المؤلفون: Viruez-Soto, Antonio, Molano-Franco, Daniel, Merino-Luna, Alfredo, Bairam, Aida, Aliaga-Raduán, Fernanda, Sanchez, Lida, Arias-Reyes, Christian, Soliz, Jorge

المصدر: Frontiers in Physiology ; volume 14 ; ISSN 1664-042X

الوصف: Previous studies on the cardiac data of healthy permanent residents living in high-altitude regions such as Tibet and the Andes have yielded inconsistent findings and significant disparities. These discrepancies can be mainly attributed to the invasive methods conventionally used for parameter evaluation. However, with the introduction of cutting-edge ultrasound technology, there is now an innovative approach to addressing and reconciling these variations. In this pilot study, we employed an ultrasound-based cardiac output monitoring (USCOM) device to evaluate cardiac output and related hemodynamic variables in a group of 20 healthy high-altitude Andean residents (comprising 10 men and 10 women) aged between 26 and 35 years old. The monocentric study was carried out in La Paz, Bolivia, located between at an altitude of 3,600–4,000 m. A total of 60 hemodynamic measurements were evaluated, accounting for three technical replicates per subject. Our results showed strong intrasubject reproducibility and revealed important differences related to both sex and hemodynamic parameters in highlanders compared to individuals residing at sea level. We conclude that USCOM represents a highly reliable technology for performing hemodynamic measurements in high-altitude residents. Our preliminary findings underscore the need for larger studies, encompassing larger sample sizes, specifically tailored to gender considerations, and extendable to broader highland populations. These findings have special significant implications for the management of hemodynamics in intensive care and postoperative settings, warranting further comprehensive research efforts.

الإتاحة: https://doi.org/10.3389/fphys.2023.1297872Test

المؤلفون: Viruez-Soto Antonio, Medina-Vera Jaime Marcelo, Valdez-Alanoca Wilson, Tintaya-Maquera Apolinar

المصدر: Revista Científica "Imaraña" del Hospital del Norte 4(1) 8-12

مصطلحات موضوعية: Cuidado intensivo, muy alta altitud, gasometría venosa periférica, embarazo

الوصف: La gasometría arterial es el estudio realizado con más frecuencia en la Unidad de Cuidados Intensivos (UCI) por ser esencial para el manejo del paciente en estado crítico, con dos objetivos, el primero es evaluar el estado acido base mediante el pH (bicarbonato y pCO2) y el segundo el estado respiratorio (mediante el pO2, pCO2), sin embargo, conlleva muchos riesgos, por lo que se sugiere que la gasometría venosa periférica (GVP), con menor riesgo de complicaciones siendo también menos dolorosa. El objetivo del presente trabajo es describir los valores de GVP a partir de residentes permanentes y gestantes. Se realizó un estudio observacional descriptivo transversal entre los meses de Enero-Marzo 2023, realizándose muestreo por conveniencia logrando incluir en un grupo a 32 residentes permanentes voluntarios sanos mayores de 18 años, así como en el otro brazo, 11 mujeres residentes permanentes con embarazo normoevolutivas. El estudio cuenta con la aprobación del Comité de Bioética Institucional. Los valores promedio en gasometría venosa periférica en adultos “sanos” residentes de Muy Alta Altitud son pH 7.37, pO2 36.15, pCO2 35.78, HCO3 20.11, Sat 58.61%, lactato 2.04 así como en gestantes normoevolutivas pH 7.41, pO2 40.09, pCO2 26.25, HCO3 18.24, Sat 62.27%, lactato 1.67. La información obtenida resulta muy útil ya que permite conocer y orientar el manejo de pacientes residentes a Muy Alta Altitud. Las diferencias entre los promedios entre residentes permanentes adultos y residentes permanentes gestantes resultan estadísticamente significativas en el caso de pH, pCO2, bicarbonato, osmolaridad, glucosa y potasio séricos.

العلاقة: https://zenodo.org/communities/imaranaTest; https://zenodo.org/record/8025164Test; https://doi.org/10.5281/zenodo.8025164Test; oai:zenodo.org:8025164

الإتاحة: https://doi.org/10.5281/zenodo.8025164Test
https://doi.org/10.5281/zenodo.8025163Test
https://zenodo.org/record/8025164Test

المؤلفون: Viruez-Soto, Antonio, Auza-Santiváñez, Jhossmar Cristians, Condori-Villca, Nayra, Segales-Camacho, Ariel, Gutiérrez-Beltrán, Joel, Prieto-Jemio, José Luis

المصدر: Revista de ciencias médicas de Pinar del Río; Vol. 27 (2023): (Sistema de Publicación Continua); e5930 ; 1561-3194

مصطلحات موضوعية: PICADURAS DE ESCORPIÓN, VENENOS DE ESCORPIÓN, ESCORPIONES, INTOXICACIÓN, SCORPION STINGS, SCORPION VENOMS, SCORPIONS, POISONING

الوصف: Introducción: las picaduras de escorpión son comunes en diversas partes del mundo y son un verdadero problema de salud pública.Objetivo: describir las especies de alacranes, características del veneno, fisiopatología, manifestaciones clínicas, clasificación de la gravedad, diagnóstico y su manejo en la unidad de cuidados intensivos.Métodos: se realizó una búsqueda de información en el periodo febrero-marzo de 2023 en las bases de datos SciELO, Scopus, PubMed/MedLine, el buscador Google Académico, así como en los servicios ClinicalKeys. De los documentos resultantes se seleccionaron aquellos redactados en los últimos 10 años, en idioma español o inglés.Desarrollo: aproximadamente existen 2584 especies de alacranes. La especie Tityus (Tityus) sorataensis fue descrita para Bolivia. Los venenos de escorpión se han estudiado durante más de un siglo. Las principales manifestaciones clínicas: placas de urticaria, hinchazón, eritema, equimosis y celulitis con edema. Las manifestaciones sistémicas van de uno a dos días después del envenenamiento y pueden desarrollar signos sistémicos: fiebre, palidez, fatiga, edema generalizado. El diagnóstico se basa en una historia de una picadura de escorpión y signos característicos de envenenamiento. El tratamiento puede ser empírico, aplicar medidas generales, manejo del dolor y si está presente algunas complicaciones como edema pulmonar, choque cardiogénico es necesario su manejo en una sala de cuidados intensivosConclusiones: la intoxicación por picadura de alacrán, es un reto terapéutico. Es recomendable la administración del antídoto (antiveneno) junto al tratamiento de sostén. un mejor conocimiento de los escorpiones, puede alentar el interés en realizar nuevas investigaciones. ; Introduction: scorpion stings are common in different parts of the world and are a real public health problem.Objective: to describe scorpion species, venom characteristics, pathophysiology, clinical manifestations, severity classification, diagnosis and management in the intensive care unit.Methods: ...

وصف الملف: application/pdf; application/xml

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Disponible en: https://doi.org/10.1186%2Fs40409-018-0145-zTest; Amaral CF, Rezende NA. Both cardiogenic and non-cardiogenic factors are involved in the pathogenesis of pulmonary oedema after scorpion envenoming. Toxicon [Internet]. 1997 [citado 06/03/2023]; 35(7):997-8. Disponible en: https://doi.org/10.1016/s0041-0101Test(96)00206-1; Elatrous S, Ouanes Besbes L, Ben Sik Ali H, Hamouda Z, BenAbdallah S, Tilouche N, et al. Study of severe scorpion envenoming following subcutaneous venom injection into dogs: hemodynamic and concentration/effect analysis. Toxicon [Internet]. 2015 [citado 07/03/2023]; 104:1-6. Disponible en: https://doi.org/10.1016/j.toxicon.2015.07.003Test; Nouira S, Elatrous S, Besbes L, Boukef R, Devaux C, Aubrey N, et al. Neurohormonal activation in severe Scorpion envenomation: correlation with hemodynamics and circulating toxin. Toxicol Appl Pharmacol [Internet]. 2005 [citado 07/03/2023]; 208(2): 111-116. Disponible en: https://pubmed.ncbi.nlm.nih.gov/16183384Test/; Abroug F, ElAtrous S, Nouira S, Haguiga H, Touzi N, Bouchoucha S. Serotherapy in scorpion envenomation: a randomised controlled trial. Lancet [Internet].1999 [citado 08/03/2023]; 354(9182): 906–909. Disponible en: https://doi.org/10.1016/s0140-6736Test(98)12083-4; Dehghani R, Fathi B. Scorpion sting in Iran: a review. Toxicon [Internet]. 2012 [citado 08/03/2023]; 60(5): 919-933. Disponible en: https://doi.org/10.1016/j.toxicon.2012.06.002Test; Jalali A, Pipelzadeh MH, Sayedian R, Rowan EG. A review of epidemiological, clinical and in vitro physiological studies of envenomation by the scorpion Hemiscorpius lepturus (Hemiscorpiidae) in Iran. Toxicon [Internet]. 2010 [citado 10/03/2023]; 55(2-3): 173-9. Disponible en: https://doi.org/10.1016/j.toxicon.2009.09.012Test; Valavi E, Amuri P, Ahmadzadeh A, et al. Acute kidney injury in Hemiscorpius lepturus scorpion stung children: Risk factors and clinical features. 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الإتاحة: https://doi.org/10.1007/s00134-020-05924-8Test
https://doi.org/10.5380//abpr.v34i0.952Test
https://doi.org/10.1590/0037-8682-0237-2015Test
https://doi.org/10.1056/nejmra1401108Test
https://doi.org/10.1016/s0041-0101Test(96)00206-1
https://doi.org/10.1016/j.toxicon.2015.07.003Test
https://doi.org/10.1016/s0140-6736Test(98)12083-4
https://doi.org/10.1016/j.toxicon.2012.06.002Test
https://doi.org/10.1016/j.toxicon.2009.09.012Test
https://doi.org/10.1378/chest.116.3.748Test

المؤلفون: Viruez-Soto, Antonio, Arias, Samuel, Casas-Mamani, Ronnie, Rada-Barrera, Gabriel, Merino-Luna, Alfredo, Molano-Franco, Daniel, Tinoco-Solorzano, Amílcar, Marques, Danuzia A., Zubieta-DeUrioste, Natalia, Zubieta-Calleja, Gustavo, Arias-Reyes, Christian, Soliz, Jorge

المساهمون: Canadian Institutes of Health Research

المصدر: Respiratory Physiology & Neurobiology ; volume 299, page 103868 ; ISSN 1569-9048

مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Physiology, General Neuroscience

الإتاحة: https://doi.org/10.1016/j.resp.2022.103868Test
https://api.elsevier.com/content/article/PII:S1569904822000271?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1569904822000271?httpAccept=text/plainTest

المؤلفون: Molano-Franco, Daniel, Viruez-Soto, Antonio, Gomez, Mario, Beltran, Edgar, Villabon, Mario, Sosa, Angela, Ortiz, Leidy, Orozco, Estefania, Hurtado, Alejandra, Sanchez, Lida, Arias-Reyes, Christian, Soliz, Jorge, Masclans, Joan R.

المصدر: Respiratory Care; Jan2024, Vol. 69 Issue 1, p99-105, 7p

مصطلحات موضوعية: NASAL cannula, COVID-19, CONFIDENCE intervals, SCIENTIFIC observation, RESEARCH methodology, RETROSPECTIVE studies, QUANTITATIVE research, ADULT respiratory distress syndrome, ARTIFICIAL respiration, QUALITATIVE research, OXYGEN therapy, SURVIVAL analysis (Biometry), KAPLAN-Meier estimator, ODDS ratio, DATA analysis software, LOGISTIC regression analysis, LONGITUDINAL method, HYPOXEMIA, DISEASE complications

مستخلص: BACKGROUND: High-flow nasal cannula (HFNC) reduces the need for intubation in adult subject with acute respiratory failure. Changes in hypobaric hypoxemia have not been studied for subject with an HFNC in ICUs at altitudes > 2,600 m above sea level. In this study, we investigated the efficacy of HFNC treatment in subjects with COVID-19 at high altitudes. We hypothesized that progressive hypoxemia and the increase in breathing frequency associated with COVID-19 in high altitudes affect the success of HFNC therapy and may also influence the performance of the traditionally used predictors of success and failure. METHODS: This was a prospective cohort study of subjects >18 y with a confirmed diagnosis of COVID-19--induced ARDS requiring HFNC who were admitted to the ICU. Subjects were followed up during the 28 d of HFNC treatment or until failure. RESULTS: One hundred and eight subjects were enrolled. At admission to the ICU, ... delivery between 0.5-0.8 (odds ratio 0.38 [95% CI 0.17-0.84]) was associated with a better response to HFNC therapy than oxygen delivery on admission between 0.8-1.0 (odds ratio 3.58 [95% CI 1.56-8.22]). This relationship continued during follow-ups at 2, 6, 12, and 24 h, with a progressive increase in the risk of failure (odds ratio 24 h 13.99 [95% CI 4.32-45.26]). A new cutoff for the ratio of oxygen saturation (ROX) index (ROX 6 4.88) after 24 h of HFNC administration was demonstrated to be the best predictor of success (odds ratio 11.0 [95% CI 3.3-47.0]). CONCLUSIONS: High-altitude subjects treated with HFNC for COVID-19 showed a high risk of respiratory failure and progressive hypoxemia when ... requirements were > 0.8 after 24 h of treatment. In these subjects, personalized management should include continuous monitoring of individual clinical conditions (such as oxygenation indices, with cutoffs adapted to those corresponding to high-altitude cities). [ABSTRACT FROM AUTHOR]

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المؤلفون: Viruez-Soto, Antonio, López-Dávalos, Mónica Marlene, Rada-Barrera, Gabriel, Merino-Luna, Alfredo, Molano-Franco, Daniel, Tinoco-Solorozano, Amílcar, Zubieta-DeUrioste, Natalia, Zubieta-Calleja, Gustavo, Arias-Reyes, Christian, Soliz, Jorge

المصدر: Respiratory Physiology & Neurobiology ; volume 292, page 103709 ; ISSN 1569-9048

مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Physiology, General Neuroscience

الإتاحة: https://doi.org/10.1016/j.resp.2021.103709Test
https://api.elsevier.com/content/article/PII:S156990482100094X?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S156990482100094X?httpAccept=text/plainTest

المؤلفون: Arias‐Reyes, Christian, Viruez‐Soto, Antonio, Arias, Samuel, Casas‐Mamani, Ronnie, Rada‐Barrera, Gabriel, Merino‐Luna, Alfredo, Molano‐Franco, Daniel, Tinoco‐Solorzano, Amilcar, Marques, Danuzia A., Zubieta‐DeUrioste, Natalia, Zubieta‐Calleja, Gustavo, Soliz, Jorge

المصدر: The FASEB Journal ; volume 36, issue S1 ; ISSN 0892-6638 1530-6860

الوصف: Patients admitted to the Intensive Care Unit (ICU) with acute hypoxemic respiratory failure automatically receive oxygen therapy to improve inspiratory oxygen fraction (FiO 2 ). Supplemental oxygen is the most prescribed drug for critically ill patients regardless of altitude of residence. In high altitude dwellers (i.e. in La Paz [»3,400 m] and El Alto [»4,150 m] in Bolivia), a peripheral oxygen saturation (SatpO 2 ) of 89‐95% and an arterial partial pressure of oxygen (PaO 2 ) of 50‐67mmHg (lower as altitude rises), are considered normal values for arterial blood. Consequently, it has been suggested that limiting oxygen therapy to maintain SatpO 2 around normoxia may help avoid episodes of hypoxemia, hyperoxemia, intermittent hypoxemia, and ultimately, mortality. In this study, we evaluated the impact of oxygen therapy on the mortality of critically ill COVID‐19 patients who permanently live at high altitudes. A multicenter cross‐sectional descriptive observational study was performed on 100 patients admitted to the ICU at the “Clinica Los Andes” (in La Paz city) and “Agramont” and “Del Norte” Hospitals (in El Alto city). Our results show that: 1) as expected, fatal cases were detected only in patients who required intubation and connection to invasive mechanical ventilation as a last resort to overcome their life‐threatening desaturation; 2) among intubated patients, prolonged periods in normoxia are associated with survival, prolonged periods in hypoxemia are associated with death, and time spent in hyperoxemia shows no association with survival or mortality; 3) the oxygenation limits required to effectively support the intubated patients’ survival in the ICU are between 89% and 93%; 4) among intubated patients with similar periods of normoxemic oxygenation, those with better SOFA scores survive; and 5) a lower frequency of observable reoxygenation events is not associated with survival. In conclusion, our findings indicate that high‐altitude patients entering an ICU at altitudes of 3,400 – 4,150 m should ...

الإتاحة: https://doi.org/10.1096/fasebj.2022.36.s1.l7958Test

المؤلفون: Arias‐Reyes, Christian, Viruez‐Soto, Antonio, López‐Dávalos, Mónica Marlene, Rada‐Barrera, Gabriel, Merino‐Luna, Alfredo, Molano‐Franco, Daniel, Tinoco‐Solorzano, Amilcar, Zubieta‐DeUrioste, Natalia, Zubieta‐Calleja, Gustavo, Soliz, Jorge

المصدر: The FASEB Journal ; volume 36, issue S1 ; ISSN 0892-6638 1530-6860

الوصف: Previous studies suggested that erythropoietin (EPO) may protect against severe COVID‐19‐induced injuries, ultimately preventing mortality. This hypothesis is based on the fact that, in addition to promoting the increase in red blood cells, EPO is an anti‐inflammatory, anti‐apoptotic and protective factor in several non‐erythropoietic tissues. Furthermore, EPO promotes nitric oxide production in the hypoxic lung and stimulates ventilation by interacting with the respiratory centers of the brainstem. Given that EPO in the blood is increased at high‐altitude, we evaluated the serum levels of EPO in critical patients with COVID‐19 at “Hospital Agramont” in the city of El Alto (4,150 masl) in Bolivia. A total of 16 patients, 15 men, one woman, with a mean age of 55.8 ± 8.49 years, admitted to the Intensive Care Unit were studied. All patients were permanent residents of El Alto, with no travel history below 3,000 masl for at least one year. Blood samples were collected upon admission to the ICU. Serum EPO concentration was assessed using an ELISA kit, and a standard technique determined hemoglobin concentration. Only half of the observed patients survived the disease. Remarkably, fatal cases showed 2.5 times lower serum EPO than survivors (2.78 ± 0.8643 mU/ml vs 7.06 ± 2.713 mU/ml; p = 0.0096), and 1.24 times lower hemoglobin levels (13.96 ± 2.56 g/dL vs 17.41 ± 1.61 g/dL; p = 0.0159). While the number of cases evaluated in this work is low, our findings strongly warrant further investigation of EPO levels in COVID‐19 patients at high and low altitudes. Our results also support the hypothesis that exogenous EPO administration could help critically ill COVID‐19 patients overcome the disease.

الإتاحة: https://doi.org/10.1096/fasebj.2022.36.s1.l7986Test

المؤلفون: Viruez-Soto, Antonio, Tinoco-Solórzano, Amílcar, Jiris-Quinteros, Jorge, Antezana-Aramayo, Jorge, Cáceres-Flores, Félix

المصدر: Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo; Vol. 14 No. 3 (2021): July-September; 291-296
Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo; Vol. 14 Núm. 3 (2021): Julio-Setiembre; 291-296
Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
instacron:HNAAA

مصطلحات موضوعية: Altitude, Lactato, Mortalidad, Lactic Acid, Mortality, Altitud, Trauma, Severe Trauma

الوصف: Background: Several studies report that lactate clearance is associated with mortality in critically ill patients. Objectives: To describe the relationship between lactate clearance and lactate normalization with mortality in high-altitude resident patients with severe trauma. To know the mortality of patients with severe trauma at altitude. Know the injury distribution of severe trauma at altitude. Material and Methods: Epidemiological, observational, analytical, cohort, retrospective study, carried out in an intensive care unit located at 4,150 "masl" in patients admitted for severe trauma. The inclusion criteria were: a) Diagnosis of severe trauma. b) Injury severity score greater than 16. c) Presence of the result of the lactate analysis at admission and at 6 hours in the ICU and d) Resident of the altitude since the age of 12. Patients with incomplete and unreadable medical records were excluded. Results: 160 patients were included, mortality of 15%, 65% of the injuries were due to severe brain trauma. In the group of survivors (136), lactate clearance was 52.27% and in the group of deceased it was 21.38%. In relation to normalization (lactate

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=od______3056::b3ffec1d4962d571a657c9a6b2c994e4Test
https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/1247Test

المؤلفون: Valencia Albert, Viruez-Soto Antonio, Masclans Joan Ramon, Villabon Mario, Gómez Duque Mario, Garzón Diego, Vásquez Pablo, Beltrán Edgar, Gómez Nicolas, Hurtado Alejandra, Nieto Victor, Molano Franco Daniel

المصدر: Journal of intensive care medicine. 37(9)

مصطلحات موضوعية: Adult, medicine.medical_treatment, Critical Care and Intensive Care Medicine, medicine.disease_cause, Cohort Studies, medicine, Intubation, Cannula, Humans, In patient, Prospective Studies, Mechanical ventilation, Noninvasive Ventilation, business.industry, Altitude, Oxygen Inhalation Therapy, Pneumonia, Hypoxemic respiratory failure, Effects of high altitude on humans, Middle Aged, medicine.disease, Anesthesia, High flow, business, Respiratory Insufficiency, Nasal cannula

الوصف: Introduction: The use of high-flow nasal cannulas (HFNC) in patients with hypoxemic ventilatory failure reduces the need for mechanical ventilation and does not increase mortality when intubation is promptly applied. The aim of the study is to describe the behavior of HFNC in patients who live at high altitudes, and the performance of predictors of success/failure of this strategy. Methods: Prospective multicenter cohort study, with patients aged over 18 years recruited for 12 months in 2020 to 21. All had a diagnosis of hypoxemic respiratory failure secondary to pneumonia, were admitted to intensive care units, and were receiving initial management with a high-flow nasal cannula. The variables assessed included need for intubation, mortality in ICU, and the validation of SaO2, respiratory rate (RR) and ROX index (IROX) as predictors of HFNC success / failure. Results: One hundred and six patients were recruited, with a mean age of 59 years and a success rate of 74.5%. Patients with treatment failure were more likely to be obese (BMI 27.2 vs 25.5; OR: 1.03; 95% CI: .95-1.1) and had higher severity scores at admission (APACHE II 12 vs 20; OR 1.15; 95% CI: 1.06-1.24). Respiratory rates after 12 (AUC .81 CI: .70-.92) and 18 h (AUC .85 CI: .72-0.90) of HFNC use were the best predictors of failure, performing better than those that included oxygenation. ICU mortality was higher in the failure group (6% vs 29%; OR 8.8; 95% CI:1.75-44.7). Conclusions: High-flow oxygen cannula therapy in patients with hypoxemic respiratory failure living at altitudes above 2600 m is associated with low rates of therapy failure and a reduced need for mechanical ventilation in the ICU. The geographical conditions and secondary physiological changes influence the performance of the traditionally validated predictors of therapy success. Respiratory rate

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3005baa806cf780705ddb01bf7347fcdTest
https://pubmed.ncbi.nlm.nih.gov/34812065Test