Browsing by Author "Díaz Patino, Orlando Alberto"
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- ItemEfectos fisiologicos de las terapias de soporte respiratorio no invasivo y su potencial rol postextubación(2021) Basoalto Escobar, Roque Ignacio; Jalil Contreras, Yorschua Frederick; Díaz Patino, Orlando Alberto; Bruhn Cruz, Alejandro RodrigoPosterior a una extubación programada existe un porcentaje de pacientes que fracasa y requiere reintubación (~20%), este evento es conocido como fracaso de extubación, el cual se asocia con mayor morbimortalidad. Para prevenir el fracaso de extubación se han propuesto terapias como la ventilación no invasiva (VNI) y la cánula nasal de alto flujo (CNAF). Estas terapias son capaces de entregar soporte respiratorio postextubación y justifican su uso en los efectos fisiológicos que son capaces de inducir, en dónde el impacto sobre el esfuerzo respiratorio e intercambio de gases sería fundamental. Con esta racionalidad fisiológica se han desarrollado diversos estudios en diferentes contextos clínicos, esto con el fin de dilucidar cuál terapia es la mejor alternativa. En esta revisión narrativa pretendemos describir y analizar los diversos efectos fisiológicos que induce la VNI y la CNAF
- ItemPhysiological effects of high-flow nasal cannula during sustained high-intensity exercise in healthy volunteers: a randomised crossover trial(2024) Moya Gallardo, Eduardo Sebastián; García Valdés, Patricio Hernán; Marambio Coloma, Consuelo Belén; Gutiérrez Escobar, Constanza Isidora; Hernández Vargas, Betsabeth Scarlet; Muñoz Castro, Carolina Andrea; Riquelme Sánchez, Santiago Martin; Moo-Millán, Joel; Basoalto Escobar, Roque Ignacio; Bruhn Cruz, Alejandro Rodrigo; Díaz Patino, Orlando Alberto; Damiani Rebolledo, Luis FelipeIntroductionHigh-flow nasal cannula (HFNC) has increased exercise capacity in patients with chronic respiratory diseases. However, it remains unknown whether HFNC impacts respiratory physiological variables during exercise. This study aimed to evaluate the effect of HFNC on respiratory physiological variables during sustained high-intensity exercise in healthy volunteers.MethodsWe performed a single-center, open-label, and randomised crossover trial to compare HFNC (60 L·min−1) and Sham-HFNC (2 L·min−1) interventions during a constant work-rate exercise (CWRET) through randomised order. The primary outcome was ΔPes, and the secondary outcomes were other variables of inspiratory effort, ventilation distribution, ventilatory variables, and clinical assessment. We evaluated volunteers at seven-time points (Baseline= T0; CWRET= T1-T2-T3 (minutes: 1′, 4′ and 6′); Cooldown-period= T4-T5-T6 (minutes: 1′; 6′;10′)) in both interventions.ResultsFourteen healthy volunteers (50% women; age: 22 [21–27] years) were enrolled. Mean differences in ΔPes decreased to favor the HFNC intervention compared to Sham-HFNC at T2 (−2.8 cmH2O; 95%CI −5.3 to −0.3), as well as the sPTPmin at T2 (−86.1 cmH2O×s·min−1;95%CI −146.2 to −26.1), and T3 (−79.9 cmH2O×s·min−1;95%CI −142.3 to −17.6). The standard deviation of the regional ventilation delay index was also lower with HFNC compared to Sham-HFNC (T1: −1.38; 95%CI −1.93 to −0.83; T2: −0.71; 95%CI −1.27 to −0.16). There was decreased dyspnea to favor the HFNC, but sPTP-per-breath, spatial distribution ventilation indexes, ventilatory variables, and clinical assessments were nonsignificant between interventions.ConclusionHFNC intervention reduces respiratory effort, dyspnea and improves temporal ventilation distribution in healthy volunteers during CWRET.
- ItemPredictores clínicos de mortalidad en el seguimiento a mediano plazo en pacientes adultos inmunocompetentes hospitalizados por neumonía adquirida en la comunidad(2013) Saldías Peñafiel, Fernando; Román Ortega, Fernando Alfonso; Maturana, Rolando O.; Díaz Patino, Orlando Alberto
- ItemReference values for inspiratory capacity in healthy nonsmokers over age 50 years(EDICIONES DOYMA S/L, 2007) Lisboa Basualto, Carmen; Leiva, Alicia; Pinochet, Ramón; Repetto Lisboa, Paula Beatriz; Borzone Tassara, Gisella Rosa; Díaz Patino, Orlando AlbertoObjective: The role of dynamic hyperinflation in triggering dyspnea and limiting exercise capacity in patients with chronic obstructive pulmonary disease has been recognized in recent years. The degree of dynamic hyperinflation can be assessed by measuring reduction in inspiratory capacity (IC). The aim of this study was to establish reference values for IC in healthy individuals of both sexes between the ages of 50 and 87 years, as such data are scarce in the literature. Subjects and methods: We studied 155 healthy volunteers (93 women) with normal spirometry. None had a prior history of respiratory, cardiovascular, or systemic diseases that might alter lung function. All were never-smokers. IC was measured during a normal, unforced inspiration to total lung capacity starting from functional residual capacity. The highest value of 6 satisfactory maneuvers was recorded. Sex, height, age, and weight were included in the regression equations. One thousand bootstrap samples for each sex were also analyzed. Results: For each sex, we found that a model including age, height, and weight produced IC prediction equations with a coefficient of determination (r2) of 0.414 for women and 0.447 for men. The mean (SD) intrasubject coefficient of variation was 4.3% (2%) for IC measured during a single session and 5.1% (0.4%) for measurements from 5 weekly sessions. Conclusions: Our results provide reference equations for IC that are valid for a healthy population over 50 years of age. Predicted values were similar to those recently obtained in an Italian population aged between 65 and 85 years.