Building global collaborative research networks in paediatric critical care: a roadmap.

Paediatric critical care units are designed for children at a vulnerable stage of development, yet the evidence base for practice and policy in paediatric critical care remains scarce. In this Health Policy, we present a roadmap providing strategic guidance for international paediatric critical care trials. We convened a multidisciplinary group of 32 paediatric critical care experts from six continents representing paediatric critical care research networks and groups.

Clinical characteristics and quality care indicators of pediatric stroke in a referral center of Colombia: eleven-year experience (pediastroke).

Objective: This study aims to describe clinical variables and quality care indicators in pediatric stroke management at a high-complexity pediatric care center in Latin America.

Methods: Retrospective study of patients with stroke, aged 2-18 years from 2011 to 2021. The principal outcomes were the mRs and mortality.

Perioperative transfusion management in craniotomies: A national survey, a starting point for the evaluation of improvements in health care.

Objective: To assess the perioperative management of haemostasis and transfusion practices in adult patients undergoing craniotomies.

Method: Online questionnaire addressed to Spanish anaesthesiologists and promoted by the Neurosciences and Haemostasis, Transfusion Medicine and Fluid Therapy Sections of SEDAR. The questionnaire was sent by email and social media, and was active between June and October 2022.

A worldwide assessment of the mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease. Analysis of the VENTILAGROUP over time. A retrospective, multicenter study.

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.

[Clinical and sociodemographic characteristics and progression of SARS-CoV-2 patients in two health areas of Extremadura during the first six months of the pandemic].

Objective: To describe clinical and sociodemographic characteristics as well as the outcome of patients infected with SARS-CoV-2 in first six months of the pandemic.

Design: Observational and ambispective study. SITE: Primary Care (two Health Areas in Extremadura).

Contextual factors influencing bubble continuous positive airway pressure implementation for paediatric respiratory distress in low-income and middle-income countries: a realist review.

Background: Bubble continuous positive airway pressure (bCPAP) is a low-cost, non-invasive respiratory support therapy for children with respiratory distress, but its effectiveness is dependent on the context. We aimed to understand contextual factors influencing bCPAP implementation for children aged 1-59 months in low-income and middle-income countries (LMICs) and to develop a theory explaining how these factors influence implementation outcomes.

Methods: In this realist review, we generated an initial programme theory comprising candidate context-mechanism-outcome configurations (CMOCs) via review of key references and team discussion.

Very old patients in the ICU in Latin America: A narrative review.

The population of very elderly patients (aged 80 years and older) in intensive care units (ICUs) is steadily growing. These patients have unique physiological, cognitive, functional, and social characteristics that affect their entire ICU course. Immobility, delirium, dysphagia, malnutrition, and polypharmacy are among the most common geriatric syndromes in these patients, and they contribute to a higher risk of acute and long-term functional decline and mortality.

Pleural Effusion Identified by Point of Care Ultrasound (POCUS) in Septic Shock: Impact on Clinical Outcomes.

To analyze the association between pleural effusion detected by chest point of care ultrasound (POCUS) and clinical outcomes in patients with septic shock admitted to an intensive care unit (ICU). A prospective evaluation of ICU patients with septic shock in whom chest POCUS was performed during the first 24 hours of diagnosis to identify the presence and characteristics of pleural effusion. Of 45 patients with septic shock, 17 (38%) had pleural effusion.

Blood matters: the hematological signatures of Coronavirus infection.

Recent developments have broadened our perception of SARS-CoV-2, indicating its capability to affect the body systemically beyond its initial recognition as a mere respiratory pathogen. However, the pathways of its widespread are not well understood. Employing a dual-modality approach, we integrated findings from a Murine Hepatitis Virus (MHV) infection model with corroborative clinical data to investigate the pervasive reach of Coronaviruses.

[Linear power and mortality in COVID-19 respiratory difficulty syndrome].

Background: Acute respiratory distress syndrome (ARDS) secondary to COVID-19 crowded intensive care units in the world with high mortality. Mechanical ventilation was fundamental in the treatment; however, the evidence of ventilatory markers associated with mortality is not entirely clear. In 2021 it was described the linear power, which was superior to other markers.

[Analysis of notifications made in the Patient Safety Notification and Learning System in an autonomous community].

Objective: Analyze the notifications made by Primary Care (PC) professionals of Galicia, in the Notification and Learning system for Patient Safety (SiNASP), of the Ministry of Health of Spain, its variables and the factors that contribute to its appearance for thus characterize security incidents in this healthcare field.

Materials And Methods: This is a retrospective descriptive study of notifications made in PC, between October 2010 and December 2019, in the SiNASP, in the Autonomous Community of Galicia. The data are presented using absolute and relative frequencies.

Challenges in institutional ethical review process and approval for international multicenter clinical studies in lower and middle-income countries: the case of PARITY study.

Background: One of the greatest challenges to conducting multicenter research studies in low and middle-income countries (LMICs) is the heterogeneity in regulatory processes across sites. Previous studies have reported variations in requirements with a lack of standardization in the Institutional Review Board (IRB) processes between centers, imposing barriers for approval, participation, and development of multicenter research.

Objectives: To describe the regulatory process, variability and challenges faced by pediatric researchers in LMICs during the IRB process of an international multicenter observational point prevalence study (Global PARITY).

Early mobilisation in patients with shock and receiving vasoactive drugs in the intensive care unit: A systematic review and meta-analysis of observational studies.

Objective: The aim of the study was to assess the feasibility and safety of early mobilisation in patients with shock requiring vasoactive drugs in the intensive care unit (ICU).

Design: Systematic review and meta-analysis.

Setting: Intensive care unit (ICU).

[Diagnostic comparison of bedside lung ultrasound and chest radiography in the intensive care unit].

Background: Bedside lung ultrasound (POCUS) offers advantages over chest X-ray, including better cost-effectiveness for diagnosing certain pulmonary pathologies. This study compares the diagnostic concordance between portable chest X-rays and bedside lung ultrasounds in the intensive care unit (ICU).

Methods: Adult ICU patients were included.

Macrophage Activation Syndrome in MIS-C.

Background: Multisystem inflammatory syndrome (MIS-C) represents a diagnostic challenge because of its overlap with Kawasaki disease, Kawasaki disease shock syndrome, and toxic shock syndrome. Macrophage activation syndrome (MAS) is a frequently fatal complication of various pediatric inflammatory disorders and has been reported in MIS-C. Early diagnosis and prompt initiation by immune modulating therapies are essential for effectively managing MAS.

Concordance between clinical diagnoses and autopsies anatomopathological findings at a tertiary-level university hospital.

Introduction: A clinical autopsy is a fundamental diagnostic tool for confirming the diagnosis of diseases of public health interest. However, the clinical-pathological concordance has not been evaluated.

Objective: To determine the concordance between clinical diagnoses and anatomopathological findings from autopsies conducted at a tertiary-level hospital institution.

Healthcare resource utilization among critically-ill COVID-19 survivors: results from the NUTRICOVID study.

Background: critically ill patients admitted to the intensive care unit (ICU) are often associated with malnutrition and nutrition therapy is recommended. Previous studies on COVID-19 focused on the recovery of critically ill patients after hospital discharge; however, there are limited data on healthcare resource utilization (HRU) after discharge. Aims: to describe and analyze the HRU and nutritional status of COVID-19 patients during hospitalization and one year after discharge.

Ultrasound use after cardiac surgery.

Surgical complexity as well as comorbidities in patients undergoing cardiac surgery is increasing. Early detection and management of post-surgical complications are key points to reduce morbidity and mortality. Ultrasound technique plays a main rol in cardiopulmonary, hemodynamic and etiological assessment of the critically ill, providing immediate, reliable and, sometimes, conclusive information, clarifying many clinical situations with an inappropiate therapeutic response.

Activities of the clinical pharmacist in the intensive care units.

The main objective of the activity carried out in an intensive care unit and in general in all hospitalization units, is to provide all the human and material resources to offer the best therapeutic care to admitted patients. Work in multidisciplinary teams, made up of specialists in Intensive Care Medicine as those responsible for the patients, doctors from other specialties, specialized nursing, physiotherapists, nutritionists and clinical pharmacists is an optimal approach to achieve the proposed objective. The activities of the clinical pharmacist can be developed at different levels (basic, intermediate and excellent) depending on the degree of involvement, the time dedicated, the training and the available resources.

Vaccine effectiveness in patients admitted for influenza during the 2023-2024 season.

Background And Goal: Vaccination against influenza is widespread worldwide, reducing complications associated with infection. However, the impact of vaccination on mortality/ICU admission in hospitalized patients has been little studied.

Material And Methods: A retrospective observational study was conducted on 238 patients hospitalized for influenza from October 2023 to January 2024 to evaluate the vaccine's effectiveness in terms of the combined event of ICU admission/mortality during hospitalization.