Browsing by Author "Valenzuela, Gonzalo"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Extubation failure after cardiac surgery in children with Down syndrome
    (2023) Salgado, Fernanda; Larios, Guillermo; Valenzuela, Gonzalo; Amstein, Rodolfo; Valle, Patricio; Valderrama, Paulo
    Extubation failure (EF) after cardiac surgery is associated with poorer outcomes. Approximately 50% of children with Down syndrome (DS) have congenital heart disease. Our primary aim was to describe the frequency of EF and identify risk factors for its occurrence in a population of patients with DS after cardiac surgery. Secondary aims were to describe complications, length of hospital stay, and mortality rates. This report was a retrospective case-control study and was carried out in a national reference congenital heart disease repair center of Chile. This study includes all infants 0-12 months old with DS who were admitted to pediatric intensive care unit after cardiac surgery between January 2010 and November 2020. Patients with EF (cases) were matched 1:1 with children who did not fail their extubation (controls) using the following criteria: age at surgery, sex, and type of congenital heart disease. Overall, 27/226 (11.3%) failed their first extubation. In the first analysis, before matching of cases and controls was made, we found association between EF and younger age (3.8 months vs 5 months; p = 0.003) and presence of coarctation of the aorta (p = 0.005). In the case-control univariate analysis, we found association between an increased cardiothoracic ratio (CTR) (p = 0.03; OR 5 (95% CI 1.6-16.7) for a CTR > 0.59) and marked hypotonia (27% vs 0%; p = 0.01) with the risk of EF. No differences were found in ventilatory management.Conclusions: In pediatric patients with DS, EF after cardiac surgery is associated with younger age, presence of aortic coarctation, higher CTR reflecting the degree of cardiomegaly and hypotonia. Recognition of these factors may be helpful when planning extubation for these patients.
  • Thumbnail Image
    Item
    Induction of SARS-CoV-2 neutralizing antibodies by CoronaVac and BNT162b2 vaccines in naive and previously infected individuals
    (2022) Muena, Nicolas A.; Garcia-Salum, Tamara; Pardo-Roa, Catalina; Jose Avendano, Maria; Serrano, Eileen F.; Levican, Jorge; Almonacid, Leonardo, I; Valenzuela, Gonzalo; Poblete, Estefany; Strohmeier, Shirin; Salinas, Erick; Munoz, Andres; Haslwanter, Denise; Dieterle, Maria Eugenia; Jangra, Rohit K.; Chandran, Kartik; Gonzalez, Claudia; Riquelme, Arnoldo; Krammer, Florian; Tischler, Nicole D.; Medina, Rafael A.
    Interpretation The decay of nAbs titres in previously infected individuals over time indicates that vaccination is needed to boost humoral memory responses. Immunization of naydve individuals with two doses of CoronaVac induced nAbs titres that were significantly lower to that of convalescent patients, and similar to vaccination with one dose of BTN162b2. The real life effectiveness for CoronaVac in Chile was higher than estimated; indicating that lower titres and additional cellular immune responses induced by CoronaVac might afford protection in a highly immunized population. Nevertheless, the lower nAb titre induced by two doses of CoronaVac as compared to the BTN162b2 vaccine in naydve individuals, highlights the need of booster immunizations over time to maintain protec-tive levels of antibody, particularly with the emergence of new SARS-CoV-2 variants. Funding FONDECYT 1161971, 1212023, 1181799, FONDECYT Postdoctorado 3190706 and 3190648, ANID Becas/ Doctorado Nacional 21212258, PIA ACT 1408, CONICYT REDES180170, Centro Ciencia & Vida, FB210008, Finan-ciamiento Basal para Centros Cient?ficos y Tecnol?ogicos de Excelencia grants from the Agencia Nacional de Inves-tigaci?on y Desarrollo (ANID) of Chile; NIH-NIAD grants U19AI135972, R01AI132633 and contracts HHSN272201400008C and 75N93019C00051; the JPB Foundation, the Open Philanthropy Project grant 2020-215611 (5384); and by anonymous donors. The funders had no role in study design, data collection and analysis, deci-sion to publish, or preparation of the manuscript. Copyright (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)