Browsing by Author "Bugedo, G"

Now showing 1 - 5 of 5
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    How is mechanical ventilation employed in the intensive care unit? An international utilization review
    (AMER THORACIC SOC, 2000) Esteban, A; Anzueto, A; Alia, I; Gordo, F; Apezteguia, C; Palizas, F; Cide, D; Goldwaser, R; Soto, L; Bugedo, G; Rodrigo, C; Pimentel, J; Raimondi, G; Tobin, MJ; Mech Ventilation Int Study Grp
    A 1-d point-prevalence study was performed with the aim of describing the characteristics of conventional mechanical ventilation in intensive care units ICUs from North America, South America Spain, and Portugal. The study involved 412 medical-surgical ICUs and 1,638 patients receiving mechanical ventilation at the moment of the study. The main outcome measures were characterization of the indications for initiation of mechanical ventilation, the artificial airways used to deliver mechanical ventilation, the ventilator modes and settings, and the methods of weaning. The median age of the study patients was 67 yr, and the median duration of mechanical ventilation at the time of the study was 7 d. Common indications for the initiation of mechanical ventilation included acute respiratory failure (66%), acute exacerbation of chronic obstructive pulmonary disease (13%), coma (10%), and neuromuscular disorders (10%). Mechanical ventilation was delivered via an endotracheal tube in 75% of patients, a tracheostomy in 24%, and a facial mask in 1%. Ventilator modes consisted of assist/control ventilation in 47% of patients and 46% were ventilated with synchronized intermittent mandatory ventilation, pressure support, or the combination of both. The median tidal volume setting was 9 ml/kg in patients receiving assist/control and the median setting of pressure support was 18 cm H2O. Positive end-expiratory pressure was not employed in 31% of patients. Method of weaning varied considerably from country to country, and even within a country several methods were in use. We conclude that the primary indications for mechanical ventilation and the ventilator settings were remarkably similar across countries, but the selection of modes of mechanical ventilation and methods of weaning varied considerably from country to country.
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    Lung recruitment in patients with the acute respiratory distress syndrome
    (MASSACHUSETTS MEDICAL SOC, 2006) Gattinoni, L; Caironi, P; Cressoni, M; Chiumello, D; Ranieri, VM; Quintel, M; Russo, S; Patroniti, N; Cornejo, R; Bugedo, G
    Background: In the acute respiratory distress syndrome (ARDS), positive end-expiratory pressure (PEEP) may decrease ventilator-induced lung injury by keeping lung regions open that otherwise would be collapsed. Since the effects of PEEP probably depend on the recruitability of lung tissue, we conducted a study to examine the relationship between the percentage of potentially recruitable lung, as indicated by computed tomography (CT), and the clinical and physiological effects of PEEP.
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    Management of septic shock with a norepinephrine-based haemodynamic algorithm
    (ELSEVIER IRELAND LTD, 2005) Hernandez, G; Bruhn, A; Romero, C; Larrondo, FJ; De La Fuente, R; Castillo, L; Bugedo, G
    Management of septic shock (SS) with a norepinephrine (noradrenaline)-based haemodynamic algorithm. Introduction: The choice of the best vasopressor for haemodynamic management of septic shock is controversial. Nevertheless, very few studies have been focused on evaluating different management algorithms. The aim of this study was to evaluate the performance of a norepinephrine (NE)-based management protocol. Experience with NE as the initial vasopressor, even if not comparative, could bring relevant data for planning future trails. We also wanted to evaluate the compliance of critical care physicians and nurses with haemodynamic management protocol.
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    Prognosis factors and outcome of community-acquired pneumonia needing mechanical ventilation
    (W B SAUNDERS CO-ELSEVIER INC, 2005) Tejerina, E; Frutos Vivar, F; Restrepo, MI; Anzueto, A; Palizas, F; Gonzalez, M; Apezteguia, C; Abroug, F; Matamis, D; Bugedo, G; Esteban, A; Int Mech Ventilation Study Grp
    Purpose: To evaluate the variables associated with mortality of patients with community-acquired pneumonia who require mechanical ventilation and to determine the attributable morbidity and intensive care unit (ICU) mortality of community-acquired pneumonia.
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    Use of methylene blue in patients with refractory septic shock: Impact on hemodynamics and gas exchange
    (W B SAUNDERS CO, 1998) Andresen, M; Dougnac, A; Diaz, O; Hernandez, G; Castillo, L; Bugedo, G; Alvarez, M; Dagnino, J
    Purpose: The purpose of this study was to assess the acute effects of methylene blue, an inhibitor of nitric oxide synthesis, on hemodynamics and gas exchange in patients with refractory septic shock in a prospective clinical trial at medical and surgical intensive care units in a tertiary university hospital.