Browsing by Author "Ramirez J."

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    Cardiac function in critically ill patients with severe COVID: A prospective cross-sectional study in mechanically ventilated patients
    (W.B. Saunders, 2022) Valenzuela E.D.; Gonzalez A.; Rovegno M.; Ramirez J.; Hernandez G.; Bruhn A.; Bakker J.; Mercado P.; Aguilera J.; Pairumani R.; Petruska E.; Morales F.; Araya C.; Medel J.N.; Ugalde D.; Eisen D.; Montoya J.; Slama M.
    © 2022 Elsevier Inc.Purpose: To evaluate cardiac function in mechanically ventilated patients with COVID-19. Materials and methods: Prospective, cross-sectional multicenter study in four university-affiliated hospitals in Chile. All consecutive patients with COVID-19 ARDS requiring mechanical ventilation admitted between April and July 2020 were included. We performed systematic transthoracic echocardiography assessing right and left ventricular function within 24 h of intubation. Results: 140 patients aged 57 ± 11, 29% female were included. Cardiac output was 5.1 L/min [IQR 4.5–6.2] and 86% of the patients required norepinephrine. ICU mortality was 29% (40 patients). Fifty-four patients (39%) exhibited right ventricle dilation out of whom 20 patients (14%) exhibited acute cor pulmonale (ACP). Eight out of the twenty patients with ACP exhibited pulmonary embolism (40%). Thirteen patients (9%) exhibited left ventricular systolic dysfunction (ejection fraction <45%). In the multivariate analysis acute cor pulmonale and PaO2/FiO2 ratio were independent predictors of ICU mortality. Conclusions: Right ventricular dilation is highly prevalent in mechanically ventilated patients with COVID-19 ARDS. Acute cor pulmonale was associated with reduced pulmonary function and, in only 40% of patients, with co-existing pulmonary embolism. Acute cor pulmonale is an independent risk factor for ICU mortality.
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    Impact of COVID-19 pandemic on the mental health of healthcare workersEl impacto de la pandemia de COVID-19 en la salud mental de los trabajadores de la salud en Chile: Datos iniciales de The Health Care Workers Study
    (2021) Alvarado R.; Soto G.; Ramirez J.; Lanio I.; Cortes M.; Aguirre A.; Bedregal P.; Allel K.; Tapia-Munoz T.; Alvarado R.; Soledad Burrone M.; Cuadra-Malinarich G.; Goycolea R.; Mascayano F.; Sapag J.; Traub C.; Schilling S.; Villarroel S.; Alarcon S.
    © 2021 Sociedad Medica de Santiago. All rights reserved.Background: Healthcare workers' mental health was affected by SARS-CoV-2 pandemic. Aim: To evaluate healthcare workers' mental health and its associated factors during the pandemic in Chile. Material and Methods: An online self-reported questionnaire was designed including the Goldberg Health Questionnaire, the Patient Health Questionnaire, (PHQ-9), and the Columbia-Suicide Severity Rating Scale among other questions. It was sent to 28,038 healthcare workers. Results: The questionnaire was answered by 1,934 participants, with a median age of 38 years (74% women). Seventy five percent were professionals, and 48% worked at a hospital. Fifty nine percent of respondents had a risk of having a mental health disorder, and 73% had depressive symptoms. Significant associations were found with sex, workplace, and some of the relevant experiences during the pandemic. Fifty one percent reported the need for mental health support, and 38% of them received it. Conclusions: There is a high percentage of health workers with symptoms of psychological distress, depression, and suicidal ideas. The gender approach is essential to understand the important differences found. Many health workers who required mental health care did not seek or received it.