LEPPE ZAMORA, JAIME ESTEBAN
Thumbnail Image
Preferred name
LEPPE ZAMORA, JAIME ESTEBAN
Main Affiliation
Email
jleppe@udd.cl
ORCID
Scopus Author ID
56875386300

Research Output

2024 2024 2023 2023 2022 2022 2021 2021 2020 2020 0.0 0.0 0.2 0.2 0.4 0.4 0.6 0.6 0.8 0.8 1.0 1.0 1.2 1.2 1.4 1.4 1.6 1.6 1.8 1.8 2.0 2.0

Filters

6
Reset filters

Settings
Now showing 1 - 6 of 6
No Thumbnail Available
Publication

Uninterrupted Actigraphy Recording to Quantify Physical Activity and Sedentary Behaviors in Mechanically Ventilated Adults

2022 , Felipe González-Seguel , Agustín Camus-Molina , Macarena Leiva-Corvalán , Kirby P. Mayer , Jaime Leppe

Purpose: We evaluated the feasibility of quantification of physical activity (PA) and sedentary behaviors (SB) using actigraphy during an entire intensive care unit (ICU) length of stay. Methods: A prospective study was performed in a 12-bed ICU. Triaxial accelerometers were fitted on the right ankle of mechanically ventilated adults. Twenty accelerometers were available to guarantee uninterrupted actigraphy recording 24 hours/day. Data were analyzed: (1) between awakening and ICU discharge to quantify daytime PA/SB and (2) between admission and ICU discharge to quantify day/nighttime inactivity. Secondarily, we assessed the relationship between inactivity/SB and clinical variables. Results: Thirty patients were enrolled, obtaining 5477 recording hours. No patient reported discomfort or injury. The median (min-max) delay time between admission and accelerometer installation was 2.1 (0.0-11.9) hours. Actigraphy recording duration was 5.4 (2.2-34.4) days. The time spent in SB and PA (percentage of minutes per hour) was 94.7% and 5.3%, respectively. PA was stratified by light, moderate, and vigorous levels equating to 91.8%, 7.7%, and 0.5%, respectively. Inactivity time (r = 0.991, P ≤ .001) and SB (r = 0.859, P ≤ .001) were strongly correlated with ICU length of stay. Conclusions: Quantifying PA levels with continuous monitoring through actigraphy is feasible, demonstrating prolonged periods of inactivity/SB. This study highlights that uninterrupted actigraphy could contribute to pursuing the optimal dose and the intervention fidelity of the ICU mobilization in the subsequent clinical trials.

View
No Thumbnail Available
Publication

Construct Validity of the Chilean-Spanish Version of the Functional Status Score for the Intensive Care Unit: A Prospective Observational Study Using Actigraphy in Mechanically Ventilated Patients

2020 , CAMUS MOLINA, AGUSTIN , Felipe González-Seguel , CASTRO AVILA, ANA CRISTINA , LEPPE ZAMORA, JAIME ESTEBAN

View
No Thumbnail Available
Publication

Uninterrupted Actigraphy Recording to Quantify Physical Activity and Sedentary Behaviors in Mechanically Ventilated Adults

2022 , Felipe González-Seguel , Agustín Camus-Molina , Macarena Leiva-Corvalán , Kirby P. Mayer , LEPPE ZAMORA, JAIME ESTEBAN

Purpose: We evaluated the feasibility of quantification of physical activity (PA) and sedentary behaviors (SB) using actigraphy during an entire intensive care unit (ICU) length of stay. Methods: A prospective study was performed in a 12-bed ICU. Triaxial accelerometers were fitted on the right ankle of mechanically ventilated adults. Twenty accelerometers were available to guarantee uninterrupted actigraphy recording 24 hours/day. Data were analyzed: (1) between awakening and ICU discharge to quantify daytime PA/SB and (2) between admission and ICU discharge to quantify day/nighttime inactivity. Secondarily, we assessed the relationship between inactivity/SB and clinical variables. Results: Thirty patients were enrolled, obtaining 5477 recording hours. No patient reported discomfort or injury. The median (min-max) delay time between admission and accelerometer installation was 2.1 (0.0-11.9) hours. Actigraphy recording duration was 5.4 (2.2-34.4) days. The time spent in SB and PA (percentage of minutes per hour) was 94.7% and 5.3%, respectively. PA was stratified by light, moderate, and vigorous levels equating to 91.8%, 7.7%, and 0.5%, respectively. Inactivity time (r = 0.991, P ≤ .001) and SB (r = 0.859, P ≤ .001) were strongly correlated with ICU length of stay. Conclusions: Quantifying PA levels with continuous monitoring through actigraphy is feasible, demonstrating prolonged periods of inactivity/SB. This study highlights that uninterrupted actigraphy could contribute to pursuing the optimal dose and the intervention fidelity of the ICU mobilization in the subsequent clinical trials.

View
No Thumbnail Available
Publication

Daily compliance of the ABCDEF liberation bundle for patients in the intensive care unit: A retrospective descriptive study

2024 , Felipe Muñoz-Muñoz , LEPPE ZAMORA, JAIME ESTEBAN , Felipe González-Seguel , CASTRO AVILA, ANA CRISTINA

Introduction Implementing the ABCDEF bundle has demonstrated improved outcomes in patients with critical illness. This study aims to describe the daily compliance of the ABCDEF bundle in a Chilean intensive care unit. Methods Retrospective observational study of electronic clinical records of nursing, physiotherapy, and medical professionals who cared for patients over 18 years of age, admitted to an intensive care unit for at least 24 hours, with or without mechanical ventilation. Daily bundle compliance was determined by considering the daily records for each element: Assess pain (element A), both spontaneous awakening trials (element B1) and spontaneous breathing trials (element B2), choice of sedation (element C), delirium assessment (element D), early mobilization (element E), and family engagement (element F). Results 4165 registered bundle elements were obtained from nursing (47%), physiotherapy (44%), and physicians (7%), including 1134 patient/days (from 133 patients). Elements E and C showed 67 and 40% compliance, while D, A, and B2 showed 24, 14 and 11%, respectively. For B1 and F, 0% compliance was achieved. Compliance was higher in patients without mechanical ventilation for A and E, while it was similar for D. Conclusions Early mobilization had the highest compliance, while spontaneous awakening trials and family engagement had absolute non-compliance. Future studies should explore the reasons for the different degrees of compliance per bundle element in clinical practice.

View
No Thumbnail Available
Publication

Impact on Mental, Physical and Cognitive functioning of a Critical care sTay during the COVID-19 pandemic (IMPACCT COVID-19): protocol for a prospective, multicentre, mixed-methods cohort study

2021 , CASTRO AVILA, ANA CRISTINA , Catalina Merino-Osorio , Felipe González-Seguel , CAMUS MOLINA, AGUSTIN , LEPPE ZAMORA, JAIME ESTEBAN

IntroductionThe ongoing pandemic could affect the duration, variety and severity of the mental, physical, and cognitive impairments intensive care unit (ICU) survivors and their families frequently present. We aim to determine the impact of the COVID-19 pandemic on the mental, physical, and cognitive health of survivors, the experience of their families and their treating healthcare professionals.Methods and analysisProspective, multicentre, mixed-methods cohort study in seven Chilean ICUs. Sample: 450 adults, able to walk independently prior to admission, in ICU and mechanical ventilation >48 hours with and without COVID-19. Clinical Frailty Scale, Charlson comorbidity index, mobility (Functional Status Score for the Status Score for the Intensive Care Unit) and muscle strength (Medical Research Council Sum Score) will be assessed at ICU discharge. Cognitive functioning (Montreal Cognitive Assessment–blind), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Impact of Event Scale-Revised) symptoms, disability (WHO Disability Assessment Schedule 2.0), quality of life (European Quality of Life Health Questionnaire), employment and survival will be assessed at ICU discharge, 3 months and 6 months. A sample will be assessed using actigraphy and the Global Physical Activity Questionnaire at 6 months after ICU discharge. Trajectories of mental, physical, and cognitive impairments will be estimated using multilevel longitudinal modelling. A sensitivity analysis using multiple imputations will be performed to account for missing data and loss-to-follow-up. Survival will be analysed using Kaplan-Meier curves. The perceptions of family members regarding the ICU stay and the later recovery will be explored 3 months after discharge. Healthcare professionals will be invited to discuss the challenges faced during the pandemic using semistructured interviews. Interviews will be thematically analysed by two independent coders to identify the main themes of the experience of family members and healthcare professionals.Ethics and disseminationThe study was approved by the Clinica Alemana Universidad del Desarrollo Ethics Committee (2020–78) and each participating site. Study findings will be published in peer-reviewed journals and disseminated through social media and conference meetings.Trial registration numberNCT04979897.

View
No Thumbnail Available
Publication

Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS

2021 , Felipe González-Seguel , Juan José Pinto-Concha , Nadine Aranis , LEPPE ZAMORA, JAIME ESTEBAN

View