GONZALEZ SEGUEL, FELIPE ANDRES
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GONZALEZ SEGUEL, FELIPE ANDRES
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fgonzalez@udd.cl
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57209215584

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Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study

2023 , CASTRO AVILA, ANA CRISTINA , Catalina Merino-Osorio , GONZALEZ SEGUEL, FELIPE ANDRES , CAMUS MOLINA, AGUSTIN , Felipe Muñoz-Muñoz , LEPPE ZAMORA, JAIME ESTEBAN , Ahmet Çağlar

Introduction The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient’s functional outcomes. To compare by bed occupancy the frequency of mental, physical, and cognitive impairments in patients admitted to ICU during the COVID-19 pandemic. Methods Prospective cohort of adults mechanically ventilated >48 hours in 19 ICUs from seven Chilean public and private hospitals. Ninety percent of nationwide beds occupied was the cut-off for low versus high bed occupancy. At ICU discharge, 3- and 6-month follow-up, we assessed disability using the World Health Organization Disability Assessment Schedule 2.0. Quality of life, mental, physical, and cognitive outcomes were also evaluated following the core outcome set for acute respiratory failure. Results We enrolled 252 participants, 103 (41%) during low and 149 (59%) during high bed occupancy. Patients treated during high occupancy were younger (P50 [P25-P75]: 55 [44–63] vs 61 [51–71]; p<0.001), more likely to be admitted due to COVID-19 (126 [85%] vs 65 [63%]; p<0.001), and have higher education qualification (94 [63%] vs 48 [47%]; p = 0.03). No differences were found in the frequency of at least one mental, physical or cognitive impairment by bed occupancy at ICU discharge (low vs high: 93% vs 91%; p = 0.6), 3-month (74% vs 63%; p = 0.2) and 6-month (57% vs 57%; p = 0.9) follow-up. Conclusions There were no differences in post-ICU outcomes between high and low bed occupancy. Most patients (>90%) had at least one mental, physical or cognitive impairment at ICU discharge, which remained high at 6-month follow-up (57%). Clinical trial registration NCT04979897 (clinicaltrials.gov).

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Settings and monitoring of mechanical ventilation during physical therapy in adult critically ill patients: protocol for a scoping review

2019 , GONZALEZ SEGUEL, FELIPE ANDRES , CAMUS MOLINA, AGUSTIN , Anita Jasmén Sepúlveda , PEREZ ARAOS, RODRIGO ALEJANDRO , Jorge Molina Blamey , GRAF SANTOS, JERÓNIMO

IntroductionEarly mobilisation has been extensively advocated to improve functional outcomes in critically ill patients, even though consistent evidence of its benefits has remained elusive. These conflicting results could be explained by a lack of knowledge on the optimal dosage of physical therapy and a mismatch between ventilatory support and exercise-induced patient ventilatory demand. Modern mechanical ventilators provide real-time monitoring of respiratory/metabolic variables and ventilatory setting that could be used for physical therapy dosage or ventilatory support titration, allowing individualised interventions in these patients. The aim of this review is to comprehensively map and summarise current knowledge on adjustments of respiratory support and respiratory or metabolic monitoring during physical therapy in adult critically ill mechanically ventilated patients.Methods and analysisThis is a scoping review protocol based on the methodology of the Joanna-Briggs-Institute. The search strategy will be conducted from inception to 30 June 2019 as a cut-off date in PubMed, CINAHL, Rehabilitation & Sport Medicine, Scielo Citation Index, Epistemónikos, Clinical Trials, PEDro and Cochrane Library, performed by a biomedical librarian and two critical care physiotherapists. All types of articles will be selected, including conference abstracts, clinical practice guidelines and expert recommendations. Bibliometric variables, patient characteristics, physical therapy interventions, ventilator settings and respiratory or metabolic monitoring will be extracted. The identified literature will be analysed by four critical care physiotherapists and reviewed by a senior critical care physician.Ethics and disseminationEthical approval is not required. The knowledge-translation of the results will be carried out based on the End-of-Grant strategies: diffusion, dissemination and application. The results will be published in a peer-review journal, presentations will be disseminated in relevant congresses, and recommendations based on the results will be developed through training for mechanical ventilation and physical therapy stakeholders.

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Inter-observer reliability of trained physiotherapists on the Functional Status Score for the Intensive Care Unit Chilean-Spanish version

2020 , GONZALEZ SEGUEL, FELIPE ANDRES , CAMUS MOLINA, AGUSTIN , Marcela Cárcamo , Stephanie Hiser , Dale M. Needham , LEPPE ZAMORA, JAIME ESTEBAN

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Estimates of price elasticity of demand for urban freeway use with high-frequency control variables: the case of Santiago, Chile

2015 , Louis de Grange , GONZALEZ SEGUEL, FELIPE ANDRES , TRONCOSO OLCHEVSKAIA, RODRIGO VLADISLAV

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Evaluación del funcionamiento físico en cuidados críticos: encuesta nacional en más de 90 centros chilenos durante la pandemia por COVID-19

2022 , GONZALEZ SEGUEL, FELIPE ANDRES , Camilo Cáceres Parra

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An empirical evaluation of the impact of three urban transportation policies on transit use

2012 , Louis de Grange , TRONCOSO OLCHEVSKAIA, RODRIGO VLADISLAV , GONZALEZ SEGUEL, FELIPE ANDRES

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Teleneurorehabilitation program (virtual reality) for patients with balance disorders: descriptive study

2021 , Marcos Maldonado , Patricia Vargas , Ricardo Vasquez , GONZALEZ SEGUEL, FELIPE ANDRES , Betel Rivero , Viviane Hidalgo , Tania Gutierrez-Panchana

Abstract Background Balance disorders are common in patients with neurological or vestibular diseases. Telerehabilitation program is a treatment to be as safe as conventional treatment. One of the most used methods to perform telerehabilitation is the incorporation of Virtual Reality. In general, rehabilitation programs train predictive postural control, so the patient does not always acquire the necessary autonomy to react to situations of instability. On the other hand, the objective and systematic supervision and measurement of these programs is limited, making it necessary to create clinical protocols with precise and measurable rehabilitation objectives. This study present the training selection methodology and clinical protocol for patients with balance disorders inserted in a Telerehabilitation Program based on Virtual Reality. Methods Descriptive study where physiotherapists were trained to use RehaMetrics®. To evaluate their level of agreement in the selection of the exercise clusters developed, the Interobserver Reliability was measured through the kappa statistic. Subsequently, the exercises were applied to a group of patients recruited with sedentary trunk control (Berg Balance Scale = 3 points in item 3), mild or normal cognitive level (Montreal Cognitive Assessment> 21 points), and prescribed for tele-rehabilitation by a doctor. Results The agreement among the expert physiotherapists irrespective of the cluster exceeds 80%, which indicates a very good strength of agreement, while the novices reached a level of agreement of 45%, which suggests a moderate strength of agreement. All clinical outcomes showed statistically significant differences between the median times, as did the Maximum Width Left Side (MWLS) (cm). The average number of minutes of training was 485.81 (SD 246.49 min), and the number of sessions performed during the 4 weeks of intervention was 17 (SD 7.15 sessions). Conclusions This analysis what had excellent interobserver reliability with trained physiotherapists. Regarding the second phase of the study, the results show a statistically significant difference between the initial and final evaluation of the clinical tests, which could result in better performance in aspects such as: balance, gait functionality, meter walked and cognition. Telerehabilitation Program based on Virtual Reality is an excellent alternative to provide continuity of treatment to patients with balance disorders.

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A Logit Model With Endogenous Explanatory Variables and Network Externalities

2015 , Louis de Grange , GONZALEZ SEGUEL, FELIPE ANDRES , Ignacio Vargas , TRONCOSO OLCHEVSKAIA, RODRIGO VLADISLAV

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Aggregate estimation of the price elasticity of demand for public transport in integrated fare systems: The case of Transantiago

2013 , Louis de Grange , GONZALEZ SEGUEL, FELIPE ANDRES , Juan Carlos Muñoz , TRONCOSO OLCHEVSKAIA, RODRIGO VLADISLAV

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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 , C. Anil Pal , GONZALEZ SEGUEL, FELIPE ANDRES , Javier A. Neyra

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