Browsing by Author "Kattan, Eduardo"

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    Doppler identified venous congestion in septic shock: protocol for an international, multi-centre prospective cohort study (Andromeda-VEXUS)
    (2023) Prager, Ross; Argaiz, Eduardo; Pratte, Michael; Rola, Philippe; Arntfield, Robert; Beaubien-Souligny, William; Denault, Andre Y.; Haycock, Korbin; Aguiar, Francisco Miralles; Bakker, Jan; Ospina-Tascon, Gustavo; Orozco, Nicolas; Rochwerg, Bram; Lewis, Kimberley; Quazi, Ibrahim; Kattan, Eduardo; Hernandez, Glenn; Basmaji, John
    Introduction Venous congestion is a pathophysiological state where high venous pressures cause organ oedema and dysfunction. Venous congestion is associated with worse outcomes, particularly acute kidney injury (AKI), for critically ill patients. Venous congestion can be measured by Doppler ultrasound at the bedside through interrogation of the inferior vena cava (IVC), hepatic vein (HV), portal vein (PV) and intrarenal veins (IRV). The objective of this study is to quantify the association between Doppler identified venous congestion and the need for renal replacement therapy (RRT) or death for patients with septic shock.Methods and analysis This study is a prespecified substudy of the ANDROMEDA-SHOCK 2 (AS-2) randomised control trial (RCT) assessing haemodynamic resuscitation in septic shock and will enrol at least 350 patients across multiple sites. We will include adult patients within 4 hours of fulfilling septic shock definition according to Sepsis-3 consensus conference. Using Doppler ultrasound, physicians will interrogate the IVC, HV, PV and IRV 6-12 hours after randomisation. Study investigators will provide web-based educational sessions to ultrasound operators and adjudicate image acquisition and interpretation. The primary outcome will be RRT or death within 28 days of septic shock. We will assess the hazard of RRT or death as a function of venous congestion using a Cox proportional hazards model. Sub-distribution HRs will describe the hazard of RRT given the competing risk of death.Ethics and dissemination We obtained ethics approval for the AS-2 RCT, including this observational substudy, from local ethics boards at all participating sites. We will report the findings of this study through open-access publication, presentation at international conferences, a coordinated dissemination strategy by investigators through social media, and an open-access workshop series in multiple languages.Trial registration number NCT05057611.
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    Drug diluent and efficacy of methylene blue in septic shock: authors’ reply
    (2023) Ibarra Estrada, Miguel; Kattan, Eduardo; Aguirre Avalos, Guadalupe; Hernández P., Glenn
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    Process-oriented metrics to provide feedback and assess the performance of students who are learning surgical procedures: The percutaneous dilatational tracheostomy case
    (TAYLOR & FRANCIS LTD, 2022) Jose Martinez, Juan; Galvez-Yanjari, Victor; de la Fuente, Rene; Kychenthal, Catalina; Kattan, Eduardo; Bravo, Sebastian; Munoz-Gama, Jorge; Sepulveda, Marcos
    Purpose Assessing competency in surgical procedures is key for instructors to distinguish whether a resident is qualified to perform them on patients. Currently, assessment techniques do not always focus on providing feedback about the order in which the activities need to be performed. In this research, using a Process Mining approach, process-oriented metrics are proposed to assess the training of residents in a Percutaneous Dilatational Tracheostomy (PDT) simulator, identifying the critical points in the execution of the surgical process. Materials and methods A reference process model of the procedure was defined, and video recordings of student training sessions in the PDT simulator were collected and tagged to generate event logs. Three process-oriented metrics were proposed to assess the performance of the residents in training. Results Although the students were proficient in classic metrics, they did not reach the optimum in process-oriented metrics. Only in 25% of the stages the optimum was achieved in the last session. In these stages, the four more challenging activities were also identified, which account for 32% of the process-oriented metrics errors. Conclusions Process-oriented metrics offer a new perspective on surgical procedures performance, providing a more granular perspective, which enables a more specific and actionable feedback for both students and instructors.
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    The emerging concept of fluid tolerance: A position paper
    (2022) Kattan, Eduardo; Castro, Ricardo; Miralles-Aguiar, Francisco; Hernandez, Glenn; Rola, Philippe
    Available online xxxx Fluid resuscitation is a core component of emergency and critical care medicine. While the focus of clinicians has largely been on detecting patients who would respond to fluid therapy, relatively little work has been done on assessing patients' tolerance to this therapy. In this article we seek to review the concept of fluid tolerance, propose a working definition, and introduce relevant clinical signals by which physicians can assess fluid tolerance, hopefully becoming a starting point for further research.
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    The seven Ts of capillary refill time: more than a clinical sign for septic shock patients
    (LIPPINCOTT WILLIAMS & WILKINS, 2020) Vera, Magdalena; Kattan, Eduardo; Castro, Ricardo; Hernandez, Glenn
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    Use of clinical simulation to train healthcare teams in conflict management: a scoping review
    (2022) Putz, Francisca; Kattan, Eduardo; Maestre, Jose M.
    Y Objective: To assess and analyze the impact of clinical simulation as a training tool in healthcare teams ability to resolve and manage conflicts, through an exploratory systematic review.