Publications by authors named "Francisco Jose Parrilla-Gomez"
Article Synopsis
- Weaning patients from mechanical ventilation is essential for managing acute respiratory failure, and spontaneous breathing trials (SBT) help determine who is ready for extubation despite the risk of extubation failure.
- A study analyzed diaphragmatic function through electrical activity of the diaphragm (EAdi) in difficult-to-wean patients, categorizing them into extubation success and failure based on whether they needed reintubation within 48 hours.
- Findings showed that EAdi significantly increased during SBT phases, with values above 30 μV predicting extubation failure with high sensitivity, indicating that EAdi could be a valuable tool for improving weaning outcomes in critical care.
Effect of aggressive vs conservative screening and confirmatory test on time to extubation among patients at low or intermediate risk: a randomized clinical trial.
Intensive Care Med
February 2024
Purpose: This study aimed to determine the best strategy to achieve fast and safe extubation.
Methods: This multicenter trial randomized patients with primary respiratory failure and low-to-intermediate risk for extubation failure with planned high-flow nasal cannula (HFNC) preventive therapy. It included four groups: (1) conservative screening with ratio of partial pressure of arterial oxygen (PaO) to fraction of inspired oxygen (FiO) ≥ 150 and positive end-expiratory pressure (PEEP) ≤ 8 cmHO plus conservative spontaneous breathing trial (SBT) with pressure support 5 cmHO + PEEP 0 cmHO); (2) screening with ratio of partial pressure of arterial oxygen (PaO) to fraction of inspired oxygen (FiO) ≥ 150 and PEEP ≤ 8 plus aggressive SBT with pressure support 8 + PEEP 5; (3) aggressive screening with PaO/FiO > 180 and PEEP 10 maintained until the SBT with pressure support 8 + PEEP 5; (4) screening with PaO/FiO > 180 and PEEP 10 maintained until the SBT with pressure support 5 + PEEP 0.
Switches in non-invasive respiratory support strategies during acute hypoxemic respiratory failure: Need to monitoring from a retrospective observational study.
Med Intensiva (Engl Ed)
April 2024
Objective: To explore combined non-invasive-respiratory-support (NIRS) patterns, reasons for NIRS switching, and their potential impact on clinical outcomes in acute-hypoxemic-respiratory-failure (AHRF) patients.
Design: Retrospective, single-center observational study.
Setting: Intensive Care Medicine.
While the incidence of thrombotic complications in critically ill patients is very high, in patients under non-invasive respiratory support (NIS) is still unknown. The specific incidence of thrombotic events in each of the clinical scenarios within the broad spectrum of severity of COVID-19, is not clearly established, and this has not allowed the implementation of thromboprophylaxis or anticoagulation for routine care in COVID-19. Patients admitted in a semi-critical unit treated initially with NIS, especially Continuous-Positive Airway Pressure (CPAP), were included in the study.
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