3 results on '"Rebeca Armenta Fernández"'
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2. The role of Intermediate Respiratory Care Units in preventing ICU collapse during the COVID pandemic
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Lorena de la Fuente, Pablo López Yeste, Elena Cabezas Pastor, Pablo Minguez, Marcel Jose Rodriguez Guzman, Sarah Heili, Germán Peces-Barba Romero, María José Checa Venegas, Abdulkader El Hachem Debek, Alba Naya Prieto, María del Pilar Carballosa de Miguel, Ainhoa Izquierdo Pérez, Andrés Giménez Velando, Francisco Laso del Hierro, Antonio Herrero González, Sandra Pelicano Vizuete, Ignacio Mahillo Fernández, Farah Ezzine de Blas, Rebeca Armenta Fernández, Marwan Mohamed Choukri, Herminia Ortiz Mayoral, Itziar Fernández Ormaechea, and Luis Jiménez Hiscock
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medicine.medical_specialty ,business.industry ,Pandemic ,medicine ,medicine.symptom ,Respiratory Care Units ,Intensive care medicine ,business ,Collapse (medical) - Abstract
Introduction : There is limited information describing features and outcomes of patients requiring Intermediate Respiratory Care Unit (IRCU) hospitalization for COVID19 disease and as of yet, no mechanical or medical treatments have clearly demonstrated efficacy in IRCU. Methods : Demographics and clinical variables on admission, as well as medical and mechanical therapeutic interventions, were extracted from Electronic Clinical Records in 274 SARS-CoV-2 infected patients attending a third level hospital IRCU. Using multivariate logistic regression analysis, variables that best discriminated mortality were obtained. Principal components analysis and a neural network (NN) algorithm were applied. Results : In relation to respiratory support, high-flow oxygen therapy and weaning procedures were associated with survival as were CPAP and non-invasive ventilation with low levels of support among the most severely affected. The IRCU achieved a survival rate of 87.6%, avoided 178 ICU admissions, successfully referred 35% to the ICU, and of these, 94% later survived the weaning phase. Higher mortality incidence was associated with cardiac and respiratory diseases and fever, heart rhythm and blood pressure disturbances. Following analysis of specific therapeutic options Corticoids and Anticoagulants were associated with better outcomes. Conclusions : The IRCU prevented the collapse of the ICU, allowed for recovered ICU patients to be quickly released from their unit, thus freeing up critical care beds and permitting them to function more effectively and in terms of mortality, achieved good results, that did not worsen due to a possible delay in intubation. In addition, we have generated an open-access NN capable of identifying severity predictors of SARS-CoV-2.
- Published
- 2020
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3. Home care in patients hospitalized for exacerbation of COPD
- Author
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Rebeca Armenta Fernández, Itziar Fernández Ormaechea, Diana Sánchez Mellado, Elena Cabezas Pastor, María Teresa Gómez del Pulgar Murcia, Germán Peces-Barba Romero, María José Checa Venegas, Andrés Giménez Velando, Felipe Villar Álvarez, and Laura Álvarez Suárez
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COPD ,medicine.medical_specialty ,Chronic bronchitis ,Exacerbation ,business.industry ,medicine.disease ,Comorbidity ,Karnofsky index ,Emergency medicine ,medicine ,Observational study ,In patient ,business ,Intensive care medicine ,Respiratory care - Abstract
INTRODUCTION: With the objective of reducing the rate of readmissions of discharged for COPD exacerbation, our chronic outpatient respiratory care unit (UCCRA) was created. METHODS: Observational study in which we compared data of patient included in UCCRA from January to October 2015 with patients with not home care, and with the patients included in UCCRA in the same period in 2014 with only telephone follow-up. Patients were admitted in UCCRA if they fit our criteria, based on our Readmission Risk Scale (RRS) that incorporates these variables: age, exacerbations (hospitalization or not) in the last year, FEV1, bacterial colonization, chronic bronchitis, Karnofsky index and cardiovascular comorbidity. Patients were included in UCCRA if they had suffered > 2 hospitalizations in the last year or > 7 points in our RRS. RESULTS: We included 399 patients, 234 patients were discharged after an exacerbation of COPD in 2015, with a mean age (MA) of 71.8 years, mean stay (MS) of 7.4 days and 13.3% of readmissions. 108 were included in UCCRA, who had significantly higher MS and previous exacerbations, reduced FEV1 and Karnofsky, and higher percentage of readmissions than not included (22.2 vs 6.3%). Patients with home care in 2015, compared with 2014 with telephone follow-up (165 patients, MA: 72.6, MS: 6.2), had more previous non-hospital exacerbations (p CONCLUSIONS: UCCRA with home care was valid to reduce readmissions in COPD patients, compared with telephone follow-up. Previous hospitalizations was the variable that better predict readmission.
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- 2016
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