Browsing by Author "Oviedo Álvarez, Vanessa Andrea"
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- ItemBeta-Lactam Antibiotics Can Be Measured in the Exhaled Breath Condensate in Mechanically Ventilated Patients: a Pilot Study(2023) Escalona Solari, José Antonio; Soto Muñoz, Dagoberto Igor; Oviedo Álvarez, Vanessa Andrea; Rivas Garrido, Elizabeth Alexis; Severino, Nicolás; Kattan Tala, Eduardo José; Andresen Hernández, Max Alfonso; Bravo Morales, Sebastián Ignacio; Basoalto Escobar, Roque Ignacio; Bachmann Barron, María Consuelo; Kwok-Yin, Wong; Pavez, Nicolás; Bruhn Cruz, Alejandro Rodrigo; Bugedo Tarraza, Guillermo Jaime; Retamal Montes, Jaime AlejandroDifferent techniques have been proposed to measure antibiotic levels within the lung parenchyma; however, their use is limited because they are invasive and associated with adverse effects. We explore whether beta-lactam antibiotics could be measured in exhaled breath condensate collected from heat and moisture exchange filters (HMEFs) and correlated with the concentration of antibiotics measured from bronchoalveolar lavage (BAL). We designed an observational study in patients undergoing mechanical ventilation, which required a BAL to confirm or discard the diagnosis of pneumonia. We measured and correlated the concentration of beta-lactam antibiotics in plasma, epithelial lining fluid (ELF), and exhaled breath condensate collected from HMEFs. We studied 12 patients, and we detected the presence of antibiotics in plasma, ELF, and HMEFs from every patient studied. The concentrations of antibiotics were very heterogeneous over the population studied. The mean antibiotic concentration was 293.5 (715) ng/mL in plasma, 12.3 (31) ng/mL in ELF, and 0.5 (0.9) ng/mL in HMEF. We found no significant correlation between the concentration of antibiotics in plasma and ELF (R2 = 0.02, p = 0.64), between plasma and HMEF (R2 = 0.02, p = 0.63), or between ELF and HMEF (R2 = 0.02, p = 0.66). We conclude that beta-lactam antibiotics can be detected and measured from the exhaled breath condensate accumulated in the HMEF from mechanically ventilated patients. However, no correlations were observed between the antibiotic concentrations in HMEF with either plasma or ELF.
- ItemReflections on a Respiratory Therapy Postgraduate Certificate Program in Chile(American Thoracic Society, 2024) Kattan Tala, Eduardo José; Basoalto Escobar, Roque Ignacio; Retamal Montes, Jaime Alejandro; Oviedo Álvarez, Vanessa Andrea; Bruhn Cruz, Alejandro Rodrigo; Bugedo Tarraza, Guillermo JaimeChile is a South American country that spans 4,300 km from north to south. Population density and access to critical care are highly concentrated in Santiago’s metropolitan region. After the educational challenges posed by the 2009 H1N1 influenza pandemic, our critical care department at the Pontificia Universidad Catolica de Chile in Santiago created the Respiratory Therapy Postgraduate Certificate as an educational intervention to address the shortage of healthcare professionals with knowledge and skills in performing respiratory support in critically ill patients. Throughout this Perspective, we aim to delineate the program design, major educational results, implementation of educational innovations that allowed us to adapt to the geographical challenges of the country and those imposed by the coronavirus disease (COVID-19) pandemic, and future challenges identified for the next decade.