Browsing by Author "Cortinez, Luis I."

Now showing 1 - 9 of 9
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    Obesity Does Not Influence the Onset and Offset of Sevoflurane Effect as Measured by the Hysteresis Between Sevoflurane Concentration and Bispectral Index
    (LIPPINCOTT WILLIAMS & WILKINS, 2011) Cortinez, Luis I.; Gambus, Pedro; Troconiz, Inaki F.; Echevarria, Ghislaine; Munoz, Hernan R.
    BACKGROUND: The onset and offset of action of anesthetic gases might be delayed by respiratory changes and gas exchange alterations present in obese patients. In this study, we assessed the influence of obesity on the hysteresis between sevoflurane and its effect as measured by the bispectral index (BIS). Because the use of positive end-expiratory pressure (PEEP) in obese patients has improved gas exchange, we also assessed the influence of PEEP on hysteresis.
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    Performance of the cerebral state index during increasing levels of propofol anesthesia: A comparison with the bispectral index
    (LIPPINCOTT WILLIAMS & WILKINS, 2007) Cortinez, Luis I.; Delfino, Alejandro E.; Fuentes, Ricardo; Munoz, Hernan R.
    BACKGROUND: The cerebral state monitor is a new device to measure depth of anesthesia. In this study we compared the cerebral state monitor with the bispectral index (BIS) monitor during propofol anesthesia.
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    Pharmacokinetics of levobupivacaine (2.5 mg/kg) after caudal administration in children younger than 3 years
    (LIPPINCOTT WILLIAMS & WILKINS, 2008) Cortinez, Luis I.; Fuentes, Ricardo; Solari, Sandra; Ostermann, Paola; Vega, Miguel; Munoz, Hernan R.
    BACKGROUND: Caudal administration of levobupivacaine (2.5 mg/kg) in children is used frequently in some hospitals. However, no reports of levobupivacaine concentrations have been published with this dosing scheme. We report the results of a study on the pharmacokinetics of levobupivacaine (2.5 mg/kg) after caudal administration in children younger than 3 yr.
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    Pulse Contour Analysis and Transesophageal Echocardiography: A Comparison of Measurements of Cardiac Output During Laparoscopic Colon Surgery
    (LIPPINCOTT WILLIAMS & WILKINS, 2009) Concha, Mario R.; Mertz, Veronica F.; Cortinez, Luis I.; Gonzalez, Katya A.; Butte, Jean M.
    BACKGROUND: Pulse wave analysis (PWA) allows cardiac output (CO) measurement after calibration by transpulmonary thermodilution. A PWA system that does not require previous calibration, the FloTrac/Vigileo (FTV), has been recently developed. We compared determinations of CO made with the FTV to simultaneous measurements using transesophageal echocardiography (TEE).
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    The Dynamic Relationship Between End-Tidal Sevoflurane Concentrations, Bispectral Index, and Cerebral State Index in Children
    (LIPPINCOTT WILLIAMS & WILKINS, 2008) Fuentes, Ricardo; Cortinez, Luis I.; Struys, Michel M. R. F.; Delfino, Alejandro; Munoz, Hernan
    BACKGROUND: To guide anesthetic administration with electroencephalogram monitors in children, an adequate characterization of the anesthetic effect measured by these monitors in this population is needed. We sought to quantify and compare the dynamic profile of sevoflurane's effect measured with the cerebral state index (CST) and the bispectral index (BIS) in children.
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    The Effective Effect-Site Propofol Concentration for Induction and Intubation with Two Pharmacokinetic Models in Morbidly Obese Patients Using Total Body Weight
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) Echevarria, Ghislaine C.; Elgueta, Maria F.; Donoso, Maria T.; Bugedo, Diego A.; Cortinez, Luis I.; Munoz, Hernan R.
    BACKGROUND: Most pharmacokinetic (PK) models used for propofol administration are based on studies in normal-weight patients. Extrapolation of these models for morbidly obese patients is controversial. Using 2 PK models and a target-controlled infusion system, we determined the predicted propofol effect-site concentration (Ce) needed for induction of anesthesia in morbidly obese subjects using total body weight.
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    The impact of norepinephrine dose reporting heterogeneity on mortality prediction in septic shock patients
    (2024-07-03) Morales, Sebastian; Wendel-Garcia, Pedro D.; Ibarra-Estrada, Miguel; Jung, Christian; Castro, Ricardo; Retamal, Jaime; Cortinez, Luis I.; Severino, Nicolás; Kiavialaitis, Greta E.; Ospina-Tascón, Gustavo; Bakker, Jan; Hernández, Glenn; Kattan, Eduardo
    Background: Norepinephrine (NE) is a cornerstone drug in the management of septic shock, with its dose being used clinically as a marker of disease severity and as mortality predictor. However, variations in NE dose reporting either as salt formulations or base molecule may lead to misinterpretation of mortality risks and hinder the process of care. Methods: We conducted a retrospective analysis of the MIMIC-IV database to assess the impact of NE dose reporting heterogeneity on mortality prediction in a cohort of septic shock patients. NE doses were converted from the base molecule to equivalent salt doses, and their ability to predict 28-day mortality at common severity dose cut-offs was compared. Results: 4086 eligible patients with septic shock were identified, with a median age of 68 [57–78] years, an admission SOFA score of 7 [6–10], and lactate at diagnosis of 3.2 [2.4–5.1] mmol/L. Median peak NE dose at day 1 was 0.24 [0.12–0.42] μg/kg/min, with a 28-day mortality of 39.3%. The NE dose showed significant heterogeneity in mortality prediction depending on which formulation was reported, with doses reported as bitartrate and tartrate presenting 65 (95% CI 79–43)% and 67 (95% CI 80–47)% lower ORs than base molecule, respectively. This divergence in prediction widened at increasing NE doses. When using a 1 μg/kg/min threshold, predicted mortality was 54 (95% CI 52–56)% and 83 (95% CI 80–87)% for tartrate formulation and base molecule, respectively. Conclusions: Heterogeneous reporting of NE doses significantly affects mortality prediction in septic shock. Standardizing NE dose reporting as base molecule could enhance risk stratification and improve processes of care. These findings underscore the importance of consistent NE dose reporting practices in critical care settings.
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    The Influence of Age on the Dynamic Relationship Between End-Tidal Sevoflurane Concentrations and Bispectral Index
    (LIPPINCOTT WILLIAMS & WILKINS, 2008) Cortinez, Luis I.; Troconiz, Inaki F.; Fuentes, Ricardo; Gambus, Pedro; Hsu, Yung Wei; Altermatt Couratier, Fernando René; Munoz, Hernan R.
    BACKGROUND: Age is an important determinant of the pharmacokinetic profile of inhaled anesthetics. The influence of age on the dynamic profile of sevoflurane's effect has not been well described. We performed this study to characterize the influence of age and other covariates on the dynamic relationship between sevoflurane end-tidal concentration (C-ET) and its effect measured by bispectral index (BIS).
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    The Volume of Lactated Ringer's Solution Required to Maintain Preload and Cardiac Index During Open and Laparoscopic Surgery
    (LIPPINCOTT WILLIAMS & WILKINS, 2009) Concha, Mario R.; Mertz, Veronica F.; Cortinez, Luis I.; Gonzalez, Katya A.; Butte, Jean M.; Lopez, Francisco; Pinedo, George; Zuniga, Alvaro
    BACKGROUND: Recent studies have emphasized the importance of perioperative fluid restriction. However, fluid restriction regimens may increase the likelihood of insufficient perioperative fluid administration or may result in excess intravascular crystalloid replacement. We postulate that the use of transesophageal echocardiography may reduce the amount of crystalloid administered during open and laparoscopic colorectal surgery.