10 results on '"Robayo-Amortegui H"'
Search Results
2. Clinical utility of rapid shallow breathing index in predicting successful weaning: secondary analysis of the COBRE-US trial.
- Author
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Varón-Vega F, Tuta-Quintero E, Robayo-Amortegui H, Rincón A, Giraldo-Cadavid LF, Palacios J, Crevoisier S, Duarte DC, Poveda M, Cucunubo L, and Monedero P
- Subjects
- Humans, Male, Middle Aged, Prospective Studies, Female, Aged, Intensive Care Units, ROC Curve, Time Factors, Predictive Value of Tests, Critical Illness, Ventilator Weaning methods, Ventilator Weaning statistics & numerical data, Airway Extubation statistics & numerical data, Respiration, Artificial methods, Respiration, Artificial statistics & numerical data
- Abstract
Objective: To assess the predictive capacity of the Rapid Shallow Breathing Index (RSBI) for success in spontaneous breathing trials (SBT) and extubation in critically ill patients. We evaluated the association between RSBI, duration of mechanical ventilation, and ventilator-free time at 28 days., Design: Prospective multicenter observational study. Secondary analysis of the COBRE-US study., Setting: Intensive care unit (ICU)., Patients or Participants: 367 patients in the ICU receiving invasive mechanical ventilation., Interventions: Assessment of RSBI at the end of SBT., Main Variables of Interest: RSBI, SBT, duration of mechanical ventilation, and ventilator-free time at 28 days were evaluated., Results: 367 patients in the ICU under invasive mechanical ventilation were evaluated, of whom 59.7% were male with a median age of 61 years (IQR: 49-72). A total of 456 SBT were conducted with a success rate of 76.5%. RSBI had a ROC-curve of 0.53 for SBT success and a ROC-curve of 0.48 for extubation. The Spearman correlation coefficient between RSBI and duration of ventilation was 0.117 (p = 0.026), while for ventilator-free time at 28 days, it was -0.116 (p = 0.028)., Conclusions: RSBI was not associated with success in SBT or extubation, regardless of the cutoff point used. Correlation analyses showed weak associations between RSBI and both the duration of ventilation and ventilator-free time at 28 days., (Copyright © 2024 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.) more...
- Published
- 2025
- Full Text
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Catalog
3. Endocarditis and ascending aortic aneurysm with aortic valve insufficiency secondary to late syphilis: Case report.
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Robayo-Amortegui H, Rojas-Perdomo J, Tuta-Quintero E, Valenzuela-Faccini N, Fuentes-Pérez C, Cely-Cely A, and Gómez-López E
- Subjects
- Humans, Female, Middle Aged, Syphilis, Cardiovascular surgery, Syphilis, Cardiovascular complications, Aorta surgery, Aorta diagnostic imaging, Aorta pathology, Endocarditis microbiology, Endocarditis surgery, Endocarditis complications, Endocarditis, Bacterial microbiology, Endocarditis, Bacterial surgery, Aortic Valve surgery, Aortic Valve pathology, Aortic Valve microbiology, Aortic Valve diagnostic imaging, Anti-Bacterial Agents therapeutic use, Treponema pallidum isolation & purification, Aneurysm, Ascending Aorta, Aortic Valve Insufficiency surgery, Aortic Valve Insufficiency etiology, Aortic Aneurysm surgery, Aortic Aneurysm diagnostic imaging, Aortic Aneurysm microbiology, Aortic Aneurysm etiology
- Abstract
Venereal syphilis, caused by Treponema pallidum, is a major global health problem. Untreated latent syphilis can progress to tertiary syphilis, often leading to severe complications such as cardiac involvement, particularly syphilitic aortitis, which may manifest decades after the initial infection. We present a case of a 46-year-old woman who developed an ascending aortic aneurysm and severe aortic valve insufficiency due to late-stage syphilis. She presented with bilateral lower limb edema, intermittent chest pain, decreased functional capacity, and dyspnea, ultimately requiring hospitalization for cardiogenic shock. Diagnostic imaging revealed significant aortic valve damage and aneurysmal dilation of the ascending aorta, while serological tests confirmed tertiary cardiovascular syphilis. Surgical intervention involved the reconstruction of the ascending aorta and replacement of the aortic valve with a bioprosthetic valve. Histopathological analysis indicated chronic endocarditis. Postoperative management included intensive care support and antibiotic treatment. The patient demonstrated satisfactory recovery, with no further complications reported at the 3-month follow-up., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. more...
- Published
- 2024
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4. Fluid dynamics of life: exploring the physiology and importance of water in the critical illness.
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Robayo-Amortegui H, Quintero-Altare A, Florez-Navas C, Serna-Palacios I, Súarez-Saavedra A, Buitrago-Bernal R, and Casallas-Barrera JO
- Abstract
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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- 2024
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5. Oxygen Debt as Predictor of Mortality and Multiple Organ Dysfunction Syndrome in Severe COVID-19 Patients: A Retrospective Study.
- Author
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Perez-Garzon M, Poveda-Henao C, Bastidas-Goyes A, and Robayo-Amortegui H
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- Humans, Middle Aged, Multiple Organ Failure etiology, Retrospective Studies, Critical Illness, Reproducibility of Results, Prognosis, SARS-CoV-2, Intensive Care Units, ROC Curve, Oxygen Consumption, Oxygen, COVID-19 complications, Sepsis
- Abstract
Background: Oxygen debt (DEOx) represents the disparity between resting and shock oxygen consumption (VO
2 ) and is associated with metabolic insufficiency, acidosis, severity, and mortality. This study aimed to assess the reliability of DEOx as an indirect quantitative measure for predicting multiple organ dysfunction syndrome (MODS) and 28-day mortality in patients admitted to the intensive care unit (ICU) with respiratory syndrome severe acute coronavirus type 2 (SARS-CoV-2) infection, in comparison to the Acute Physiology and Chronic Health Evaluation II (APACHE II), sepsis-related organ failure assessment (SOFA), and 4C scores. Methods: A retrospective cohort study was conducted, including ICU patients with SARS-CoV-2 infection between 2020 and 2021. Clinical data were extracted from the EPIMED Monitor Database®. APACHE II, SOFA, and 4C scores were calculated upon ICU admission, and their accuracy in predicting 28-day mortality and MODS was compared to DEOx. Multivariate logistic regression analysis was performed to analyze the outcome variables. Results: 708 patients were included, with a mortality rate of 44.4%. DEOx value was 11.16 ml O2/kg. The mean age was 58.7 years. Multivariate analysis showed that DEOx was independently associated with mortality, intubation, and renal injury. Each point increase in creatinine was associated with a higher risk of MODS. To determine the precision of the scores, area under the receiver operating characteristic curves (AUROC) analysis was performed with weak discrimination and similar behavior for the primary outcomes. The most accurate scale for mortality and MODS was 4C with an AUC of 0.683 and APACHE II with an AUC of 0.814, while that of the AUROC of DEOx was 0.612 and 0.646, respectively. Conclusions: DEOx showed similar predictive value to established scoring systems in critically ill patients with SARS-CoV-2 infection. The correlation of DEOx with these scores may facilitate early intervention in critically ill patients., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. more...- Published
- 2024
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6. Outcomes of ECMO support with polypropylene membrane during pandemic times: a retrospective cohort study.
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Valenzuela-Faccini N, Poveda-Henao C, Flórez-Navas C, Pérez-Garzón M, Boada-Becerra N, Mercado-Diaz M, Salcedo P, and Robayo-Amortegui H
- Subjects
- Male, Humans, Adult, Female, Polypropylenes, Retrospective Studies, Pandemics, SARS-CoV-2, Extracorporeal Membrane Oxygenation adverse effects, Polyenes
- Abstract
Background: The SARS-CoV-2 pandemic resulted in shortages of supplies, which limited the use of extracorporeal membrane oxygenation (ECMO) support. As a contingency strategy, polypropylene (PP) oxygenation membranes were used. This study describes the clinical outcomes in patients on ECMO with PP compared to poly-methylpentene (PMP) oxygenation membranes., Methods: Retrospective cohort of patients in ECMO support admitted between 2020 and 2021., Results: A total of 152 patients with ECMO support were included, 71.05% were men with an average age of 42 (SD 9.91) years. Veno-venous configuration was performed in 75.6% of cases. The PP oxygenation membranes required more changes 22 (63.1%), than the PMP Sorin® 24 (32,8%) and Euroset® 15 (31,9%) (p.0.022). The main indication for membrane change was low oxygen transfer for PP at 56.2%, Sorin® at 50%, and Euroset® at 14.8%. Renal replacement therapy was the most frequent complication with PP membrane in 22 patients (68.7%) Sorin® 25 patients (34.2%), and Euroset® 15 patients (31.9%) (p 0.001) without statistically significant differences in mortality., Conclusion: PP oxygenation membranes was a useful and feasible strategy. It allowed a greater disponibility of ECMO support for critically ill in a situation of great adversity during the SARS-CoV-2 pandemic., (© 2024. The Author(s).) more...
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- 2024
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7. Boosting the Beat: A Critical Showdown of Levosimendan and Milrinone in Surgical and Non-Surgical Scenarios: A Narrative Review.
- Author
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Quintero-Altare A, Flórez-Navas C, Robayo-Amortegui H, Rojas-Arrieta M, Tuta-Quintero E, Bastidas-Goyes A, Martínez-Delgado L, Casallas-Barrera JO, Poveda-Henao C, and Buitrago-Bernal R
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- Humans, Hemodynamics drug effects, Treatment Outcome, Sepsis drug therapy, Sepsis mortality, Cardiac Output, Low drug therapy, Simendan therapeutic use, Milrinone therapeutic use, Milrinone administration & dosage, Cardiotonic Agents therapeutic use, Cardiac Surgical Procedures adverse effects, Heart Failure physiopathology, Heart Failure drug therapy, Heart Failure mortality
- Abstract
Acute heart failure, advanced cardiac failure, cardiac surgery, and sepsis are conditions that require simultaneous treatment to stimulate contractility and/or reduce systemic vascular resistance, with levosimendan and milrinone being treatment options. This research's aim is to review the current indications and evidence for these medications across various scenarios. Evidence suggests that levosimendan is a non-inferior alternative to dobutamine and superior to milrinone in treating low cardiac output syndrome following cardiac surgery. In cases of septic shock, levosimendan has been linked to lower mortality rates compared to placebo, while milrinone's efficacy remains inconclusive. Furthermore, postoperative patients undergoing correction for congenital heart disease have shown reduced mechanical ventilation time and intensive care unit stays when treated with levosimendan, although differences exist between the populations assigned to each intervention. In conclusion, levosimendan, compared to milrinone, appears to offer better hemodynamic favorability in patients undergoing cardiac surgery. However, additional research is necessary to further understand its impact on hemodynamic outcomes, mortality, intensive care unit, and hospital stays in patients with cardiogenic shock of both ischemic and non-ischemic etiologies, as well as septic shock., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. more...
- Published
- 2024
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8. Neurological outcomes and quality of life in post-cardiac arrest patients with return of spontaneous circulation supported by ECMO: A retrospective case series.
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Poveda-Henao C, Valenzuela-Faccini N, Pérez-Garzón M, Mantilla-Viviescas K, Chavarro-Alfonso O, and Robayo-Amortegui H
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- Humans, Adult, Quality of Life, Retrospective Studies, Return of Spontaneous Circulation, Cardiopulmonary Resuscitation, Extracorporeal Membrane Oxygenation, Heart Arrest complications, Heart Arrest therapy
- Abstract
Post-cardiac arrest brain injury constitutes a significant contributor to morbidity and mortality, leading to cognitive impairment and subsequent disability. Individuals within this patient cohort grapple with uncertainty regarding the potential advantages of extracorporeal life support (ECMO) cannulation. This study elucidates the neurological outcomes and quality of life of post-cardiac arrest patients who attained spontaneous circulation and underwent ECMO cannulation. This is a retrospective case study within a local context, the research involved 32 patients who received ECMO support following an intrahospital cardiac arrest with return of spontaneous circulation (ROSC). An additional 32 patients experienced cardiac arrest with ROSC before undergoing cannulation. The average age was 41 years, with the primary causes of cardiac arrest identified as acute coronary syndrome (46.8%), pulmonary thromboembolism (21.88%), and hypoxemia (18.7%). The most prevalent arrest rhythm was asystole (37.5%), followed by ventricular fibrillation (34.4%). The mean SOFA score was 7 points (IQR 6.5-9), APACHE II score was 12 (IQR 9-16), RESP score was -1 (IQR -1 to -4) in cases of respiratory ECMO, and SAVE score was -3 (IQR -5 to 2) in cases of cardiac ECMO. Overall survival was 71%, and at 6 months, the Barthel score was 75 points, modified Rankin score was 2, cerebral performance categories score was 1, and the SF-12 had an average score of 30. Notably, there were no significant associations between the time, cause, or rhythm of cardiac arrest and neurological outcomes. Importantly, cardiac arrest is not a contraindication for ECMO cannulation. A meticulous assessment of candidates who have achieved spontaneous circulation after cardiac arrest, considering the absence of early signs of poor neurological prognosis, is crucial in patient selection. Larger prospective studies are warranted to validate and extend these findings., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.) more...
- Published
- 2023
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9. Severe gastrointestinal injury associated with SARS-CoV-2 infection: Thrombosis or Inflammation?: A retrospective case series study.
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Robayo-Amortegui H, Forero-Delgadillo A, Pérez-Garzón M, Poveda-Henao C, Muñoz-Claros C, Bayona-Solano A, Orozco C, and Buitrago-Bernal R
- Subjects
- Humans, SARS-CoV-2, Retrospective Studies, Inflammation, Necrosis, COVID-19 complications, Thrombosis etiology, Abdominal Injuries
- Abstract
Objectives: Acute gastrointestinal injury (AGI) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a low incidence of complications in patients admitted to the intensive care unit (ICU). Pathophysiological knowledge related to AGI is limited, as few studies have been published on this topic. Therefore, this study was carried out to identify the clinical and histopathological features of patients with SARS-CoV-2 infection and grade IV AGI., Methods: This is a retrospective case study of fifteen patients with SARS-CoV-2 infection and grade IV AGI who underwent emergency surgery., Results: This study revealed a mortality rate of 62.5%. The most frequent gastrointestinal symptoms were abdominal distension (100%) and increased gastric residual volume (93.3%). Distended bowel loops on plain abdominal radiography (90%) and intestinal pneumatosis on computed tomography (50%) were the most frequent imaging findings. Surgical exploration revealed intestinal ischemia (66.6%) and necrosis (46.6%), and histopathology showed ischemic and liquefactive necrosis with mixed inflammatory involvement and absence of thrombosis as the cause of AGI., Conclusions: AGI associated with severe SARS-CoV-2 infection has a high mortality rate and poses a diagnostic challenge in the ICU. The complex pathophysiology and histopathological findings indicate an associated inflammatory phenomenon as the main alteration in the absence of thrombosis, as per the intestinal biopsies of the cases studied. Further clinical studies are required to gain a better understanding of this pathology., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.) more...
- Published
- 2022
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10. Cerebral venous thrombosis in a patient with Down syndrome and coronavirus disease 2019: a case report.
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Robayo-Amortegui H, Valenzuela-Faccini N, Quecano-Rosas C, Zabala-Muñoz D, and Perez-Garzon M
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- Female, Humans, Pandemics, SARS-CoV-2, COVID-19, Down Syndrome complications, Venous Thrombosis
- Abstract
Background: The new coronavirus disease 2019 pandemic has spread throughout most of the world. Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection., Case Presentation: We report the case of a Hispanic woman with Down syndrome who has coronavirus disease 2019 and presents as a complication extensive cerebral venous thrombosis., Conclusions: Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. In the absence of clinical and epidemiological data, it is important to carry out further investigation of the risk factors and pathophysiological causes related to the development of cerebrovascular thrombotic events in patients with Down syndrome with coronavirus disease 2019 infection., (© 2021. The Author(s).) more...
- Published
- 2021
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