Browsing by Author "Florez, Jorge"

Now showing 1 - 4 of 4
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    Effects of dobutamine on systemic, regional and microcirculatory perfusion parameters in septic shock: a randomized, placebo-controlled, double-blind, crossover study
    (2013) Hernández P., Glenn; Bruhn, Alejandro; Luengo Messen, Cecilia; Regueira Heskia, Tomás; Kattan Tala, Eduardo José; Fuentealba, Andrea; Florez, Jorge; Castro López, Ricardo; Aquevedo Salazar, Andrés Fernando; Pairumani, Ronald; Mc-Nab Martin, Paul Andrew; Ince, Can
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    Hantavirus cardiopulmonary syndrome successfully treated with high-volume hemofiltration
    (2016) Bugedo Tarraza, Guillermo; Florez, Jorge; Ferrés Garrido, Marcela Viviana; Roessler Barrón, Eric; Bruhn, Alejandro
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    High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial
    (2014) Hemmes, Sabrine N. T.; de Abreu, Marcelo Gama; Pelosi, Paolo; Schultz, Marcus J.; Severgnini, Paolo; Hollmann, Markus W.; Binnekade, Jan M.; Wrigge, Hermann; Canet, Jaume; Hiesmayr, Michael; Schmid, Werner; Jaber, Samir; Hedenstierna, Goran; Putensen, Christian; Sessler, Daniel I.; Lachmann, Burkhard; Kacmarek, Robert M.; Slutsky, Arthur S.; De Baerdemaeker, Luc; De Hert, Stefan; Heyse, Bjorn; Van Limmen, Jurgen; Mulier, Jan-Paul; Velghe, David; Jamaer, Luc; Vandenbrande, Jeroen; Bugedo, Guillermo; Florez, Jorge; Goranovic, Tatjana; Mazul-Sunko, Branka; Bluth, Thomas; Guldner, Andreas; Kiss, Thomas; Koch, Thea; Spieth, Peter Markus; Uhlig, Christopher; Yaqub, Jonathan; Bastin, Bea; Geib, Johann; Schaefer, Maximilian S.; Weiss, Martin; Treschan, Tanja A.; Reske, Andreas W.; Simon, Philipp; Ferner, Alexander Brodhun Marion; Hartmann, Eric; Laufenberg-Feldmann, Rita; Strys, Lydia; De Robertis, Edoardo; Perilli, Valter; Proietti, Rodolfo; Amantea, Bruno; Caroleo, Santo; Tropea, Francesco; Bacuzzi, Alessandro; Vanoni, Massimo; Cinnella, Gilda; Caggianelli, Girolamo; D'Antini, Davide; La Bella, Daniela; Mollica, Giuseppina; Cortegiani, Andrea; Giarratano, Antonino; Montalto, Francesca; Raineri, Santi Maurizio; Barberis, Bruno; Celentano, Cristian; Grio, Michele; Spagnolo, Luigi; Gratarola, Angelo; Molin, Alexandre; Pellerano, Giulia; Pezzato, Stefano; Rusca, Roberta; Della Rocca, Giorgio; Bos, Lieuwe D. J.; Brunelli, Andrea; Marti, Agnes; Cegarra, Virginia; Merten, Alfred; Victoria Moral, Maria; Parera, Ana; Carmen Unzueta, Maria; Sabate, Sergi; Sierra, Pilar; Mayoral, Juan F.; Prieto, Merce; Granell Gil, Manuel; Minguez Marin, Conrado; Mills, Gary H.; Bodger, Phoebe; Melo, Marcos F. Vidal; Sulemanji, Demet; Sprung, Juraj; De Bruyne, Ann; Ongena, Patricia; Bleyl, Jorg-Uwe; Koch, Moritz; Muller, Michael; Rossel, Thomas; Saeger, Hans-Detlef; Weitz, Jurgen; Babian, Renate; Rathmann, Anna Malina; Pochert, Julia; Dathe, Mandy; Chiaravalloti, Fernando; Madia, Daniela; Pezzoli, Ivana; Caruso, Andrea; Bianco, Maria Francesca; Picicco, Francesco; Mirabella, Lucia; Rauseo, Michela; Anguilano, Romina; Palmeri, Cesira; Strano, Maria Teresa; Federico, Antonino; Pompei, Livia; Buttera, Stefania; Everingham, Kirsty; Han, Ruth; Hewson, Russell; Januszewska, Marta; Mohr, Otto; Pearse, Rupert; Raj, Ashok; Oto, Jun; Kacmarek, Robert M.; Weingarten, Toby N.
    Background The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H2O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression and lung injury from overdistension. We tested the hypothesis that a high level of positive end-expiratory pressure with recruitment manoeuvres protects against postoperative pulmonary complications in patients at risk of complications who are receiving mechanical ventilation with low tidal volumes during general anaesthesia for open abdominal surgery.
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    Relationship of systemic, hepatosplanchnic, and microcirculatory perfusion parameters with 6-hour lactate clearance in hyperdynamic septic shock patients: an acute, clinical-physiological, pilot study
    (2012) Hernández P., Glenn; Regueira Heskia, Tomás; Bruhn, Alejandro; Castro López, Ricardo; Rovegno Echavarria, Maxiliano; Fuentealba, Andrea; Veas, Enrique; Florez, Jorge; Kattan Tala, Eduardo José; Martin, Celeste; Ince, Can; Berrutti, Dolores
    Abstract Background Recent clinical studies have confirmed the strong prognostic value of persistent hyperlactatemia and delayed lactate clearance in septic shock. Several potential hypoxic and nonhypoxic mechanisms have been associated with persistent hyperlactatemia, but the relative contribution of these factors has not been specifically addressed in comprehensive clinical physiological studies. Our goal was to determine potential hemodynamic and perfusion-related parameters associated with 6-hour lactate clearance in a cohort of hyperdynamic, hyperlactatemic, septic shock patients. Methods We conducted an acute clinical physiological pilot study that included 15 hyperdynamic, septic shock patients undergoing aggressive early resuscitation. Several hemodynamic and perfusion-related parameters were measured immediately after preload optimization and 6 hours thereafter, with 6-hour lactate clearance as the main outcome criterion. Evaluated parameters included cardiac index, mixed venous oxygen saturation, capillary refill time and central-to-peripheral temperature difference, thenar tissue oxygen saturation (StO2) and its recovery slope after a vascular occlusion test, sublingual microcirculatory assessment, gastric tonometry (pCO2 gap), and plasma disappearance rate of indocyanine green (ICG-PDR). Statistical analysis included Wilcoxon and Mann–Whitney tests. Results Five patients presented a 6-hour lactate clearance <10%. Compared with 10 patients with a 6-hour lactate clearance ≥10%, they presented a worse hepatosplanchnic perfusion as represented by significantly more severe derangements of ICG-PDR (9.7 (8–19) vs. 19.6 (9–32)%/min, p < 0.05) and pCO2 gap (33 (9.1-62) vs. 7.7 (3–58) mmHg, p < 0.05) at 6 hours. No other systemic, hemodynamic, metabolic, peripheral, or microcirculatory parameters differentiated these subgroups. We also found a significant correlation between ICG-PDR and pCO2 gap (p = 0.02). Conclusions Impaired 6-hour lactate clearance could be associated with hepatosplanchnic hypoperfusion in some hyperdynamic septic shock patients. Improvement of systemic, metabolic, and peripheral perfusion parameters does not rule out the persistence of hepatosplanchnic hypoperfusion in this setting. Severe microcirculatory abnormalities can be detected in hyperdynamic septic shock patients, but their role on lactate clearance is unclear. ICG-PDR may be a useful tool to evaluate hepatosplanchnic perfusion in septic shock patients with persistent hyperlactatemia. Trial registration ClinicalTrials.gov Identifier: NCT01271153