Browsing by Author "Vera, Magdalena"

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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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    Expanding ICU facilities in a pandemic scenario
    (SOC MEDICA SANTIAGO, 2020) Andresen, Max; Born, Pablo; Kattan, Eduardo; Vera, Magdalena; Cataldo, Alejandro; Ruiz, Carolina; Bravo, Sebastian
    Our country is suffering the effects of the ongoing pandemic of coronavirus disease (COVID-19). Because the vulnerability of healthcare systems, especially the intensive care areas they can rapidly be overloaded. That challenge the ICUs simultaneously on multiple fronts making urgent to increase the number of beds, without lowering the standards of care. The purpose of this article is to discuss some aspects of the national situation and to provide recommendations on the organizational management of intensive care units such as isolation protocols, surge in ICU bed capacity, ensure adequate supplies, protect and train healthcare workers maintaining quality clinical management.
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    How far are we from predicting multi-drug interactions during treatment for COVID-19 infection?
    (WILEY, 2022) Lozano, Benjamin; Santibanez, Javier; Severino, Nicolas; Saldias, Cristina; Vera, Magdalena; Retamal, Jaime; Torres, Soledad; Barrera, Nelson P.
    Seriously ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and hospitalized in intensive care units (ICUs) are commonly given a combination of drugs, a process known as multi-drug treatment. After extracting data on drug-drug interactions with clinical relevance from available online platforms, we hypothesize that an overall interaction map can be generated for all drugs administered. Furthermore, by combining this approach with simulations of cellular biochemical pathways, we may be able to explain the general clinical outcome. Finally, we postulate that by applying this strategy retrospectively to a cohort of patients hospitalized in ICU, a prediction of the timing of developing acute kidney injury (AKI) could be made. Whether or not this approach can be extended to other diseases is uncertain. Still, we believe it represents a valuable pharmacological insight to help improve clinical outcomes for severely ill patients.
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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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    Implementation of Distance-Based Simulation Training Programs for Healthcare Professionals Breaking Barriers During COVID-19 Pandemic
    (LIPPINCOTT WILLIAMS & WILKINS, 2021) Vera, Magdalena; Kattan, Eduardo; Cerda, Tomas; Niklitshek, Jessie; Montana, Rodrigo; Varas, Julian; Corvetto, Marcia A.
    A Summary Statement: The sudden rise of critically ill patients secondary to the SARS-CoV-2 pandemic has triggered a surge in healthcare response. This project's goal was to provide essential cognitive and technical skills to healthcare professionals returning to the workforce or reassigned to critical care clinical duties during the COVID-19 pandemic. The plan included the implementation of 4 distance-based simulation training programs, with asynchronous personalized feedback. The courses allowed the acquisition of skills for the complete critical care patient management chain: use of personal protection equipment, use of a high-flow nasal cannula, endotracheal intubation, and prone positioning. Participants logged into the platform, reviewed material, practiced while recording the session, and uploaded the video through the training platform. The expert tutor remotely delivered asynchronous feedback. Participants trained remotely until achieving course approval. Remote-based simulation seems a feasible and attractive alternative to provide adequate educational solutions, especially for remote and rural areas.
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    Reduction of Respiratory Rate in COVID-19-Associated ARDS
    (2022) Damiani, L. Felipe; Oviedo, Vanessa; Alegria, Leyla; Soto, Dagoberto; Basoalto, Roque; Consuelo Bachmann, M.; Jalil Contreras, Yorschua Frederick; Santis, Cesar; Vera, Magdalena; Retamal, Jaime; Bruhn, Alejandro; Bugedo, Guillermo
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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
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    Trasplante hepático: Evolución, curva de aprendizaje y resultados después de los primeros 300 casos
    (2019) Francisco Guerra, Juan; Luis Quezada, Jose; Cancino, Alejandra; Arrese, Marco; Wolff, Rodrigo; Benitez, Carlos; Carlos Pattillo, Juan; Cristobal Gana, Juan; Concha, Mario; Cortinez, Luis; Vera, Magdalena; Miranda, Paula; Rubilar, Francisco; Troncoso, Andres; Briceno, Eduardo; Dib, Martin; Jarufe, Nicolas; Martinez, Jorge
    Background: Liver transplantation (LT) is an option for people with liver failure who cannot be cured with other therapies and for some people with liver cancer. Aim: To describe, and analyze the first 300 LT clinical results, and to establish our learning curve. Material and Methods: Retrospective cohort study with data obtained from a prospectively collected LT Program database. We included all LT performed at a single center from March 1994 to September 2017. The database gathered demographics, diagnosis, indications for LT, surgical aspects and postoperative courses. We constructed a cumulative summation test for learning curve (LC-CUSUM) using 30-day post-LT mortality. Mortality at 30 days, and actuarial 1-, and 5-year survival rate were analyzed. Results: A total of 281 patients aged 54 (0-71) years (129 women) underwent 300 LT. Ten percent of patients were younger than 18 years old. The first, second and third indications for LT were non-alcoholic steatohepatitis, chronic autoimmune hepatitis and alcoholic liver cirrhosis, respectively. Acute liver failure was the LT indication in 51 cases (17%). The overall complication rate was 71%. Infectious and biliary complications were the most common of them (47 and 31% respectively). The LC-CUSUM curve shows that the first 30 patients corresponded to the learning curve. The peri-operative mortality was 8%. Actuarial 1 and 5-year survival rates were 82 and 71.4%, respectively. Conclusions: Outcome improvement of a LT program depends on the accumulation of experience after the first 30 transplants and the peri-operative mortality directly impacted long-term survival.