Browsing by Author "Hernandez, Glenn"

Now showing 1 - 7 of 7
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    Clinical characteristics, systemic complications, and in-hospital outcomes for patients with COVID-19 in Latin America. LIVEN-Covid-19 study: A prospective, multicenter, multinational, cohort study
    (PUBLIC LIBRARY SCIENCE, 2022) Reyes, Luis F.; Bastidas, Alirio; Narvaez, Paula O.; Parra-Tanoux, Daniela; Fuentes, Yuli, V; Serrano-Mayorga, Cristian C.; Ortiz, Valentina; Caceres, Eder L.; Ospina-Tascon, Gustavo; Diaz, Ana M.; Jibaja, Manuel; Vera, Magdalena; Silva, Edwin; Gorordo-Delsol, Luis Antonio; Maraschin, Francesca; Varon-Vega, Fabio; Buitrago, Ricardo; Poveda, Marcela; Saucedo, Lina M.; Estenssoro, Elisa; Ortiz, Guillermo; Nin, Nicolas; Calderon, Luis E.; Montano, Gina S.; Chaar, Aldair J.; Garcia, Fernanda; Ramirez, Vanessa; Picoita, Fabricio; Pelaez, Cristian; Unigarro, Luis; Friedman, Gilberto; Cucunubo, Laura; Bruhn, Alejandro; Hernandez, Glenn; Martin-Loeches, Ignacio
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    Evolution of peripheral vs metabolic perfusion parameters during septic shock resuscitation. A clinical-physiologic study
    (W B SAUNDERS CO-ELSEVIER INC, 2012) Hernandez, Glenn; Pedreros, Cesar; Veas, Enrique; Bruhn, Alejandro; Romero, Carlos; Rovegno, Maximiliano; Neira, Rodolfo; Bravo, Sebastian; Castro, Ricardo; Kattan, Eduardo; Ince, Can
    Purpose: Perfusion assessment during septic shock resuscitation is difficult and usually complex determinations. Capillary refill time (CRT) and central-to-toe temperature difference (Tc-toe) have been proposed as objective reproducible parameters to evaluate peripheral perfusion. The comparative evolution of peripheral vs metabolic perfusion parameters in septic shock resuscitation has not been studied. We conducted a prospective observational clinical-physiologic study to address this subject.
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    Hypoxia-related parameters during septic shock resuscitation: Pathophysiological determinants and potential clinical implications
    (AME PUBL CO, 2020) Pavez, Nicolas; Kattan, Eduardo; Vera, Magdalena; Ferri, Giorgio; Daniel Valenzuela, Emilio; Alegria, Leyla; Bravo, Sebastian; Pairumani, Ronald; Santis, Cesar; Oviedo, Vanessa; Soto, Dagoberto; Ospina Tascon, Gustavo; Bakker, Jan; Hernandez, Glenn; Castro, Ricardo
    Background: Assessment of tissue hypoxia at the bedside has yet to be translated into daily clinical practice in septic shock patients. Perfusion markers are surrogates of deeper physiological phenomena. Lactate-to-pyruvate ratio ( LPR) and the ratio between veno-arterial PCO2 difference and Ca-vO(2) (Delta PCO2/Ca-vO(2)) have been proposed as markers of tissue hypoxia, but they have not been compared in the clinical scenario. We studied acute septic shock patients under resuscitation. We wanted to evaluate the relationship of these hypoxia markers with clinical and biochemical markers of hypoperfusion during septic shock resuscitation.
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    Intra-abdominal hypertension: Incidence and association with organ dysfunction during early septic shock
    (W B SAUNDERS CO-ELSEVIER INC, 2008) Regueira, Tomas; Bruhn, Alejandro; Hasbun, Pablo; Aguirre, Marcia; Romero, Carlos; Llanos, Osvaldo; Castro, Ricardo; Bugedo, Guillermo; Hernandez, Glenn
    Purpose: The objective of this article is to study the cumulative incidence of intra-abdominal hypertension (IAH) in septic shock (SS) patients during the first 72 hours of intensive care unit (ICU) admission and to determine if the presence and severity of IAH are associated with sepsis morbidity and mortality.
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    Persistent sepsis-induced hypotension without hyperlactatemia: Is it really septic shock?
    (W B SAUNDERS CO-ELSEVIER INC, 2011) Hernandez, Glenn; Castro, Ricardo; Romero, Carlos; de la Hoz, Claudio; Angulo, Daniela; Aranguiz, Ignacio; Larrondo, Jorge; Bujes, Andres; Bruhn, Alejandro
    Purpose: The prognostic value of hyperlactatemia in septic shock is unquestionable. However, as current definitions do not include hyperlactatemia as a mandatory criterion, some hypotensive patients may be diagnosed as having septic shock despite exhibiting normolactatemia. The significance of persistent sepsis-induced hypotension without hyperlactatemia is unclear. Is it really septic shock? Our aim was to determine differences in outcome between patients diagnosed as having septic shock but exhibiting normal vs elevated lactate levels during evolution. We also explored the potential implications of including hyperlactatemia as an obligatory diagnostic criterion.
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    Risk factors for developing ventilator-associated lower respiratory tract infection in patients with severe COVID-19: a multinational, multicentre study, prospective, observational study
    (NATURE PORTFOLIO, 2023) Reyes, Luis Felipe; Rodriguez, Alejandro; Fuentes, Yuli V.; Duque, Sara; Garcia-Gallo, Esteban; Bastidas, Alirio; Serrano-Mayorga, Cristian C.; Ibanez-Prada, Elsa D.; Moreno, Gerard; Ramirez-Valbuena, Paula C.; Ospina-Tascon, Gustavo; Hernandez, Glenn; Silva, Edwin; Diaz, Ana Maria; Jibaja, Manuel; Vera-Alarcon, Magdalena; Diaz, Emili; Bodi, Maria; Sole-Violan, Jordi; Ferrer, Ricard; Albaya-Moreno, Antonio; Socias, Lorenzo; Figueroa, William; Lozano-Villanueva, Jose L.; Varon-Vega, Fabio; Estella, Angel; Loza-Vazquez, Ana; Jorge-Garcia, Ruth; Sancho, Isabel; Shankar-Hari, Manu; Martin-Loeches, Ignacio
    Around one-third of patients diagnosed with COVID-19 develop a severe illness that requires admission to the Intensive Care Unit (ICU). In clinical practice, clinicians have learned that patients admitted to the ICU due to severe COVID-19 frequently develop ventilator-associated lower respiratory tract infections (VA-LRTI). This study aims to describe the clinical characteristics, the factors associated with VA-LRTI, and its impact on clinical outcomes in patients with severe COVID-19. This was a multicentre, observational cohort study conducted in ten countries in Latin America and Europe. We included patients with confirmed rtPCR for SARS-CoV-2 requiring ICU admission and endotracheal intubation. Only patients with a microbiological and clinical diagnosis of VA-LRTI were included. Multivariate Logistic regression analyses and Random Forest were conducted to determine the risk factors for VA-LRTI and its clinical impact in patients with severe COVID-19. In our study cohort of 3287 patients, VA-LRTI was diagnosed in 28.8% [948/3287]. The cumulative incidence of ventilator-associated pneumonia (VAP) was 18.6% [610/3287], followed by ventilator-associated tracheobronchitis (VAT) 10.3% [338/3287]. A total of 1252 bacteria species were isolated. The most frequently isolated pathogens were Pseudomonas aeruginosa (21.2% [266/1252]), followed by Klebsiella pneumoniae (19.1% [239/1252]) and Staphylococcus aureus (15.5% [194/1,252]). The factors independently associated with the development of VA-LRTI were prolonged stay under invasive mechanical ventilation, AKI during ICU stay, and the number of comorbidities. Regarding the clinical impact of VA-LRTI, patients with VAP had an increased risk of hospital mortality (OR [95% CI] of 1.81 [1.40-2.34]), while VAT was not associated with increased hospital mortality (OR [95% CI] of 1.34 [0.98-1.83]). VA-LRTI, often with difficult-to-treat bacteria, is frequent in patients admitted to the ICU due to severe COVID-19 and is associated with worse clinical outcomes, including higher mortality. Identifying risk factors for VA-LRTI might allow the early patient diagnosis to improve clinical outcomes.
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    The seven Ts of capillary refill time: more than a clinical sign for septic shock patients
    (LIPPINCOTT WILLIAMS & WILKINS, 2020) Vera, Magdalena; Kattan, Eduardo; Castro, Ricardo; Hernandez, Glenn