Multimorbidity patterns in COVID-19 patients and their relationship with infection severity: MRisk-COVID study.

Background: Several chronic conditions have been identified as risk factors for severe COVID-19 infection, yet the implications of multimorbidity need to be explored. The objective of this study was to establish multimorbidity clusters from a cohort of COVID-19 patients and assess their relationship with infection severity/mortality.

Methods: The MRisk-COVID Big Data study included 14 286 COVID-19 patients of the first wave in a Spanish region.

Volume Infusion Markedly Increases Femoral dP/dtmax in Fluid-Responsive Patients Only.

Objectives: To evaluate the preload dependence of femoral maximal change in pressure over time (dP/dtmax) during volume expansion in preload dependent and independent critically ill patients.

Design: Retrospective database analysis.

Setting: Two adult polyvalent ICUs.

Thenar oxygen saturation (StO) alterations during a spontaneous breathing trial predict extubation failure.

Background: Weaning from mechanical ventilation (MV) is a cardiovascular stress test. Monitoring the regional oxygenation status has shown promising results in predicting the tolerance to spontaneously breathe in the process of weaning from MV. Our aim was to determine whether changes in skeletal muscle oxygen saturation (StO) measured by near-infrared spectroscopy (NIRS) on the thenar eminence during a vascular occlusion test (VOT) can be used to predict extubation failure from mechanical ventilation.

Influence of changes in ventricular systolic function and loading conditions on pulse contour analysis-derived femoral dP/dt.

Background: Femoral dP/dt (maximum rate of the arterial pressure increase during systole) measured by pulse contour analysis has been proposed as a surrogate of left ventricular (LV) dP/dt and as an estimator of LV systolic function. However, femoral dP/dt may be influenced by LV loading conditions. In this study, we evaluated the impact of variations of LV systolic function, preload and afterload on femoral dP/dt in critically ill patients with cardiovascular failure to ascertain its reliability as a marker of LV systolic function.

Central venous-to-arterial carbon dioxide difference combined with arterial-to-venous oxygen content difference is associated with lactate evolution in the hemodynamic resuscitation process in early septic shock.

Introduction: Since normal or high central venous oxygen saturation (ScvO₂) values cannot discriminate if tissue perfusion is adequate, integrating other markers of tissue hypoxia, such as central venous-to-arterial carbon dioxide difference (PcvaCO₂ gap) has been proposed. In the present study, we aimed to evaluate the ability of the PcvaCO₂ gap and the PcvaCO₂/arterial-venous oxygen content difference ratio (PcvaCO₂/CavO₂) to predict lactate evolution in septic shock.

Methods: Observational study.

Thenar oxygen saturation during weaning from mechanical ventilation: an observational study.

Our aim was to determine whether thenar tissue oxygen saturation (S(tO2)), measured by noninvasive near-infrared spectroscopy, and its changes derived from an ischaemic challenge are associated with weaning outcome. Our study comprised a prospective observational study in a 26-bed medical-surgical intensive care unit. Patients receiving mechanical ventilation for >48 h, and considered ready to wean by their physicians underwent a 30-min weaning trial.

Thenar oxygen saturation and invasive oxygen delivery measurements in critically ill patients in early septic shock.

This prospective study was aimed to test the hypothesis that tissue hemoglobin oxygen saturation (StO₂) measured noninvasively using near-infrared spectroscopy is a reliable indicator of global oxygen delivery (DO₂) measured invasively using a pulmonary artery catheter (PAC) in patients with septic shock. The study setting was a 26-bed medical-surgical intensive care unit at a university hospital. Subjects were adult patients in septic shock who required PAC hemodynamic monitoring for resuscitation.

[III Catalan registry of ST elevation acute myocardial infarction. Comparison with former Catalan registries I and II from Catalonia, Spain].

Background And Objective: To analyze the use of reperfusion therapy in patients with ST elevation myocardial infarction (STEMI) in Catalonia in a registry performed in 2006 (IAM CAT III) and its comparison with 2 previous registries

Patients And Methods: Frequency of reperfusion therapy and time intervals between symptom onset - reperfusion therapy were the principal variables investigated. The IAM CAT I (June-December 2000) included 1,450 patients, the IAM CAT II (October 2002-April 2003) 1,386, and the IAM CAT III (October-December 2006) 367.

Results: The proportion of patients treated with reperfusion increased progressively (72%, 79% and 81%) as the use of primary angioplasty (5%, 10% and 33%).

Thenar oxygen saturation measured by near infrared spectroscopy as a noninvasive predictor of low central venous oxygen saturation in septic patients.

Objective: To validate thenar oxygen saturation (StO(2)) measured by near-infrared spectroscopy (NIRS) as a noninvasive estimation of central venous saturation (ScvO(2)) in septic patients.

Design: Prospective observational study.

Setting: A 26-bed medical-surgical intensive care unit at a university-affiliated hospital.

Ward mortality in patients discharged from the ICU with tracheostomy may depend on patient's vulnerability.

Objective: To determine the effect of discharge from the ICU with a tracheostomy tube on ward mortality and its relation to patient vulnerability.

Design And Setting: Retrospective single-center cohort study.

Methods: Database (2003-2006) review of patients undergoing mechanical ventilation (MV) > 24 h and discharged from the ICU with or without tracheostomy tube in place and followed up to hospital discharge or death.

A modified McCabe score for stratification of patients after intensive care unit discharge: the Sabadell score.

Introduction: Mortality in the ward after an intensive care unit (ICU) stay is considered a quality parameter, and is described as a source of avoidable mortality. Additionally, the attending intensivist frequently anticipates fatal outcome after ICU discharge. Our objective was to test the ability of a new score to stratify patients according to ward mortality after ICU discharge.

Noninvasive ventilation in patients with "do-not-intubate" orders: medium-term efficacy depends critically on patient selection.

Objective: Randomized clinical trials demonstrating benefits of noninvasive ventilation (NIV) systematically exclude patients with "do-not-intubate" (DNI) orders, but in daily clinical practice these patients are frequently treated with NIV. A recent North American study found a 43% hospital survival rate in patients with DNI orders. Our hypothesis was that, due to the very different social and cultural setting, written DNI orders in a southern European country would be restricted to a population with a poor outcome, independently of whether they receive NIV, and we analyzed hospital survival in patients receiving NIV and the impact of DNI orders on survival.