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2. Isavuconazole Pharmacokinetics in Critically Ill Patients: Relationship with Clinical Effectiveness and Patient Safety

Author

María Martín-Cerezuela, Cristina Maya Gallegos, María Remedios Marqués-Miñana, María Jesús Broch Porcar, Andrés Cruz-Sánchez, Juan Carlos Mateo-Pardo, José Esteban Peris Ribera, Ricardo Gimeno, Álvaro Castellanos-Ortega, José Luis Poveda Andrés, and Paula Ramírez Galleymore

Subjects
isavuconazole, pharmacokinetics, critical care, extracorporeal membrane oxygenation, antifungal, Therapeutics. Pharmacology, RM1-950
Abstract

Isavuconazole is used to treat fungal infections. This study aims to describe isavuconazole pharmacokinetics in critically ill patients and evaluate their relationship with clinical efficacy and patient safety. We conducted a prospective, observational study in patients treated with intravenous isavuconazole. Samples were collected at predose (Cmin), 1 h (Cmax) and 12 h (C50) after the last dose. The plasma concentration was determined by high-performance liquid chromatography. The relationship between plasma concentration and clinical and microbiological outcomes and safety was evaluated. The influence of covariates (age, sex, weight, SAPS3, creatinine, liver enzymes and extracorporeal devices: continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO)) was analysed. Population pharmacokinetic modelling was performed using NONMEN®. A total of 71 isavuconazole samples from 24 patients were analysed. The mean Cmin was 1.76 (1.02) mg/L; 87.5% reached the optimal therapeutic target and 12.5% were below 1 mg/L. Population pharmacokinetics were best described by a one-compartment model with first-order elimination. No factor had a significant impact on the plasma concentration or pharmacokinetic parameters. Thus, isavuconazole could be safely used in a critically ill population, even in those treated with CRRT and ECMO, from a pharmacokinetic standpoint. Therefore, routine therapeutic drug monitoring may not be strictly necessary in daily clinical practice.

Published
2024
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5. Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Author

Cabello, María Aguilar, Alcaraz-Serrano, Victoria, Aldecoa, Cesar, Alegre, Cynthia, Calderón, Ángela Algaba, Álvarez, Sergio, Ruiz, Antonio Álvarez, Andrea, Ruth, Aparicio, Maria de Alba, Arrieta, Marta, Ayestarán, J. Ignacio, Badia, Joan Ramon, Badía, Mariona, Pravia, Orville Báez, Mariño, Ana Balan, Balsera, Begoña, Barbena, Laura, Barbeta, Enric, Bardi, Tommaso, Segade, Patricia Barral, Barroso, Marta, García, José Ángel Berezo, Bermejo, Jesus, Bigas, Judit, Blancas, Rafael, Cortés, María Luisa Blasco, Saera, María Bodi, Bofill, Neus, Vieiro, María Teresa Bouza, Bueno, Leticia, Bustamante-Munguira, Juan, Martínez, Cecilia del Busto, Hermoso, David Campi, Fernández, Sandra Campos, Cano, Iosune, Canseco, Joan, Fernández, Pablo Cardinal, García, Laura Carrión, Carvalho, Sulamita, Castellà, Manuel, Castellví, Andrea, Castro, Pedro, Centelles-Serrano, María José, Ávila, Ramon Cicuendez, Cillóniz, Catia, Clar, Luisa, Climent, Cristina, Codina, Jordi, Conde, Pamela, Contreras, Sofía, Parra, Raul de Frutos, Sánchez, Raul de Pablo, Mendoza, Diego De, Díaz, Yolanda, Vilas, María Digna Rivas, Moreno, Cristina Dólera, Dot, Irene, Giraudo, Pedro Enríquez, Arijón, Inés Esmorís, Monjo, Teresa Farre, Fernández, Javier, Ferrando, Carlos, Figueras, Albert, Espina, Lorena Forcelledo, Franquesa, Enric, Furro, Àngels, Gabarrus, Albert, Galbán, Cristóbal, García, Felipe, García, Beatriz, Prieto, Emilio García, Redruello, Carlos García, Sagastume, Amaia García, Castillo, Maria Luisa Gascón, Gomà, Gemma, Casal, Vanesa Gómez, Gómez, Silvia, Gonzalez, Carmen Gómez, Gordo, Federico, Gracia, Maria Pilar, Fernández, María José Gutierrez, Herraiz, Alba, Herrán-Monge, Rubén, Ibarz, Mercedes, Iglesias, Silvia, Janer, Maria Teresa, Jiménez, Gabriel, Díaz, Mar Juan, Kiarostami, Karsa, Álvarez, Juan I. Lazo, León, Miguel, López-Gavín, Alexandre, Guerrero, Desiree Macias, Herrera, Nuria Mamolar, Mendiluce, Rafael Mañez, Mantellini, Cecilia L., Naya, Gregorio Marco, Barcos, Iris Marco, Marcos, Pilar, Peis, Enrique Marmol, Cuadrado, Marta Martín, Delgado, María Cruz Martin, Vicente, Paula Martín, Martínez, María, Fernández, Carmen Eulalia Martínez, Juan, Maria Dolores Martínez, Palacios, Basilisa Martínez, Jimenez, Juan Fernando Masa, Masclans, Joan Ramon, Maseda, Emilio, Fernández, Eva María Menor, Banderas, Priscila Metora, Minguez, Olga, Miralbés, Mar, Monclou, Josman, Montejo-González, Juan Carlos, Montserrat, Neus, Aznar, María Mora, Morales, Dulce, Cano, Sara Guadalupe Moreno, Rodríguez, David Mosquera, Muñoz-Bermúdez, Rosana, Nicolás, José María, Bou, Ramon Nogue, Salinas, Rafaela Nogueras, Ocón, Marta, Ortega, Ana, Ossa, Sergio, Pagliarani, Pablo, Parrilla, Francisco, Pedregosa-Díaz, José, Bastida, Leire Pérez, Pérez, Purificación, Pérez-García, Felipe, Planelles, Gloria Pérez, Rubio, Eva Pérez, Laguna, David Pestaña, Prados, Javier, Pujol, Andrés, Coll, Núria Ramon, Sanchez-Giron, Gloria Renedo, Roche-Campo, Ferran, Rodriguez, Laura, Castro, Felipe Rodríguez de, Rodríguez, Silvia, Ruiz, Covadonga Rodríguez, Rubio, Jorge, López, Alberto Rubio, Ruiz-García, Ángela Leonor, Miralles, Miriam Ruiz, Murúa, Pablo Ryan, Paz, Eva Saborido, Degracia, Ana Salazar, Sanchez, Miguel, Sánchez, Ana, Chinesta, Susana Sancho, Santacoloma, Bitor, Sariñena, Maria Teresa, Pensado, Marta Segura, Serra, Lidia, Serra-Fortuny, Mireia, Lázaro, Ainhoa Serrano, Servià, Lluís, Soliva, Laura, Speziale, Carla, Tormos, Adrián, Torres, Mateu, Tranque-Liberal, Celia, Trefler, Sandra, Trujillano, Javier, Vaca, Rafaela, Val, Estela, Ruiz, Luis Valdivia, Vallverdú, Montserrat, Martin-Montalvo, Maria Van der Hofstadt, Adrio, Sabela Vara, Vázquez, Nil, Vengoechea, Javier, Vilà-Vilardel, Clara, Vilanova, Judit, Warrington, Tatiana Villada, Yang, Hua, Yang, Minlan, Zapatero, Ana, González, Jessica, de Batlle, Jordi, Benítez, Iván D., Torres, Gerard, Santisteve, Sally, Targa, Adriano D.S., Gort-Paniello, Clara, Moncusí-Moix, Anna, Aguilà, Maria, Seck, Fatty, Ceccato, Adrián, Ferrer, Ricard, Motos, Anna, Riera, Jordi, Fernández, Laia, Menéndez, Rosario, Lorente, José Ángel, Peñuelas, Oscar, Garcia-Gasulla, Dario, Peñasco, Yhivian, Ricart, Pilar, Abril Palomares, Elena, Aguilera, Luciano, Rodríguez, Alejandro, Boado Varela, Maria Victoria, Beteré, Belén, Pozo-Laderas, Juan Carlos, Solé-Violan, Jordi, Salvador-Adell, Inmaculada, Novo, Mariana Andrea, Barberán, José, Amaya Villar, Rosario, Garnacho-Montero, José, Gómez, José M., Blandino Ortiz, Aaron, Tamayo Lomas, Luis, Úbeda, Alejandro, Catalán-González, Mercedes, Sánchez-Miralles, Angel, Martínez Varela, Ignacio, Jorge García, Ruth Noemí, Franco, Nieves, Gumucio-Sanguino, Víctor D., Bustamante-Munguira, Elena, Valdivia, Luis Jorge, Caballero, Jesús, Gallego, Elena, Rodríguez, Covadonga, Castellanos-Ortega, Álvaro, Trenado, Josep, Marin-Corral, Judith, Albaiceta, Guillermo M., de la Torre, Maria del Carmen, Loza-Vázquez, Ana, Vidal, Pablo, Añón, Jose M., Carbajales Pérez, Cristina, Sagredo, Victor, Carbonell, Nieves, Socias, Lorenzo, Barberà, Carme, Estella, Angel, Diaz, Emili, de Gonzalo-Calvo, David, Torres, Antoni, and Barbé, Ferran

Published
2023
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6. Contingency Plan for the Intensive Care Services for the COVID-19 pandemic

Author

Ferrer Roca, Ricard, Castellanos Ortega, Álvaro, Trenado Álvarez, Josep, Tesorero, Virginia Fraile Gutiérrez, Tejedor, Alberto Hernández, Gutiérrez, Manuel Herrera, Ramírez Galleymore, Paula, Sanz, M. Ángeles Ballesteros, Sedes, Pedro Rascado, de la Oliva Calvo, Leire López, Delgado, María Cruz Martín, Torredá, Marta Raurell, Barrio Linares, Miriam del, García, Marta Romero, García, María Teresa Ruiz, Hito, María Pilar Delgado, Mondéjar, Juan José Rodríguez, Arroyo, Carmen Moreno, Arribas, Alicia San José, Mera, María Jesús Frade, Rascado Sedes, P., Ballesteros Sanz, M.Á., Bodí Saera, M.A., Carrasco RodríguezRey, L.F., Castellanos Ortega, Á., Catalán González, M., de Haro López, C., Díaz Santos, E., Escriba Barcena, A., Frade Mera, M.J., Igeño Cano, J.C., Martín Delgado, M.C., Martínez Estalella, G., Raimondi, N., Roca i Gas, O., Rodríguez Oviedo, A., Romero San Pío, E., Trenado Álvarez, J., and Raurell, M.

Published
2020
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8. Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study

Author

Benítez, Iván D., de Batlle, Jordi, Torres, Gerard, González, Jessica, de Gonzalo-Calvo, David, Targa, Adriano D.S., Gort-Paniello, Clara, Moncusí-Moix, Anna, Ceccato, Adrián, Fernández-Barat, Laia, Ferrer, Ricard, Garcia-Gasulla, Dario, Menéndez, Rosario, Motos, Anna, Peñuelas, Oscar, Riera, Jordi, Bermejo-Martin, Jesús F., Peñasco, Yhivian, Ricart, Pilar, Martin Delgado, María Cruz, Aguilera, Luciano, Rodríguez, Alejandro, Boado Varela, Maria Victoria, Suarez-Sipmann, Fernando, Pozo-Laderas, Juan Carlos, Solé-Violan, Jordi, Nieto, Maite, Novo, Mariana Andrea, Barberán, José, Amaya Villar, Rosario, Garnacho-Montero, José, García-Garmendia, Jose Luis, Gómez, José M., Lorente, José Ángel, Blandino Ortiz, Aaron, Tamayo Lomas, Luis, López-Ramos, Esther, Úbeda, Alejandro, Catalán-González, Mercedes, Sánchez-Miralles, Angel, Martínez Varela, Ignacio, Jorge García, Ruth Noemí, Franco, Nieves, Gumucio-Sanguino, Víctor D., Huerta Garcia, Arturo, Bustamante-Munguira, Elena, Valdivia, Luis Jorge, Caballero, Jesús, Gallego, Elena, Martínez de la Gándara, Amalia, Castellanos-Ortega, Álvaro, Trenado, Josep, Marin-Corral, Judith, Albaiceta, Guillermo M, de la Torre, Maria del Carmen, Loza-Vázquez, Ana, Vidal, Pablo, Lopez Messa, Juan, Añón, Jose M., Carbajales Pérez, Cristina, Sagredo, Victor, Bofill, Neus, Carbonell, Nieves, Socias, Lorenzo, Barberà, Carme, Estella, Angel, Valledor Mendez, Manuel, Diaz, Emili, López Lago, Ana, Torres, Antoni, and Barbé, Ferran

Published
2022
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9. Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units

Author

Vidal-Cortés, P., Díaz Santos, E., Aguilar Alonso, E., Amezaga Menéndez, R., Ballesteros, M.Á., Bodí, M.A., Bordejé Laguna, M.L., Garnacho Montero, J., García Sánchez, M., López Sánchez, M., Martín-Loeches, I., Ochagavía Calvo, A., Ramírez Galleymore, P., Alcántara Carmona, S., Andaluz Ojeda, D., Badallo Arébalo, O., Barrasa González, H., Borges Sa, M., Castellanos-Ortega, Á., Estella, Á., Ferrer Roca, R., Fraile Gutiérrez, V., Fuset Cabanes, M., Giménez-Esparza Vich, C., González Iglesias, C., Hernández-Tejedor, A., Igeño Cano, J.C., Iglesias Posadilla, D., Jiménez Rivera, J.J., Llanos Jorge, C., Llompart-Pou, J.A., López Camps, V., Lorencio Cárdenas, C., Marcos Neira, P., Martín Delgado, M.C., Martín-Macho González, M., Martín Villén, L., Nuvials Casals, X., Ortiz Suñer, A., Quintana Díaz, M., Rascado Sedes, P., Recuerda Núñez, M., del Río Carbajo, L., Rodríguez Aguirregabiria, M., Rodríguez Oviedo, A., Seijas Betolaza, I., Soriano Cuesta, C., Suberviola Cañas, B., Vera Ching, C., Vidal González, Á., Zapata Fenor, L., and Zaragoza Crespo, R.

Published
2022
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10. Recomendaciones para el manejo de los pacientes críticos con COVID-19 en las Unidades de Cuidados Intensivos

Author

Vidal-Cortés, P., Díaz Santos, E., Aguilar Alonso, E., Amezaga Menéndez, R., Ballesteros, M.Á., Bodí, M.A., Bordejé Laguna, M.L., Garnacho Montero, J., García Sánchez, M., López Sánchez, M., Martín-Loeches, I., Ochagavía Calvo, A., Ramírez Galleymore, P., Alcántara Carmona, S., Andaluz Ojeda, D., Badallo Arébalo, O., Barrasa González, H., Borges Sa, M., Castellanos-Ortega, Á., Estella, Á., Ferrer Roca, R., Fraile Gutiérrez, V., Fuset Cabanes, M., Giménez-Esparza Vich, C., González Iglesias, C., Hernández-Tejedor, A., Igeño Cano, J.C., Iglesias Posadilla, D., Jiménez Rivera, J.J., Llanos Jorge, C., Llompart-Pou, J.A., López Camps, V., Lorencio Cárdenas, C., Marcos Neira, P., Martín Delgado, M.C., Martín-Macho González, M., Martín Villén, L., Nuvials Casals, X., Ortiz Suñer, A., Quintana Díaz, M., Rascado Sedes, P., Recuerda Núñez, M., del Río Carbajo, L., Rodríguez Aguirregabiria, M., Rodríguez Oviedo, A., Seijas Betolaza, I., Soriano Cuesta, C., Suberviola Cañas, B., Vera Ching, C., Vidal González, Á., Zapata Fenor, L., and Zaragoza Crespo, R.

Published
2022
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12. Seguridad del paciente, ¿qué aportan la simulación clínica y la innovación docente?

Author

Broch Porcar, María Jesús and Castellanos-Ortega, Álvaro

Abstract

La simulación clínica en medicina intensiva es un método de gran utilidad para potenciar la seguridad del paciente. Permite enfocar sobre la complejidad de la asistencia en la unidad de cuidados intensivos, donde se han de afrontar situaciones críticas que requieren decisiones rápidas y técnicas invasivas que pueden aumentar el riesgo de errores. La simulación, al reproducir contextos clínicos, resulta esencial para desarrollar habilidades técnicas y conductuales, y potenciar el trabajo en equipo en un ambiente seguro, sin daño para el paciente. La simulación in situes un enfoque valioso para entrenar en entornos de trabajo reales y detectar amenazas latentes de seguridad. Nuevos métodos como la realidad virtual y la telesimulación están ganando aceptación. Se presentan evidencias de la utilidad de la simulación clínica para mejorar la seguridad de técnicas y procedimientos, el rendimiento de los equipos y los resultados clínicos. Finalmente, se proponen líneas futuras de investigación.

Published
2025
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13. Contingency plan for the intensive care services for the COVID-19 pandemic

Author

Rascado Sedes, P., Ballesteros Sanz, M.A., Bodí Saera, M.A., Carrasco Rodríguez-Rey, L.F., Castellanos Ortega, A., Catalán González, M., de Haro López, C., Díaz Santos, E., Escriba Barcena, A., Frade Mera, M.J., Igeño Cano, J.C., Martín Delgado, M.C., Martínez Estalella, G., Raimondi, N., Roca i Gas, O., Rodríguez Oviedo, A., Romero San Pío, E., and Trenado Álvarez, J.

Published
2020
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14. Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)

Author

Rubio Sanchiz, Olga, Rodríguez Yago, Miguel Ángel, Fraile Gutiérrez, Virginia, Fuset Cabanes, M. Paz, Zapata Fenor, Lluis, Montesinos de la Peña, Manuel García, Ortega Montes, Ana, Navas Pérez, Ana, Arias Verdú, María Dolores, Pont Castellana, Teresa, Maraví Poma, Enrique, Rubio Muñoz, Juan José, del Río Gallegos, Francisco, Catalán González, Mercedes, Díaz Santos, Emili, Iglesias Posadilla, David, Riera Sagrera, María, Vera-Ching, Claudia, Lorencio Cárdenas, Carolina, González Iglesias, Carlos, Riveiro Vilaboa, Marylin, Enríquez Giraudo, Pedro, Igeño Cano, José Carlos, Cruz Martín, M., Trenado, Josep, Carlos Montejo, Juan, Sánchez Sánchez, Manuel, Giménez-Esparza Vich, Carola, Priego Sanz, Jesús, Broch Porcar, María Jesús, de la Fuente, Miguel Valdivia, Martín Delgado, M. Cruz, Palacios Castañeda, Diego, Fernández Ferreira, Aida, Socias, Antonia, Baldirà, Jaume, Gero Escapa, María, Quintana Díaz, Manuel, Marcos Neira, Pilar, Serrano Lázaro, Ainhoa, Argudo Serra, Eduard, Ferrer Roca, Ricard, Castellanos Ortega, Álvaro, Trenado Álvarez, Josep, Herrera Gutiérrez, Manuel, Ramírez Galleymore, Paula, Rascado Sedes, Pedro, de la Oliva Calvo, Leire López, Martín Delgado, María Cruz, Ballesteros Sanz, M.Á., Hernández-Tejedor, A., Estella, Á., Jiménez Rivera, J.J., González de Molina Ortiz, F.J., Sandiumenge Camps, A., Vidal Cortés, P., de Haro, C., Aguilar Alonso, E., Bordejé Laguna, L., García Sáez, I., Bodí, M., García Sánchez, M., Párraga Ramírez, M.J., Alcaraz Peñarrocha, R.M., Amézaga Menéndez, R., and Burgueño Laguía, P.

Published
2020
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15. Plan de contingencia para los servicios de medicina intensiva frente a la pandemia COVID-19

Author

Rascado Sedes, P., Ballesteros Sanz, M.A., Bodí Saera, M.A., Carrasco Rodríguez-Rey, L.F., Castellanos Ortega, A., Catalán González, M., López, C. de Haro, Díaz Santos, E., Escriba Barcena, A., Frade Mera, M.J., Igeño Cano, J.C., Martín Delgado, M.C., Martínez Estalella, G., Raimondi, N., Roca i Gas, O., Rodríguez Oviedo, A., Romero San Pío, E., and Trenado Álvarez, J.

Published
2020
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16. Plan de contingencia para los servicios de medicina intensiva frente a la pandemia COVID-19

Author

Ferrer Roca, Ricard, Castellanos Ortega, Álvaro, Trenado Álvarez, Josep, Tesorero, Virginia Fraile Gutiérrez, Tejedor, Alberto Hernández, Gutiérrez, Manuel Herrera, Ramírez Galleymore, Paula, Ballesteros Sanz, M. Ángeles, Sedes, Pedro Rascado, de la Oliva Calvo, Leire López, Delgado, María Cruz Martín, Torredá, Marta Raurell, Barrio Linares, Miriam del, García, Marta Romero, García, María Teresa Ruiz, Hito, María Pilar Delgado, Mondéjar, Juan José Rodríguez, Arroyo, Carmen Moreno, Arribas, Alicia San José, Mera, María Jesús Frade, Sedes, P. Rascado, Sanz, M.Á. Ballesteros, Saera, M.A. Bodí, RodríguezRey, L.F. Carrasco, Ortega, Á. Castellanos, González, M. Catalán, López, C. de Haro, Santos, E. Díaz, Barcena, A. Escriba, Mera, M.J. Frade, Cano, J.C. Igeño, Delgado, M.C. Martín, Estalella, G. Martínez, Raimondi, N., Gas, O. Roca i, Oviedo, A. Rodríguez, Pío, E. Romero San, Álvarez, J. Trenado, and Raurell, M.

Published
2020
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21. Isavuconazole Pharmacokinetics in Critically Ill Patients: Relationship with Clinical Effectiveness and Patient Safety.

Author

Martín-Cerezuela, María, Maya Gallegos, Cristina, Marqués-Miñana, María Remedios, Broch Porcar, María Jesús, Cruz-Sánchez, Andrés, Mateo-Pardo, Juan Carlos, Peris Ribera, José Esteban, Gimeno, Ricardo, Castellanos-Ortega, Álvaro, Poveda Andrés, José Luis, and Ramírez Galleymore, Paula

Subjects
DRUG monitoring, EXTRACORPOREAL membrane oxygenation, HIGH performance liquid chromatography, RENAL replacement therapy, LIVER enzymes
Abstract

Isavuconazole is used to treat fungal infections. This study aims to describe isavuconazole pharmacokinetics in critically ill patients and evaluate their relationship with clinical efficacy and patient safety. We conducted a prospective, observational study in patients treated with intravenous isavuconazole. Samples were collected at predose (Cmin), 1 h (Cmax) and 12 h (C50) after the last dose. The plasma concentration was determined by high-performance liquid chromatography. The relationship between plasma concentration and clinical and microbiological outcomes and safety was evaluated. The influence of covariates (age, sex, weight, SAPS3, creatinine, liver enzymes and extracorporeal devices: continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO)) was analysed. Population pharmacokinetic modelling was performed using NONMEN®. A total of 71 isavuconazole samples from 24 patients were analysed. The mean Cmin was 1.76 (1.02) mg/L; 87.5% reached the optimal therapeutic target and 12.5% were below 1 mg/L. Population pharmacokinetics were best described by a one-compartment model with first-order elimination. No factor had a significant impact on the plasma concentration or pharmacokinetic parameters. Thus, isavuconazole could be safely used in a critically ill population, even in those treated with CRRT and ECMO, from a pharmacokinetic standpoint. Therefore, routine therapeutic drug monitoring may not be strictly necessary in daily clinical practice. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Effect of pharmacokinetic/pharmacodynamic ratio on tigecycline clinical response and toxicity in critically ill patients with multidrug-resistant Gram-negative infections

Author

Jesus Ruiz, Paula Ramirez, Esther Villarreal, Mónica Gordon, María Ángeles Sánchez, María Martín, and Álvaro Castellanos-Ortega

Subjects
Medicine (General), R5-920
Abstract

Introduction: The information about the pharmacokinetics and optimal dose of tigecycline in critically ill patients with severe underlying diseases is limited and controversial. In this study, we evaluate the pharmacokinetic parameters of tigecycline in critically ill patients with multidrug-resistant Gram-negative infection and explore the association between the pharmacokinetic/pharmacodynamic ratio and treatment response. Methods: A prospective study was designed including critically ill patients treated with tigecycline for multidrug-resistant Gram-negative infections. Blood samples were collected at day 3–5 of treatment, and pharmacokinetics parameters were evaluated using NONMEM ® software. Relationship between area under the free concentration–time curve and minimum inhibitory concentration ratio (fAUC/MIC) and treatment failure was evaluated. Association between tigecycline fAUC and hepatobiliary toxicity was also investigated. Results: Twenty-five critically ill patients were included in the study. In the pharmacokinetic model, weight and total bilirubin level were found to be significant predictors of tigecycline clearance. Fifteen (60.0%) patients achieved an fAUC/MIC ratio >4.5, seven (28.0%) an fAUC/MIC > 6.96 and only three (12.0%) an fAUC/MIC > 17.9. No differences in fAUC/MIC ratio were obtained between those patients with and without clinical failure (5.28 (IC95%: 2.57–7.94) vs 8.71 (3.57–13.84)). fAUC values were higher in those patients who suffered hepatobiliary disorders (7.63 (3.93–11.34) vs 17.63 (7.85–26.28) mg/L/h). Conclusion: An important percentage of critically ill patients with multidrug-resistant Gram-negative infection treated with tigecycline do not achieve an appropriate pharmacokinetic/pharmacodynamic value. Tigecycline fAUC seems to be associated with hepatobiliary disorders in this study population. The effect of fAUC/MIC ratio on clinical response remains unclear.

Published
2020
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26. Ceftolozane/Tazobactam Dosing Requirements Against Bacteremia

Author

Jesus Ruiz, Alejandra Ferrada, Miguel Salavert, Mónica Gordon, Esther Villarreal, Álvaro Castellanos-Ortega, and Paula Ramirez

Subjects
Therapeutics. Pharmacology, RM1-950
Abstract

Objectives: To assess the probability of reaching adequate pharmacokinetic/pharmacodynamics values for ceftolozane/tazobactam at different doses and degrees of renal functions in patients with Pseudomonas aeruginosa bacteremia. Methods: Six dosing regimens were evaluated: 0.5/0.25 g, 1/0.5 g, and 2/1 g every 8 hours given as 1 hour or 3 hours infusions. Pharmacokinetic data were obtained from the literature. Susceptibility data to ceftolozane were collected from patients with P aeruginosa infection treated with ceftolozane-tazobactam. Probability of reaching a fraction of time (fT) >40% minimum inhibitory concentration (MIC) and fT >100%MIC value for ceftolozane at 3 different renal clearance values was evaluated. For tazobactam, the probability of reaching an fT >40% and >70% for 3 limit values was calculated. Results: Thirty-seven strains were included. For ceftolozane, the probability of reaching a fT >40%MIC was greater than 90% for any degree of renal function. The probability of reaching a fT >100%MIC for 1 g dose infused over 1 hour and 3 hours was 82.2% and 86.4% for a creatinine clearance (ClCr) >90 mL/min. Using a 2 g dose, the probability was greater than 90% for both infusions rates. For tazobactam, the probability of reaching a value of fT >50% of the limit concentrations was greater than 90% for a ClCr of 70 mL/min. In the case of a ClCr >90 mL/min and limit concentration values ≥ 0.25 mg/mL, only extended infusions showed a probability >90%. Conclusions and Relevance: The standard doses of ceftolozane/tazobactam achieve an adequate fT >40%MIC value. However, doses of 2 g in extended infusion is necessary to reach a value of fT >100%MIC, especially in patients with an increased renal clearance and high levels of beta-lactamases expression.

Published
2020
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27. Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic: a matched analysis

Author

Universitat Rovira i Virgili, Riera, J; Barbeta, E; Tormos, A; Mellado-Artigas, R; Ceccato, A; Motos, A; Fernandez-Barat, L; Ferrer, R; Garcia-Gasulla, D; Penuelas, O; Lorente, JA; Menendez, R; Roca, O; Palomeque, A; Ferrando, C; Sole-Violan, J; Novo, M; Boado, MV; Tamayo, L; Estella, A; Galban, C; Trenado, J; Huerta, A; Loza, A; Aguilera, L; Garmendia, JLG; Barbera, C; Gumucio, V; Socias, L; Franco, N; Valdivia, LJ; Vidal, P; Sagredo, V; Ruiz-Garcia, AL; Varela, IM; Lopez, J; Pozo, JC; Nieto, M; Gomez, JM; Blandino, A; Valledor, M; Bustamante-Munguira, E; Sanchez-Miralles, A; Penasco, Y; Barberan, J; Ubeda, A; Amaya-Villar, R; Martin, MC; Jorge, R; Caballero, J; Marin, J; Anon, JM; Sipmann, FS; Albaiceta, GM; Castellanos-Ortega, A; Adell-Serrano, B; Catalan, M; Gandara, AMD; Ricart, P; Carbajales, C; Rodriguez, A; Diaz, E; Torre, MCD; Gallego, E; Canton-Bulnes, L; Carbonell, N; Gonzalez, J; de Gonzalo-Calvo, D; Barbe, F; Torres, A, Universitat Rovira i Virgili, and Riera, J; Barbeta, E; Tormos, A; Mellado-Artigas, R; Ceccato, A; Motos, A; Fernandez-Barat, L; Ferrer, R; Garcia-Gasulla, D; Penuelas, O; Lorente, JA; Menendez, R; Roca, O; Palomeque, A; Ferrando, C; Sole-Violan, J; Novo, M; Boado, MV; Tamayo, L; Estella, A; Galban, C; Trenado, J; Huerta, A; Loza, A; Aguilera, L; Garmendia, JLG; Barbera, C; Gumucio, V; Socias, L; Franco, N; Valdivia, LJ; Vidal, P; Sagredo, V; Ruiz-Garcia, AL; Varela, IM; Lopez, J; Pozo, JC; Nieto, M; Gomez, JM; Blandino, A; Valledor, M; Bustamante-Munguira, E; Sanchez-Miralles, A; Penasco, Y; Barberan, J; Ubeda, A; Amaya-Villar, R; Martin, MC; Jorge, R; Caballero, J; Marin, J; Anon, JM; Sipmann, FS; Albaiceta, GM; Castellanos-Ortega, A; Adell-Serrano, B; Catalan, M; Gandara, AMD; Ricart, P; Carbajales, C; Rodriguez, A; Diaz, E; Torre, MCD; Gallego, E; Canton-Bulnes, L; Carbonell, N; Gonzalez, J; de Gonzalo-Calvo, D; Barbe, F; Torres, A

Abstract

Background The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with coronavirus disease 2019 (COVID-19)-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior noninvasive respiratory support on outcomes.Methods This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICUs) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of ICU admission. Propensity score matching was used to achieve a balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different time-point (48 h from ICU admission) for early and delayed intubation.Results Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After propensity score matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%; p=0.01), ICU mortality (25.7% versus 36.1%; p=0.007) and 90-day mortality (30.9% versus 40.2%; p=0.02) compared with the early intubation group. Very similar findings were observ

Published
2023

31. Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Author

González, Jessica, primary, de Batlle, Jordi, additional, Benítez, Iván D., additional, Torres, Gerard, additional, Santisteve, Sally, additional, Targa, Adriano D.S., additional, Gort-Paniello, Clara, additional, Moncusí-Moix, Anna, additional, Aguilà, Maria, additional, Seck, Fatty, additional, Ceccato, Adrián, additional, Ferrer, Ricard, additional, Motos, Anna, additional, Riera, Jordi, additional, Fernández, Laia, additional, Menéndez, Rosario, additional, Lorente, José Ángel, additional, Peñuelas, Oscar, additional, Garcia-Gasulla, Dario, additional, Peñasco, Yhivian, additional, Ricart, Pilar, additional, Abril Palomares, Elena, additional, Aguilera, Luciano, additional, Rodríguez, Alejandro, additional, Boado Varela, Maria Victoria, additional, Beteré, Belén, additional, Pozo-Laderas, Juan Carlos, additional, Solé-Violan, Jordi, additional, Salvador-Adell, Inmaculada, additional, Novo, Mariana Andrea, additional, Barberán, José, additional, Amaya Villar, Rosario, additional, Garnacho-Montero, José, additional, Gómez, José M., additional, Blandino Ortiz, Aaron, additional, Tamayo Lomas, Luis, additional, Úbeda, Alejandro, additional, Catalán-González, Mercedes, additional, Sánchez-Miralles, Angel, additional, Martínez Varela, Ignacio, additional, Jorge García, Ruth Noemí, additional, Franco, Nieves, additional, Gumucio-Sanguino, Víctor D., additional, Bustamante-Munguira, Elena, additional, Valdivia, Luis Jorge, additional, Caballero, Jesús, additional, Gallego, Elena, additional, Rodríguez, Covadonga, additional, Castellanos-Ortega, Álvaro, additional, Trenado, Josep, additional, Marin-Corral, Judith, additional, Albaiceta, Guillermo M., additional, de la Torre, Maria del Carmen, additional, Loza-Vázquez, Ana, additional, Vidal, Pablo, additional, Añón, Jose M., additional, Carbajales Pérez, Cristina, additional, Sagredo, Victor, additional, Carbonell, Nieves, additional, Socias, Lorenzo, additional, Barberà, Carme, additional, Estella, Angel, additional, Diaz, Emili, additional, de Gonzalo-Calvo, David, additional, Torres, Antoni, additional, Barbé, Ferran, additional, Cabello, María Aguilar, additional, Alcaraz-Serrano, Victoria, additional, Aldecoa, Cesar, additional, Alegre, Cynthia, additional, Calderón, Ángela Algaba, additional, Álvarez, Sergio, additional, Ruiz, Antonio Álvarez, additional, Andrea, Ruth, additional, Aparicio, Maria de Alba, additional, Arrieta, Marta, additional, Ayestarán, J. Ignacio, additional, Badia, Joan Ramon, additional, Badía, Mariona, additional, Pravia, Orville Báez, additional, Mariño, Ana Balan, additional, Balsera, Begoña, additional, Barbena, Laura, additional, Barbeta, Enric, additional, Bardi, Tommaso, additional, Segade, Patricia Barral, additional, Barroso, Marta, additional, García, José Ángel Berezo, additional, Bermejo, Jesus, additional, Bigas, Judit, additional, Blancas, Rafael, additional, Cortés, María Luisa Blasco, additional, Saera, María Bodi, additional, Bofill, Neus, additional, Vieiro, María Teresa Bouza, additional, Bueno, Leticia, additional, Bustamante-Munguira, Juan, additional, Martínez, Cecilia del Busto, additional, Hermoso, David Campi, additional, Fernández, Sandra Campos, additional, Cano, Iosune, additional, Canseco, Joan, additional, Fernández, Pablo Cardinal, additional, García, Laura Carrión, additional, Carvalho, Sulamita, additional, Castellà, Manuel, additional, Castellví, Andrea, additional, Castro, Pedro, additional, Centelles-Serrano, María José, additional, Ávila, Ramon Cicuendez, additional, Cillóniz, Catia, additional, Clar, Luisa, additional, Climent, Cristina, additional, Codina, Jordi, additional, Conde, Pamela, additional, Contreras, Sofía, additional, Parra, Raul de Frutos, additional, Sánchez, Raul de Pablo, additional, Mendoza, Diego De, additional, Díaz, Yolanda, additional, Vilas, María Digna Rivas, additional, Moreno, Cristina Dólera, additional, Dot, Irene, additional, Giraudo, Pedro Enríquez, additional, Arijón, Inés Esmorís, additional, Monjo, Teresa Farre, additional, Fernández, Javier, additional, Ferrando, Carlos, additional, Figueras, Albert, additional, Espina, Lorena Forcelledo, additional, Franquesa, Enric, additional, Furro, Àngels, additional, Gabarrus, Albert, additional, Galbán, Cristóbal, additional, García, Felipe, additional, García, Beatriz, additional, Prieto, Emilio García, additional, Redruello, Carlos García, additional, Sagastume, Amaia García, additional, Castillo, Maria Luisa Gascón, additional, Gomà, Gemma, additional, Casal, Vanesa Gómez, additional, Gómez, Silvia, additional, Gonzalez, Carmen Gómez, additional, Gordo, Federico, additional, Gracia, Maria Pilar, additional, Fernández, María José Gutierrez, additional, Herraiz, Alba, additional, Herrán-Monge, Rubén, additional, Ibarz, Mercedes, additional, Iglesias, Silvia, additional, Janer, Maria Teresa, additional, Jiménez, Gabriel, additional, Díaz, Mar Juan, additional, Kiarostami, Karsa, additional, Álvarez, Juan I. Lazo, additional, León, Miguel, additional, López-Gavín, Alexandre, additional, Guerrero, Desiree Macias, additional, Herrera, Nuria Mamolar, additional, Mendiluce, Rafael Mañez, additional, Mantellini, Cecilia L., additional, Naya, Gregorio Marco, additional, Barcos, Iris Marco, additional, Marcos, Pilar, additional, Peis, Enrique Marmol, additional, Cuadrado, Marta Martín, additional, Delgado, María Cruz Martin, additional, Vicente, Paula Martín, additional, Martínez, María, additional, Fernández, Carmen Eulalia Martínez, additional, Juan, Maria Dolores Martínez, additional, Palacios, Basilisa Martínez, additional, Jimenez, Juan Fernando Masa, additional, Masclans, Joan Ramon, additional, Maseda, Emilio, additional, Fernández, Eva María Menor, additional, Banderas, Priscila Metora, additional, Minguez, Olga, additional, Miralbés, Mar, additional, Monclou, Josman, additional, Montejo-González, Juan Carlos, additional, Montserrat, Neus, additional, Aznar, María Mora, additional, Morales, Dulce, additional, Cano, Sara Guadalupe Moreno, additional, Rodríguez, David Mosquera, additional, Muñoz-Bermúdez, Rosana, additional, Nicolás, José María, additional, Bou, Ramon Nogue, additional, Salinas, Rafaela Nogueras, additional, Ocón, Marta, additional, Ortega, Ana, additional, Ossa, Sergio, additional, Pagliarani, Pablo, additional, Parrilla, Francisco, additional, Pedregosa-Díaz, José, additional, Bastida, Leire Pérez, additional, Pérez, Purificación, additional, Pérez-García, Felipe, additional, Planelles, Gloria Pérez, additional, Rubio, Eva Pérez, additional, Laguna, David Pestaña, additional, Prados, Javier, additional, Pujol, Andrés, additional, Coll, Núria Ramon, additional, Sanchez-Giron, Gloria Renedo, additional, Roche-Campo, Ferran, additional, Rodriguez, Laura, additional, Castro, Felipe Rodríguez de, additional, Rodríguez, Silvia, additional, Ruiz, Covadonga Rodríguez, additional, Rubio, Jorge, additional, López, Alberto Rubio, additional, Ruiz-García, Ángela Leonor, additional, Miralles, Miriam Ruiz, additional, Murúa, Pablo Ryan, additional, Paz, Eva Saborido, additional, Degracia, Ana Salazar, additional, Sanchez, Miguel, additional, Sánchez, Ana, additional, Chinesta, Susana Sancho, additional, Santacoloma, Bitor, additional, Sariñena, Maria Teresa, additional, Pensado, Marta Segura, additional, Serra, Lidia, additional, Serra-Fortuny, Mireia, additional, Lázaro, Ainhoa Serrano, additional, Servià, Lluís, additional, Soliva, Laura, additional, Speziale, Carla, additional, Tormos, Adrián, additional, Torres, Mateu, additional, Tranque-Liberal, Celia, additional, Trefler, Sandra, additional, Trujillano, Javier, additional, Vaca, Rafaela, additional, Val, Estela, additional, Ruiz, Luis Valdivia, additional, Vallverdú, Montserrat, additional, Martin-Montalvo, Maria Van der Hofstadt, additional, Adrio, Sabela Vara, additional, Vázquez, Nil, additional, Vengoechea, Javier, additional, Vilà-Vilardel, Clara, additional, Vilanova, Judit, additional, Warrington, Tatiana Villada, additional, Yang, Hua, additional, Yang, Minlan, additional, and Zapatero, Ana, additional

Published
2023
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34. Análisis de la aceptación y validez de los métodos utilizados para la implementación de un programa de formación basado en competencias en un servicio de Medicina Intensiva de un hospital universitario de referencia

Author

R. García-Ros, F. Pérez, Álvaro Castellanos-Ortega, M. Barrios, M.D. Sancerni-Beitia, Paula Ramirez, Maria Jesús Broch, M.C. Fuentes-Dura, C. Vicent, and Ricardo Gimeno

Subjects
03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, business.industry, Medicine, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, business, Humanities
Abstract

Resumen Objetivos 1) Determinar la satisfaccion de tutores y residentes con la metodologia utilizada para la implementacion de CoBaTrICE, y 2) determinar la validez y la fiabilidad de las escalas de valoracion global disenados ad hoc para analizar el desempeno de los residentes con fines formativos. Diseno Estudio prospectivo de cohortes. Participantes Todos los residentes y tutores del Servicio de Medicina Intensiva del Hospital Universitario y Politecnico La Fe de Valencia. Intervencion En marzo del 2016 se inicio la implementacion de CoBaTrICE sustentada en: 1) formacion de los tutores en tecnicas de retroalimentacion; 2) realizacion por los residentes de multiples ejercicios reales de evaluacion objetiva y estructurada para adquirir las competencias del programa, y 3) uso de un portafolio electronico para registrar las evidencias del progreso y estimular la reflexion. Metodos La satisfaccion con CoBaTrICE se evaluo mediante una encuesta realizada tras 9 meses de implementacion a los 15 residentes y 5 tutores del servicio. Se pregunto sobre la metodologia de las evaluaciones, calidad de la retroalimentacion, autorregulacion del aprendizaje y utilidad del portafolio. Se determinaron la consistencia interna (alfa de Cronbach), indices de generalizabilidad y fiabilidad interjueces (indice de correlacion intraclase) de las escalas de valoracion global. Resultados La aplicacion de CoBaTrICE fue satisfactoria en todas las dimensiones estudiadas. Se constataron la validez y la fiabilidad de las escalas de valoracion utilizadas. Conclusiones La metodologia utilizada para implementar CoBaTrICE fue valorada positivamente por tutores y residentes. Las escalas de valoracion global utilizadas en la evaluacion formativa demostraron ser validas, fiables y reproducibles.

Published
2021
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35. National Survey: How Do We Approach the Patient at Risk of Clinical Deterioration outside the ICU in the Spanish Context?

Author

Clemente Vivancos, Álvaro, León Castelao, Esther, Castellanos Ortega, Álvaro, Bodi Saera, Maria, Gordo Vidal, Federico, Martin Delgado, Maria Cruz, Jorge-Soto, Cristina, Fernandez Mendez, Felipe, Igeño Cano, Jose Carlos, Trenado Álvarez, José, Caballero, Jesús, Parraga Ramirez, Manuel Jose, and Universitat Autònoma de Barcelona

Subjects
Reanimació, Clinical Deterioration, Health, Toxicology and Mutagenesis, Resuscitation, Public Health, Environmental and Occupational Health, Medical personnel, Rapid response team, Early warning score, Urgències mèdiques, Quality Improvement, Medical emergencies, Personal sanitari, Intensive Care Units, Cross-Sectional Studies, Humans, rapid response team, hospital medical emergency team, early warning score, Hospital medical emergency team, Hospital Rapid Response Team
Abstract

Background: Anticipating and avoiding preventable intrahospital cardiac arrest and clinical deterioration are important priorities for international healthcare systems and institutions. One of the internationally followed strategies to improve this matter is the introduction of the Rapid Response Systems (RRS). Although there is vast evidence from the international community, the evidence reported in a Spanish context is scarce. Methods: A nationwide cross-sectional research consisting of a voluntary 31-question online survey was performed. The Spanish Society of Intensive, Critical and Coronary Care Medicine (SEMICYUC) supported the research. Results: We received 62 fully completed surveys distributed within 13 of the 17 regions and two autonomous cities of Spain. Thirty-two of the participants had an established Rapid Response Team (RRT). Common frequency on measuring vital signs was at least once per shift but other frequencies were contemplated (48.4%), usually based on professional criteria (69.4%), as only 12 (19.4%) centers used Early Warning Scores (EWS) or automated alarms on abnormal parameters. In the sample, doctors, nurses (55%), and other healthcare professionals (39%) could activate the RRT via telephone, but only 11.3% of the sample enacted this at early signs of deterioration. The responders on the RRT are the Intensive Care Unit (ICU), doctors, and nurses, who are available 24/7 most of the time. Concerning the education and training of general ward staff and RRT members, this varies from basic to advanced and specific-specialized level, simulating a growing educational methodology among participants. A great number of participants have emergency resuscitation equipment (drugs, airway adjuncts, and defibrillators) in their general wards. In terms of quality improvement, only half of the sample registered RRT activity indicators. In terms of the use of communication and teamwork techniques, the most used is clinical debriefing in 29 centers. Conclusions: In terms of the concept of RRS, we found in our context that we are in the early stages of the establishment process, as it is not yet a generalized concept in most of our hospitals. The centers that have it are in still in the process of maturing the system and adapting themselves to our context. post-print 368 KB

Published
2022
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36. Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic: a matched analysis

Author

Riera, Jordi, primary, Barbeta, Enric, additional, Tormos, Adrián, additional, Mellado-Artigas, Ricard, additional, Ceccato, Adrián, additional, Motos, Anna, additional, Fernández-Barat, Laia, additional, Ferrer, Ricard, additional, García-Gasulla, Darío, additional, Peñuelas, Oscar, additional, Lorente, José Ángel, additional, Menéndez, Rosario, additional, Roca, Oriol, additional, Palomeque, Andrea, additional, Ferrando, Carlos, additional, Solé-Violán, Jordi, additional, Novo, Mariana, additional, Boado, María Victoria, additional, Tamayo, Luis, additional, Estella, Ángel, additional, Galban, Cristóbal, additional, Trenado, Josep, additional, Huerta, Arturo, additional, Loza, Ana, additional, Aguilera, Luciano, additional, Garmendia, José Luís García, additional, Barberà, Carme, additional, Gumucio, Víctor, additional, Socias, Lorenzo, additional, Franco, Nieves, additional, Valdivia, Luis Jorge, additional, Vidal, Pablo, additional, Sagredo, Víctor, additional, Ruiz-García, Ángela Leonor, additional, Varela, Ignacio Martínez, additional, López, Juan, additional, Pozo, Juan Carlos, additional, Nieto, Maite, additional, Gómez, José M, additional, Blandino, Aaron, additional, Valledor, Manuel, additional, Bustamante-Munguira, Elena, additional, Sánchez-Miralles, Ángel, additional, Peñasco, Yhivian, additional, Barberán, José, additional, Ubeda, Alejandro, additional, Amaya-Villar, Rosario, additional, Martín, María Cruz, additional, Jorge, Ruth, additional, Caballero, Jesús, additional, Marin, Judith, additional, Añón, José Manuel, additional, Sipmann, Fernando Suárez, additional, Muñiz, Guillermo, additional, Castellanos-Ortega, Álvaro, additional, Adell-Serrano, Berta, additional, Catalán, Mercedes, additional, de la Gándara, Amalia Martínez, additional, Ricart, Pilar, additional, Carbajales, Cristina, additional, Rodríguez, Alejandro, additional, Díaz, Emili, additional, de la Torre, Mari C, additional, Gallego, Elena, additional, Cantón-Bulnes, Luisa, additional, Carbonell, Nieves, additional, González, Jessica, additional, de Gonzalo-Calvo, David, additional, Barbé, Ferran, additional, and Torres, Antoni, additional

Published
2022
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42. National Survey: How Do We Approach the Patient at Risk of Clinical Deterioration outside the ICU in the Spanish Context?

Author

Universitat Rovira i Virgili, Clemente Vivancos Á; León Castelao E; Castellanos Ortega Á; Bodi Saera M; Gordo Vidal F; Martin Delgado MC; Jorge-Soto C; Fernandez Mendez F; Igeño Cano JC; Trenado Alvarez J; Caballero Lopez J; Parraga Ramirez MJ, Universitat Rovira i Virgili, and Clemente Vivancos Á; León Castelao E; Castellanos Ortega Á; Bodi Saera M; Gordo Vidal F; Martin Delgado MC; Jorge-Soto C; Fernandez Mendez F; Igeño Cano JC; Trenado Alvarez J; Caballero Lopez J; Parraga Ramirez MJ

Abstract

Background: Anticipating and avoiding preventable intrahospital cardiac arrest and clinical deterioration are important priorities for international healthcare systems and institutions. One of the internationally followed strategies to improve this matter is the introduction of the Rapid Response Systems (RRS). Although there is vast evidence from the international community, the evidence reported in a Spanish context is scarce. Methods: A nationwide cross-sectional research consisting of a voluntary 31-question online survey was performed. The Spanish Society of Intensive, Critical and Coronary Care Medicine (SEMICYUC) supported the research. Results: We received 62 fully completed surveys distributed within 13 of the 17 regions and two autonomous cities of Spain. Thirty-two of the participants had an established Rapid Response Team (RRT). Common frequency on measuring vital signs was at least once per shift but other frequencies were contemplated (48.4%), usually based on professional criteria (69.4%), as only 12 (19.4%) centers used Early Warning Scores (EWS) or automated alarms on abnormal parameters. In the sample, doctors, nurses (55%), and other healthcare professionals (39%) could activate the RRT via telephone, but only 11.3% of the sample enacted this at early signs of deterioration. The responders on the RRT are the Intensive Care Unit (ICU), doctors, and nurses, who are available 24/7 most of the time. Concerning the education and training of general ward staff and RRT members, this varies from basic to advanced and specific-specialized level, simulating a growing educational methodology among participants. A great number of participants have emergency resuscitation equipment (drugs, airway adjuncts, and defibrillators) in their general wards. In terms of qu

Published
2022

44. ¿Profesionales flexibles? Cocineros, enfermeras y directivos en el siglo XXI

Author

Pablo Meseguer Gancedo, Mari Luz Castellanos Ortega, and Carlos Bezos Daleske

Subjects
Directivos, cocineros, enfermeros, profesión, flexibilidad, Geography. Anthropology. Recreation, Anthropology, GN1-890
Abstract

El artículo analiza las transformaciones recientes que están aconteciendo en el trabajo de los directivos, los cocineros y las enfermeras en España. Estas transformaciones están diluyendo algunas de las características que tradicionalmente han definido a estos grupos profesionales, tanto en lo que se refiere a sus actividades productivas como en la configuración de la estructura de sus empleos y su biografía laboral. Ante estos cambios, los grupos profesionales estudiados han puesto en marcha procesos de redefinición de su identidad profesional con vistas a mantener las posiciones adquiridas en sus respectivos segmentos del mercado laboral, ahora amenazadas por la flexibilización del empleo. La suerte de estas apuestas depende del modo en que cada grupo sea capaz de construir un nuevo vínculo con sus puestos de trabajo, vínculo que se está viendo amenazado por transformaciones en los procesos de trabajo y en las formaciones de los trabajadores de estos tres sectores en un contexto de creciente competitividad.

Published
2006
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45. Extreme ultraviolet-excited time-resolved luminescence spectroscopy using an ultrafast table-top high-harmonic generation source

Author

M. L. S. van der Geest, E. I. Wooning, L. Wu, T. M. Meerwijk, Peter M. Kraus, S. Castellanos Ortega, R. Bloem, Albert M. Brouwer, Najmeh Sadegh, ARCNL, LaserLaB - Physics of Light, and Spectroscopy and Photonic Materials (HIMS, FNWI)

Subjects
Chemical Physics (physics.chem-ph), Materials science, Physics - Instrumentation and Detectors, Streak camera, business.industry, FOS: Physical sciences, Applied Physics (physics.app-ph), Instrumentation and Detectors (physics.ins-det), Physics - Applied Physics, Scintillator, Extreme ultraviolet, Picosecond, Physics - Chemical Physics, Ultrafast laser spectroscopy, Optoelectronics, Luminescence, Spectroscopy, business, Instrumentation, Ultrashort pulse, Optics (physics.optics), Physics - Optics
Abstract

We present a table-top extreme ultraviolet (XUV) beamline for measuring time- and frequency-resolved XUV-excited optical luminescence (XEOL) with additional femtosecond-resolution XUV transient absorption spectroscopy functionality. XUV pulses are generated via high-harmonic generation using a near-infrared pulse in a noble gas medium and focused to excite luminescence from a solid sample. The luminescence is collimated and guided into a streak camera where its spectral components are temporally resolved with picosecond temporal resolution. We time-resolve XUV-excited luminescence and compare the results to luminescence decays excited at longer wavelengths for three different materials: (i) sodium salicylate, an often used XUV scintillator; (ii) fluorescent labeling molecule 4-carbazole benzoic (CB) acid; and (iii) a zirconium metal oxo-cluster labeled with CB, which is a photoresist candidate for extreme-ultraviolet lithography. Our results establish time-resolved XEOL as a new technique to measure transient XUV-driven phenomena in solid-state samples and identify decay mechanisms of molecules following XUV and soft-x-ray excitation.

Published
2021
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47. In vitro study of antimicrobial activity on Klebsiella Pneumoniae biofilms in endotracheal tubes

Author

Jesus Ruiz, Carmen Amaro, Paula Ramirez, Monica Gordon, Álvaro Castellanos-Ortega, Eva Sanjuán, and Esther Villarreal

Subjects
0301 basic medicine, Pharmacology, Klebsiella, biology, Klebsiella pneumoniae, medicine.drug_class, Chemistry, 030106 microbiology, Antibiotics, Biofilm, Tigecycline, biochemical phenomena, metabolism, and nutrition, Fosfomycin, biology.organism_classification, Antimicrobial, Microbiology, 03 medical and health sciences, Minimum inhibitory concentration, 0302 clinical medicine, Infectious Diseases, Oncology, 030220 oncology & carcinogenesis, medicine, Pharmacology (medical), medicine.drug
Abstract

Effective treatment approaches for biofilms in endotracheal tubes (ETTs) are lacking. In this study, we evaluated the in vitro effects of five antimicrobials against biofilms formed by Klebsiella pneumoniae in ETTs. K. pneumoniae was added to minimal mucin medium prior to inoculation in microtiter plates containing ETT fragments. Biofilm susceptibility was assessed by crystal violet staining. At 24 h, the antimicrobials significantly reduced biofilm formation. At 48 h, all of the antimicrobial agents exhibited significant reductions in biofilm formation, even at concentrations above the minimum inhibitory concentration (MIC). Tigecycline and fosfomycin showed the greatest inhibition capacity, with good activity at concentrations twofold greater than the MIC. K. pneumoniae exhibited excellent biofilm formation ability, with formation in the first 24 h and significantly reduced antimicrobial activity. These results contribute to the establishment of new antibiotic breakpoints for the adequate management of infections associated with biofilm formation. Abbreviations ETT Endotracheal tube MIC Minimum inhibitory concentration MBIC Minimum biofilm inhibitory concentration OD Optical density PBS Phosphate-buffered saline VAP Ventilator-associated pneumonia.

Published
2019
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48. Recomendaciones para el manejo de los pacientes críticos con COVID-19 en las Unidades de Cuidados Intensivos

Author

E Díaz Santos, P. Vidal-Cortés, A Rodríguez Oviedo, E. Aguilar Alonso, S. Alcántara Carmona, A. Hernández-Tejedor, J. Garnacho Montero, C. Soriano Cuesta, Á. Castellanos-Ortega, C. Lorencio Cárdenas, M. López Sánchez, Ignacio Martin-Loeches, V. Fraile Gutiérrez, V. López Camps, C. Llanos Jorge, P. Marcos Neira, M.C. Martín Delgado, H. Barrasa González, R. Ferrer Roca, C Giménez-Esparza Vich, R. Amézaga Menéndez, M. Borges Sa, I. Seijas Betolaza, J.J. Jiménez Rivera, D. Iglesias Posadilla, B. Suberviola Cañas, D. Andaluz Ojeda, R. Zaragoza Crespo, M. Recuerda Núñez, A. Ortiz Suñer, M. Quintana Díaz, L. Martín Villén, M. Rodríguez Aguirregabiria, M.P. Fuset Cabanes, Angel Estella, J.A. Llompart-Pou, M.A. Bodí, M.Á. Ballesteros, J.C. Igeño Cano, L. Zapata Fenor, P. Ramírez Galleymore, X. Nuvials Casals, P. Rascado Sedes, A. Ochagavía Calvo, L. del Río Carbajo, M. Martín-Macho González, O. Badallo Arébalo, C. González Iglesias, M.L. Bordejé Laguna, M. García Sánchez, C. Vera Ching, and Á. Vidal González

Subjects
Critical care, Intensive Care Units, COVID-19 Testing, business.industry, SARS-CoV-2, Medicine, COVID-19, COVID-19 drug treatment, Critical Care and Intensive Care Medicine, business, Humanities
Abstract

Resumen La pandemia por COVID-19 ha provocado el ingreso de un elevado numero de pacientes en UCI, generalmente por insuficiencia respiratoria severa. Desde la aparicion de los primeros casos de infeccion por SARS-CoV-2, a finales de 2019, en China, se ha publicado una cantidad ingente de recomendaciones de tratamiento de esta entidad, no siempre respaldadas por evidencia cientifica suficiente ni con el rigor metodologico necesario. Gracias al esfuerzo de distintos grupos de investigadores, actualmente disponemos de resultados de ensayos clinicos, y otro tipo de estudios, de mayor calidad. Consideramos necesario realizar un documento que incluya recomendaciones que recojan estas evidencias en cuanto al diagnostico y tratamiento de la COVID-19, pero tambien aspectos que otras guias no han contemplado y que consideramos fundamentales en el manejo del paciente critico con COVID-19. Para ello se ha creado un comite redactor, conformado por miembros de los Grupos de Trabajo de SEMICYUC mas directamente relacionados con diferentes aspectos especificos del manejo de estos pacientes.

Published
2021

49. Hospital mortality prognostication in sepsis using the new biomarkers suPAR and proADM in a single determination on ICU admission

Author

Suberviola, B., Castellanos-Ortega, A., Ruiz Ruiz, A., Lopez-Hoyos, M., and Santibañez, M.

Subjects
Prognosis, Patient outcomes, Mortality -- Spain -- Taiwan, C-reactive protein, Medical research, Infection -- Patient outcomes -- Prognosis, EDTA, Biological markers, Medicine, Experimental, Ethylenediaminetetraacetic acid
Abstract

Author(s): B. Suberviola [sup.1], A. Castellanos-Ortega [sup.1], A. Ruiz Ruiz [sup.1], M. Lopez-Hoyos [sup.2], M. Santibañez [sup.3] Author Affiliations: (1) grid.411325.0, 0000000106274262, Intensive Care Department, University Hospital Marques de Valdecilla-IFIMAV, [...], Purpose The soluble form of the urokinase-type plasminogen activator receptor (suPAR) and proadrenomedullin (proADM) are two new and promising sepsis biomarkers. We assessed the prognostic value of a single determination of proADM and suPAR, comparing them with C-reactive protein (CRP) and procalcitonin (PCT), and evaluating whether their addition to severity scores (APACHE II and SOFA) could improve their prognostic accuracy. Methods A single-centre prospective observational study conducted in an adult intensive care department at Marques de Valdecilla University Hospital in Spain. APACHE II and SOFA scores, CRP, PCT, suPAR and proADM levels on the day of ICU admission were collected. Results A total of 137 consecutive septic patients were studied. The best area under the curve (AUC) for the prediction of in-hospital mortality was for APACHE II (0.82) and SOFA (0.75) scores. The ROC curve for suPAR yielded an AUC of 0.67, higher than proADM (0.62), CRP (0.50) and PCT (0.44). Significant dose-response trends were found between hospital mortality and suPAR (OR Q4 = 4.83, 95 % CI 1.60-14.62) and pro-ADM (OR Q4 = 3.00, 95 % CI 1.06-8.46) quartiles. Non-significant associations were found for PCT and CRP. The combination of severity scores and each biomarker did not provide superior AUCs. Conclusions SuPAR and, to a lesser extent, proADM levels on ICU admission were better tools in prognosticating in-hospital mortality than CRP or PCT. However, neither of the two new biomarkers has been demonstrated to be excessively useful in the current setting. The prognostic accuracy was better for severity scores than for any of the biomarkers.

Published
2013
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50. Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units

Author

Vidal-Cortés, P., primary, Díaz Santos, E., additional, Aguilar Alonso, E., additional, Amezaga Menéndez, R., additional, Ballesteros, M.Á., additional, Bodí, M.A., additional, Bordejé Laguna, M.L., additional, Garnacho Montero, J., additional, García Sánchez, M., additional, López Sánchez, M., additional, Martín-Loeches, I., additional, Ochagavía Calvo, A., additional, Ramírez Galleymore, P., additional, Alcántara Carmona, S., additional, Andaluz Ojeda, D., additional, Badallo Arébalo, O., additional, Barrasa González, H., additional, Borges Sa, M., additional, Castellanos-Ortega, Á., additional, Estella, Á., additional, Ferrer Roca, R., additional, Fraile Gutiérrez, V., additional, Fuset Cabanes, M., additional, Giménez-Esparza Vich, C., additional, González Iglesias, C., additional, Hernández-Tejedor, A., additional, Igeño Cano, J.C., additional, Iglesias Posadilla, D., additional, Jiménez Rivera, J.J., additional, Llanos Jorge, C., additional, Llompart-Pou, J.A., additional, López Camps, V., additional, Lorencio Cárdenas, C., additional, Marcos Neira, P., additional, Martín Delgado, M.C., additional, Martín-Macho González, M., additional, Martín Villén, L., additional, Nuvials Casals, X., additional, Ortiz Suñer, A., additional, Quintana Díaz, M., additional, Rascado Sedes, P., additional, Recuerda Núñez, M., additional, del Río Carbajo, L., additional, Rodríguez Aguirregabiria, M., additional, Rodríguez Oviedo, A., additional, Seijas Betolaza, I., additional, Soriano Cuesta, C., additional, Suberviola Cañas, B., additional, Vera Ching, C., additional, Vidal González, Á., additional, Zapata Fenor, L., additional, and Zaragoza Crespo, R., additional

Published
2021
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