásquez-Hoyos , Franco Diaz-Rubio , Nicolas Monteverde-Fernandez , Juan Camilo Jaramillo-Bustamante , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , Alberto Serra , Todd Karsies , Alexandre Tellechea Rotta , Sebastián González-Dambrauskas

BackgroundThe COVID-19 pandemic reached the Southern Hemisphere in the autumn of 2020, thus coinciding with its expected annual viral respiratory season. The potential impact of national strategies aimed at mitigating COVID-19 during the pandemic on the incidence of other critical viral lower respiratory tract infections (LRTIs) in children is unknown.MethodsWe analysed admission data for LRTIs from 22 paediatric intensive care units (PICUs) in four countries, part of a large international Latin American registry of children with acute respiratory failure (Red Colaborativa Pediátrica de Latinoamérica [LARed Network]).ResultsBetween January and August, there were 83% fewer PICU admissions for LRTIs in 2020 compared to the 2018/2019 average over the same period. Similar decreases were noted for PICU admissions due to respiratory syncytial virus and influenza (92% and 78%, respectively).ConclusionWe observed a striking reduction in PICU admissions due to viral LRTIs over winter, during the COVID-19 pandemic in South America.

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Mild hypothermia attenuates lung edema and plasma interleukin-1β in a rat mechanical ventilation-induced lung injury model

2011 , Cruces, Pablo , Ronco, Ricardo , Benjamín Erranz , CONGET MOLINA, PAULETTE ANDREA , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , Alejandro Donoso , Franco Díaz

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Surfactant deactivation in a pediatric model induces hypovolemia and fluid shift to the extravascular lung compartment

2012 , FRANCO JAVIER DIAZ RUBIO , Benjamín Erranz , Alejandro Donoso , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , Tatiana Salomón , María Torres , Pablo Cruces , Andrew Davidson

Surfactant deficiency is the pivotal abnormality in Neonatal and Acute Respiratory Distress Syndrome. Surfactant deactivation can produce hypoxemia, loss of lung compliance, and pulmonary edema, but its circulatory consequences are less understood. Objective To describe the sequential hemodynamic changes and pulmonary edema formation after surfactant deactivation in piglets. Methods: Surfactant deactivation was induced by tracheal instillation of polysorbate 20 in 15 anesthetized and mechanically ventilated Large White piglets. The hemodynamic consequences of surfactant deactivation were assessed at 30, 120, and 240 min by transpulmonary thermodilution and traditional methods. Results: Surfactant deactivation caused hypoxemia, reduced lung compliance, and progressively increased lung water content (P < 0.01). Early hypovolemia was observed, with reductions of the global end-diastolic volume and stroke volume (P < 0.05). Reduced cardiac output was observed at the end of the study (P < 0.05). Standard monitoring was unable to detect these early preload alterations. Surprisingly, the bronchoalveolar protein content was greatly increased at the end of the study compared with baseline levels (P < 0.01). This finding was inconsistent with the notion that the pulmonary edema induced by surfactant deactivation was exclusively caused by high surface tension. Conclusions: Hypovolemia develops early after surfactant deactivation, in part due to the resulting fluid shift from the intravascular compartment to the lungs

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Consecuencias hemodinámicas y respiratorias del síndrome compartimental abdominal en un modelo experimental

2012 , Franco Díaz R , Alejandro Donoso F , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , Tatiana Salomón S , María Fernanda Torres G , Benjamín Erranz M , Pablo Cruces R

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Mild hypothermia increases pulmonary anti-inflammatory response during protective mechanical ventilation in a piglet model of acute lung injury

2013 , Pablo Cruces , Erranz, Benjamín , Alejandro Donoso , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , Tatiana Salomón , María Fernanda Torres , Franco Díaz , Brian Anderson

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A REDCap application that links researchers, animal facility staff and members of the IACUC in animal health monitoring

2019 , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , Catalina Vallejos , Dominique Lemaitre , Jorge Ruiz , Camila Guzmán , Valentina Aguilera , Diego Baño , SEBASTIAN DANTE CALLIGARIS

Research studies involving animal experimentation are regulated by the Institutional Animal Care and Use Committee (IACUC). To this end, the IACUC must integrate the information provided by the investigators of each preclinical study and the veterinarians from the animal facility in order to monitor and approve the process. Using a paper-based system to collect animal health and welfare data is a common, albeit time-consuming practice, prone to transcription and reading errors, not to mention inconvenient for veterinarians and investigators wishing to make timely and collaborative decisions when animal welfare is at risk. We created a web-based monitoring system focused on animal health with the potential to improve animal welfare. The data management system is based on REDCap software, which enables data integration in order to offer a solution for animal welfare assessment. The proposed scheme includes key indicators of general health status, such as environment, physical/nutritional information, and behavioral parameters during animal breeding and experimentation, as important components of animal welfare. In addition, the system facilitates communication of this information among researchers, animal facility staff, and the IACUC. REDCap is available to non-profit organizations, and may be adapted and replicated by institutions interested in and responsible for animal care, and used in research. REDCap is an excellent tool for promoting good practices that benefit experimental animal health.

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Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental

2012 , Franco Díaz , Alejandro Donoso , CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL , Tatiana Salomón , María Torres , Benjamín Erranz , Pablo Cruces