Browsing by Author "Kattan E."

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    A microcirculation-guided trial: never trying is worse than failing
    (Springer, 2023) Bruno R.R.; Hernandez G.; Thiele H.; Kattan E.; Jung C.; CEDEUS (Chile)
    © 2022 European Mathematical Society.Let G be the topological fundamental group of a given nonsingular complex projective surface. We prove that the Chern slopes c12(S)/c2(S) of minimal nonsingular surfaces of general type S with π1(S) ≃ G are dense in the interval [1; 3].
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    Correction: Direct assessment of microcirculation in shock: a randomized-controlled multicenter study (Intensive Care Medicine, (2023), 49, 6, (645-655), 10.1007/s00134-023-07098-5)
    (2023) Bruno R.R.; Wollborn J.; Fengler K.; Flick M.; Wunder C.; Allgauer S.; Thiele H.; Schemmelmann M.; Hornemann J.; Moecke H.M.E.; Demirtas F.; Palici L.; Franz M.; Saugel B.; Kattan E.; De Backer D.; Bakker J.; Hernandez G.; Kelm M.; Jung C.
    © 2023, The Author(s).In this article the author Marcus Franz has been mistakenly affiliated with the Erasmus MC University Medical Center, Rotterdam, The Netherlands. He is only affiliated with the “Department of Internal Medicine I, University Hospital Jena, Jena, Germany”. The original article has been corrected. The Authors apologize for this mistake.
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    Hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial study protocol
    (2022) Kattan E.; Castro R.; Hernandez G.; Bakker J.; Estenssoro E.; Ospina-Tascon G.A.; Cavalcanti A.B.; De Backer D.; Vieillard-Baron A.; Teboul J.-L.
    © 2022 Associacao de Medicina Intensiva Brasileira - AMIB. All rights reserved.Background: Early reversion of sepsis-induced tissue hypoperfusion is essential for survival in septic shock. However, consensus regarding the best initial resuscitation strategy is lacking given that interventions designed for the entire population with septic shock might produce unnecessary fluid administration. This article reports the rationale, study design and analysis plan of the ANDROMEDA-2 study, which aims to determine whether a peripheral perfusion-guided strategy consisting of capillary refill time-targeted resuscitation based on clinical and hemodynamic phenotypes is associated with a decrease in a composite outcome of mortality, time to organ support cessation, and hospital length of stay compared to standard care in patients with early (< 4 hours of diagnosis) septic shock. Methods: The ANDROMEDA-2 study is a multicenter, multinational randomized controlled trial. In the intervention group, capillary refill time will be measured hourly for 6 hours. If abnormal, patients will enter an algorithm starting with pulse pressure assessment. Patients with pulse pressure less than 40mmHg will be tested for fluid responsiveness and receive fluids accordingly. In patients with pulse pressure > 40mmHg, norepinephrine will be titrated to maintain diastolic arterial pressure > 50mmHg. Patients who fail to normalize capillary refill time after the previous steps will be subjected to critical care echocardiography for cardiac dysfunction evaluation and subsequent management. Finally, vasopressor and inodilator tests will be performed to further optimize perfusion. A sample size of 1,500 patients will provide 88% power to demonstrate superiority of the capillary refill time-targeted strategy. Conclusions: If hemodynamic phenotype-based, capillary refill time-targeted resuscitation demonstrates to be a superior strategy, care processes in septic shock resuscitation can be optimized with bedside tools.
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    Respiratory support of the COVID-19 critically ill patient: 18 months since the pandemic started in ChileSoporte ventilatorio en pacientes críticos con COVID-19: A 18 meses de la pandemia en Chile
    (2021) Ulloa R.; Born P.; Kattan E.; Bugedo G.
    © 2021 Sociedad de Anestesiologia de Chile. All rights reserved.After 18 months from the beginning of the pandemic, we have increased our knowledge about different aspects of respiratory care of critically ill patients with SARS-CoV-2 pneumonia. In this review, we analyze the available evidence regarding physiopathology and clinical course of COVID-19 pneumonia; the pillars of respiratory support (both non-invasive and invasive); pharmacological therapy, and the challenges derived from the chronic critically ill COVID-19 patient. Even though there are still many questions left to be answered, as long as we keep learning from this new disease and its’ impact on our organism, we will opportunely adapt our care strategies.