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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Respiratory Support Adjustments and Monitoring of Mechanically Ventilated Patients Performing Early Mobilization: A Scoping Review

2021 , GONZALEZ SEGUEL, FELIPE ANDRES , CAMUS MOLINA, AGUSTIN , Anita Jasmén , Jorge Molina , PEREZ ARAOS, RODRIGO ALEJANDRO , GRAF SANTOS, JERÓNIMO

Objectives: This scoping review is aimed to summarize current knowledge on respiratory support adjustments and monitoring of metabolic and respiratory variables in mechanically ventilated adult patients performing early mobilization. Data Sources: Eight electronic databases were searched from inception to February 2021, using a predefined search strategy. Study Selection: Two blinded reviewers performed document selection by title, abstract, and full text according to the following criteria: mechanically ventilated adult patients performing any mobilization intervention, respiratory support adjustments, and/or monitoring of metabolic/respiratory real-time variables. Data Extraction: Four physiotherapists extracted relevant information using a prespecified template. Data Synthesis: From 1,208 references screened, 35 documents were selected for analysis, where 20 (57%) were published between 2016 and 2020. Respiratory support settings (ventilatory modes or respiratory variables) were reported in 21 documents (60%). Reported modes were assisted (n = 11) and assist-control (n = 9). Adjustment of variables and modes were identified in only seven documents (20%). The most frequent respiratory variable was the Fio 2, and only four studies modified the level of ventilatory support. Mechanical ventilator brand/model used was not specified in 26 documents (74%). Monitoring of respiratory, metabolic, and both variables were reported in 22 documents (63%), four documents (11%) and 10 documents (29%), respectively. These variables were reported to assess the physiologic response (n = 21) or safety (n = 13). Monitored variables were mostly respiratory rate (n = 26), pulse oximetry (n = 22), and oxygen consumption (n = 9). Remarkably, no study assessed the work of breathing or effort during mobilization. Conclusions: Little information on respiratory support adjustments during mobilization of mechanically ventilated patients was identified. Monitoring of metabolic and respiratory variables is also scant. More studies on the effects of adjustments of the level/mode of ventilatory support on exercise performance and respiratory muscle activity monitoring for safe and efficient implementation of early mobilization in mechanically ventilated patients are needed.

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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 , Jasim Najum-Flores , Pamela Seron

Abstract Rationale 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. Objective This overview aimed to synthesize risk factors for ICUAW, categorizing its modifiable and nonmodifiable factors. Methods 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. Results 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. Conclusions 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.

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Confiabilidad en ecografía muscular esquelética por evaluadores experimentados y novatos de cuidados críticos

2023 , GONZALEZ SEGUEL, FELIPE ANDRES , Jorge Molina , Francisco Ríos-Castro

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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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Evaluating a Muscle Ultrasound Education Program: Theoretical Knowledge, Hands-on Skills, Reliability, and Satisfaction of Critical Care Physiotherapists

2021 , GONZALEZ SEGUEL, FELIPE ANDRES , Juan José Pinto-Concha , Francisco Ríos-Castro , Alexis Silva-Gutiérrez , Agustín Camus-Molina , Kirby P. Mayer , Selina M. Parry

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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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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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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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International Classification of Functioning, Disability, and Health Domains of 60 Physical Functioning Measurement Instruments Used During the Adult Intensive Care Unit Stay: A Scoping Review

2018 , GONZALEZ SEGUEL, FELIPE ANDRES , Evelyn Jane Corner , Catalina Merino-Osorio

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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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