Publications by authors named "Frutos-Vivar F"
Objective: To evaluate the intrarater and interrater reliability of the Clinical Frailty Scale-Spain (CFS-España) and FRAIL-España and the internal consistency of the FRAIL-España when implemented in critically ill patients by intensive care nurses and physicians.
Design: Descriptive, observational and metric study.
Setting: intensive care unit (ICU) of Spain.
Background: The trend over time and across different geographical areas of outcomes and management with noninvasive ventilation or invasive mechanical ventilation in patients admitted for acute exacerbations of chronic obstructive pulmonary disease and treated with ventilatory support is unknown. The purpose of this study was to describe outcomes and identify variables associated with survival for patients admitted to an intensive care unit (ICU) with acute exacerbation of chronic obstructive pulmonary disease [aeCOPD] who received noninvasive or invasive mechanical ventilation worldwide.
Methods: Retrospective, multi-national, and multicenter studies, including four observational cohort studies, were carried out in 1998, 2004, 2010, and 2016 for the VENTILAGROUP following the same methodology.
Objective: To analyze the presence of frailty in survivors of severe COVID-19 admitted in the Intensive Care Unit (ICU) and followed six months after discharge.
Design: An observational, prospective and multicenter, nation-wide study.
Setting: Eight adult ICU across eight academic acute care hospitals in Mexico.
Aim: To translate and culturally adapt the FRAIL scale into Spanish and perform a preliminary test of diagnostic accuracy in patients admitted to intensive care units.
Design: Cross-sectional diagnostic study.
Methods: Five intensive care units (ICU) in Spain were participated.
Article Synopsis
- A study was conducted to compare low tidal volume (V) versus intermediate V ventilation strategies in patients at risk for acute respiratory distress syndrome (ARDS) to see which one better prevents lung complications.
- The trial involved 98 patients who were randomly assigned to either low V (≤ 6 mL/kg) or intermediate V (> 8 mL/kg) settings for invasive ventilation, with the primary focus on ARDS development over the first week.
- Results indicated no significant difference in ARDS incidence, pneumonia, atelectasis, or length of ICU stay between the two groups, leading to the conclusion that a low V strategy does not offer advantages over an intermediate V strategy for these patients.
Background: Despite the need for specific weaning strategies in neurological patients, evidence is generally insufficient or lacking. We aimed to describe the evolution over time of weaning and extubation practices in patients with acute brain injury compared with patients who are mechanically ventilated (MV) due to other reasons.
Methods: We performed a secondary analysis of three prospective, observational, multicenter international studies conducted in 2004, 2010, and 2016 in adults who had need of invasive MV for more than 12 h.
Background: Prone positioning reduces mortality in patients with moderate/severe ARDS. It remains unclear which physiological parameters could guide clinicians to assess which patients are likely to benefit from prone position. This study aimed to determine the association between relative changes in physiological parameters at 24 h of prone positioning and ICU mortality in adult subjects with ARDS.
View Article and Find Full Text PDFPurpose: We studied the impact of age on survival and functional recovery in brain-injured patients.
Methods: We performed an observational cohort study of all consecutive adult patients with brain injury admitted to ICU in 8 years. To estimate the optimal cut-off point of the age associated with unfavorable outcomes (mRS 3-6), receiver operating characteristic (ROC) curve analyses were used.
Purpose: To evaluate changes in the disconnection of mechanical ventilation in Spain from 1998 to 2016.
Design: Post-hoc analysis of four cohort studies.
Ambit: 138 Spanish ICUs.
Background: Information is lacking regarding long-term survival and predictive factors for mortality in patients with acute hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19) and undergoing invasive mechanical ventilation. We aimed to estimate 180-day mortality of patients with COVID-19 requiring invasive ventilation, and to develop a predictive model for long-term mortality.
Methods: Retrospective, multicentre, national cohort study between March 8 and April 30, 2020 in 16 intensive care units (ICU) in Spain.
Background: Driving pressure (ΔP) has been described as a risk factor for mortality in patients with ARDS. However, the role of ΔP in the outcome of patients without ARDS and on mechanical ventilation has received less attention. Our objective was to evaluate the association between ΔP on the first day of mechanical ventilation with the development of ARDS.
View Article and Find Full Text PDFBackground: During the first wave of the COVID-19 pandemic, shortages of ventilators and ICU beds overwhelmed health care systems. Whether early tracheostomy reduces the duration of mechanical ventilation and ICU stay is controversial.
Research Question: Can failure-free day outcomes focused on ICU resources help to decide the optimal timing of tracheostomy in overburdened health care systems during viral epidemics?
Study Design And Methods: This retrospective cohort study included consecutive patients with COVID-19 pneumonia who had undergone tracheostomy in 15 Spanish ICUs during the surge, when ICU occupancy modified clinician criteria to perform tracheostomy in Patients with COVID-19.
Purpose: To evaluate changes in the disconnection of mechanical ventilation in Spain from 1998 to 2016.
Design: Post-hoc analysis of four cohort studies.
Ambit: 138 Spanish ICUs.
Background: Mechanical Ventilation (MV) is a complex and central treatment process in the care of critically ill patients. It influences acid-base balance and can also cause prognostically relevant biotrauma by generating forces and liberating reactive oxygen species, negatively affecting outcomes. In this work we evaluate the use of a Recurrent Neural Network (RNN) modelling to predict outcomes of mechanically ventilated patients, using standard mechanical ventilation parameters.
View Article and Find Full Text PDFObjectives: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality.
Design: Secondary analysis of three prospective, observational, multicenter studies.
Setting: Cohort studies conducted in 2004, 2010, and 2016.
Background: The growing proportion of elderly intensive care patients constitutes a public health challenge. The benefit of critical care in these patients remains unclear. We compared outcomes in elderly versus very elderly subjects receiving mechanical ventilation.
View Article and Find Full Text PDFBackground: The aim was to describe the incidence and risk factors of barotrauma in patients with the Coronavirus disease 2019 (COVID-19) on invasive mechanical ventilation, during the outbreak in our region (Lombardy, Italy).
Methods: The study was an electronic survey open from March 27 to May 2, 2020. Patients with COVID-19 who developed barotrauma while on invasive mechanical ventilation from 61 hospitals of the COVID-19 Lombardy Intensive Care Unit network were involved.
Article Synopsis
- The study aimed to validate a modified Sequential Organ Failure Assessment (mSOFA) that uses the Richmond Agitation-Sedation Scale (RASS) instead of the Glasgow Coma Scale (GCS) to predict ICU mortality.
- Despite differences in the mean scores, both SOFA and mSOFA were similarly effective in predicting ICU mortality, indicating that RASS can serve as a reliable substitute for GCS.
- The findings suggest that incorporating alternative neurologic assessments like RASS into severity scoring systems can maintain their predictive validity for patient outcomes in critical care settings.
Invasive Mechanical Ventilation in Chronic Obstructive Pulmonary Disease Exacerbations.
Semin Respir Crit Care Med
December 2020
Chronic obstructive pulmonary disease (COPD) continues to be an important cause of morbidity, mortality, and health care costs worldwide. Although there exist some heterogeneity between patients, the course of COPD is characterized by recurrent acute exacerbations, which are among the most common causes of medical admission to hospital. Patients with frequent exacerbations have accelerated lung function decline, worse quality of life, and greater mortality.
View Article and Find Full Text PDFPurpose: Evaluate diagnostic accuracy of portable chest radiograph in mechanically ventilated patients taking autopsy findings as the gold standard and the interobserver agreement among intensivists and radiologists.
Materials And Methods: Retrospective study of 422 patients over 22 years who died in the ICU, underwent an autopsy, and had at least one portable chest radiograph 72 h prior to death. Two intensivists and two radiologists independently read each chest radiograph.
Mechanical ventilation in Spain, 1998-2016: Epidemiology and outcomes.
Med Intensiva (Engl Ed)
October 2021
Purpose: To evaluate changes in the epidemiology of mechanical ventilation in Spain from 1998 to 2016.
Design: A post hoc analysis of four cohort studies was carried out.
Setting: A total of 138 Spanish ICUs.
Article Synopsis
- The study investigates the mortality rates of mechanically ventilated patients across different countries, adjusting for clinical characteristics and management strategies.
- Significant reductions in 28-day mortality were observed over time, with protective ventilatory strategies and continuous sedation having notable effects.
- Country-specific variability in mortality rates persisted, suggesting that geographical factors influence outcomes, albeit the impact decreased over the analyzed years.
Background: Acute respiratory distress syndrome (ARDS) is a life-threatening disease. We evaluated the prognostic utility of Model for End-stage Liver Disease excluding INR (MELD-XI) score for predicting mortality in a cohort of critically ill patients on mechanical ventilation.
Methods: In total, 11,091 mechanically ventilated patients were included in our post-hoc retrospective analysis, a subgroup of the VENTILA study (NCT02731898).
Autopsy studies show that IA is among the most commonly missed diagnoses in critically ill patients. And, because of lack of unequivocal diagnostic criteria, a timely diagnosis remains challenging. We investigate the epidemiology of and the clinical risk factors for IA in critically ill patients.
View Article and Find Full Text PDFObjective: The main study objectives were to describe the practice of mechanical ventilation over an 18-year period in Mexico, and estimate changes in mortality among critical patients subjected to invasive mechanical ventilation (IMV).
Design: A retrospective subanalysis of a prospective observational study conducted in 1998, 2004, 2010 and 2016 was carried out.
Setting: Intensive Care Units (ICUs) in Mexico.