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Article ; Online: Emergency ventilatory support for acute adult respiratory distress syndrome secondary to COVID-19.

Cinesi Gómez, César / Carratalá Perales, José Manuel

Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

2020 Volume 32, Issue 3, Page(s) 197–200

Title translation	Soporte respiratorio en el paciente adulto con insuficiencia respiratoria aguda secundaria a COVID-19 en urgencias y emergencias.
MeSH term(s)	COVID-19 ; Coronavirus Infections/complications ; Emergency Medical Services ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Respiration, Artificial ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy
Language	Spanish
Publishing date	2020-06-08
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2127173-2
ISSN	2386-5857 ; 1137-6821
ISSN (online)	2386-5857
ISSN	1137-6821
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Failure of Non-Invasive Respiratory Support in Patients with SARS-CoV-2.

García-Fernández, Juan Javier / Sánchez-Nicolás, José Andrés / Galicia-Puyol, Sonia / Gil-Rosa, Isabel / Guerras-Conesa, Juan José / Bernal-Morell, Enrique / Cinesi-Gómez, César

Journal of clinical medicine

2023 Volume 12, Issue 20

Abstract: Introduction: The objective of this study is to assess the failure of therapies with HFNO (high-flow nasal oxygen), CPAP, Bilevel, or combined therapy in patients with hypoxemic acute respiratory failure due to SARS-CoV-2 during their hospitalization.!## ...

Abstract	Introduction: The objective of this study is to assess the failure of therapies with HFNO (high-flow nasal oxygen), CPAP, Bilevel, or combined therapy in patients with hypoxemic acute respiratory failure due to SARS-CoV-2 during their hospitalization. Methods: This was a retrospective and observational study of SARS-CoV-2-positive patients who required non-invasive respiratory support (NIRS) at the Reina Sofía General University Hospital of Murcia between March 2020 and May 2021. Results: Of 7355 patients, 197 (11.8%) were included; 95 of them failed this therapy (48.3%). We found that during hospitalization in the ward, the combined therapy of HFNO and CPAP had an overall lower failure rate and the highest treatment with Bilevel ( Conclusions: The use of NIRS during conventional hospitalization is safe and effective in patients with respiratory failure secondary to SARS-CoV-2 infection. The therapeutic strategy of Bilevel increases the probability of failure, with the combined therapy strategy of CPAP and HFNO being the most promising option.
Language	English
Publishing date	2023-10-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12206537
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Article ; Online: Predictors of noninvasive mechanical ventilation weaning failure in the emergency department.

Cinesi Gómez, César / Trigueros Ruiz, Natalia / de la Villa Zamora, Blanca / Blázquez González, Leonor / Piñera Salmerón, Pascual / Lázaro Aragüés, Paula

Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

2021 Volume 33, Issue 1, Page(s) 9–14

Abstract: Objectives: To analyze factors related to the failure of noninvasive mechanical ventilation (NIV) weaning in a hospital emergency department (ED).: Material and methods: Prospective, observational cohort study with enrolled a sample of consecutive ... ...

Title translation	Factores predictivos de fracaso en el destete de la ventilación mecánica no invasiva en urgencias.
Abstract	Objectives: To analyze factors related to the failure of noninvasive mechanical ventilation (NIV) weaning in a hospital emergency department (ED). Material and methods: Prospective, observational cohort study with enrolled a sample of consecutive patients who required NIV during ED care. The dependent variable was NIV weaning failure, defined by the need to restart NIV in the ED after a first attempt to withdraw the respirator. Results: Of a total of 675 candidates, we included 360 patients (53.4%). Exclusions were 100 patients (31.7%) who were on NIV at home; 58 (18.4%) in whom NIV initially failed; and 157 (49.9%) in whom weaning was attempted outside the ED. Seventy-two (17.3%) cases of weaning failure in the ED were observed. Factors independently associated with failure were the bicarbonate (HCO3) concentrations before attempted weaning (adjusted odds ratio [aOR], 1.06; 95% CI, 1.01-1.12; P = .014), time on NIV in hours (aOR, 1.10; 95% CI, 1.04-1.16; P .001), and a pH less than 7.35 before weaning (aOR, 2.48; 95% CI, 1.16-5.31; P = .019). Conclusion: Weaning failure occurs in 17% of ED patients on NIV. Time on NIV, HCO3 concentration, and a pH less than 7.35 before weaning are independently associated with failure to wean from the respirator.
MeSH term(s)	Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Prospective Studies ; Respiration, Artificial ; Respiratory Insufficiency/therapy
Language	Spanish
Publishing date	2021-01-25
Publishing country	Spain
Document type	Journal Article ; Observational Study
ZDB-ID	2127173-2
ISSN	2386-5857 ; 2386-5857
ISSN (online)	2386-5857
ISSN	2386-5857
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Article ; Online: Multidisciplinary Consensus on the Management of Non-Invasive Respiratory Support in the COVID-19 Patient.

Luján, Manel / Cinesi Gómez, César / Peñuelas, Oscar / Ferrando, Carlos / Heili-Frades, Sarah Béatrice / Carratalá Perales, José Manuel / Mas, Arantxa / Sayas Catalán, Javier / Mediano, Olga / Roca, Oriol / García Fernández, Javier / González Varela, Antonio / Sempere Montes, Gonzalo / Rialp Cervera, Gemma / Hernández, Gonzalo / Millán, Teresa / Ferrer Monreal, Miquel / Egea Santaolalla, Carlos

Archivos de bronconeumologia

2024

Abstract: Acute respiratory failure due to COVID-19 pneumonia often requires a comprehensive approach that includes non-pharmacological strategies such as non-invasive support (including positive pressure modes, high flow therapy or awake proning) in addition to ... ...

Abstract	Acute respiratory failure due to COVID-19 pneumonia often requires a comprehensive approach that includes non-pharmacological strategies such as non-invasive support (including positive pressure modes, high flow therapy or awake proning) in addition to oxygen therapy, with the primary goal of avoiding endotracheal intubation. Clinical issues such as determining the optimal time to initiate non-invasive support, choosing the most appropriate modality (based not only on the acute clinical picture but also on comorbidities), establishing criteria for recognition of treatment failure and strategies to follow in this setting (including palliative care), or implementing de-escalation procedures when improvement occurs are of paramount importance in the ongoing management of severe COVID-19 cases. Organizational issues, such as the most appropriate setting for management and monitoring of the severe COVID-19 patient or protective measures to prevent virus spread to healthcare workers in the presence of aerosol-generating procedures, should also be considered. While many early clinical guidelines during the pandemic were based on previous experience with acute respiratory distress syndrome, the landscape has evolved since then. Today, we have a wealth of high-quality studies that support evidence-based recommendations to address these complex issues. This document, the result of a collaborative effort between four leading scientific societies (SEDAR, SEMES, SEMICYUC, SEPAR), draws on the experience of 25 experts in the field to synthesize knowledge to address pertinent clinical questions and refine the approach to patient care in the face of the challenges posed by severe COVID-19 infection.
Language	Spanish
Publishing date	2024-03-04
Publishing country	Spain
Document type	Practice Guideline
ZDB-ID	733126-5
ISSN	1579-2129 ; 0300-2896
ISSN (online)	1579-2129
ISSN	0300-2896
DOI	10.1016/j.arbres.2024.02.017
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Article ; Online: Mortalidad y fracaso renal agudo en pacientes con ventilación no invasiva.

Cinesi Gómez, César / Vigil Velis, Martín / Antonio Gonzalez, Marina M / Serrano Navarro, Juana M / Rico Lledó, María José

Medicina

2019 Volume 79, Issue 5, Page(s) 367–372

Abstract: We developed a prospective observational study, obtaining clinical and analytical data of patients admitted to the intensive care unit of the Hospital Reina Sofía, who required noninvasive ventilation, from January 1, 2013 to December 31, 2015. The main ... ...

Title translation	Mortality and acute kidney injury in patients with noninvasive ventilation.
Abstract	We developed a prospective observational study, obtaining clinical and analytical data of patients admitted to the intensive care unit of the Hospital Reina Sofía, who required noninvasive ventilation, from January 1, 2013 to December 31, 2015. The main objective was to determine the 90-day mortality in these patients and conditions, who required noninvasive ventilation as treatment for acute respiratory failure and who developed acute kidney injury. Acute renal failure was defined as an increase in serum creatinine > 0.3 mg/dl at 48 hours with respect to the baseline. The patients were followed for 90 days. We analyzed 221 patients, 65 (29.4%) presented acute kidney injury and 156 (70.6%) normal renal function. Overall mortality at 90 days was 44 (19.9%). In the group of acute kidneys injury, it was 33 (51.6%), being 11 (7.1%) in patients without acute kidney injury (RR 7.340, 95% CI: 3.974-13.559, p < 0.001). Hospital stay in days was 24.2 ± 24.1 with acute kidney injury vs. 21.5 ± 0.7, p = 0.429; stay in the intensive care unit in days was 10.9 ± 14.4 with acute kidney injury vs. 7.3 ± 9.6, p = 0.357, and days of non-invasive ventilation 3.4 ± 3.0 with acute kidney injury vs. 2.7 ± 1.9, p = 0.569, in those patients not affected by the presence of acute kidney injury. In conclusion, the presence of acute kidney injury is an independent factor of mortality in patients with acute respiratory failure requiring noninvasive ventilation.
MeSH term(s)	Acute Kidney Injury/mortality ; Aged ; Aged, 80 and over ; Analysis of Variance ; Creatinine/blood ; Female ; Humans ; Intensive Care Units ; Kaplan-Meier Estimate ; Length of Stay ; Male ; Middle Aged ; Noninvasive Ventilation/mortality ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive/therapy ; Respiratory Insufficiency/therapy ; Spain ; Statistics, Nonparametric ; Time Factors
Chemical Substances	Creatinine (AYI8EX34EU)
Language	Spanish
Publishing date	2019-09-27
Publishing country	Argentina
Document type	Journal Article ; Observational Study
ZDB-ID	411586-7
ISSN	1669-9106 ; 0025-7680 ; 0325-951X
ISSN (online)	1669-9106
ISSN	0025-7680 ; 0325-951X
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Mortalidad de los pacientes con fracaso respiratorio agudo en tratamiento crónico con benzodiacepinas.

Piñero-Zapata, Manuel / Cinesi-Gómez, César / Luna-Maldonado, Aurelio

Enfermeria clinica

2013 Volume 23, Issue 3, Page(s) 89–95

Abstract: The benzodiazepines (BZD) are among the drugs most used by the population. Its contraindications include severe respiratory failure and sleep apnoea. The main objective of this work was to establish the relationship between the chronic use of ... ...

Title translation	Mortality in patients with acute respiratory failure on chronic treatment with benzodiazepines.
Abstract	The benzodiazepines (BZD) are among the drugs most used by the population. Its contraindications include severe respiratory failure and sleep apnoea. The main objective of this work was to establish the relationship between the chronic use of benzodiazepines and hospital mortality and up to 30 days after admission. This study was carried out on a retrospective cohort of 243 patients admitted via emergency room into «Reina Sofia» University General Hospital in Murcia during the year 2011, and were selected for having been treated with non-invasive mechanical ventilation (NIV) during their admission. The method used was a review of clinical histories by searching for the code corresponding to the NIV process. Overall mortality was 20.6%. In patients with chronic consumption of BZD it was 22.45% and 19.4% in patients who did not use these drugs (P=.608). We were unable to establish a significant relationship between chronic use of benzodiazepines and overall mortality figures. On the other hand, we have linked the increased mortality in patients treated with NIV for acute respiratory failure with other indicators such as, age above 75 years old, blood bicarbonate below 22mmol/L; lactic acid higher than 2mmol/L; serum creatinine above 1.5mg/dL, and sepsis.
MeSH term(s)	Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Benzodiazepines/adverse effects ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Respiration, Artificial ; Respiratory Insufficiency/mortality ; Respiratory Insufficiency/therapy ; Retrospective Studies
Chemical Substances	Benzodiazepines (12794-10-4)
Language	Spanish
Publishing date	2013-05
Publishing country	Spain
Document type	English Abstract ; Journal Article
ISSN	1579-2013
ISSN (online)	1579-2013
DOI	10.1016/j.enfcli.2013.02.002
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Mortality and acute kidney injury in patients with noninvasive ventilation

César Cinesi Gómez / Martín Vigil Velis / Marina M. Antonio Gonzalez / Juana M. Serrano Navarro / María José Rico Lledó

Medicina (Buenos Aires), Vol 79, Iss 5, Pp 367-

2019 Volume 372

Abstract	We developed a prospective observational study, obtaining clinical and analytical data of patients admitted to the intensive care unit of the Hospital Reina Sofía, who required noninvasive ventilation, from January 1, 2013 to December 31, 2015. The main objective was to determine the 90-day mortality in these patients and conditions, who required noninvasive ventilation as treatment for acute respiratory failure and who developed acute kidney injury. Acute renal failure was defined as an increase in serum creatinine > 0.3 mg/dl at 48 hours with respect to the baseline. The patients were followed for 90 days. We analyzed 221 patients, 65 (29.4%) presented acute kidney injury and 156 (70.6%) normal renal function. Overall mortality at 90 days was 44 (19.9%). In the group of acute kidneys injury, it was 33 (51.6%), being 11 (7.1%) in patients without acute kidney injury (RR 7.340, 95% CI: 3.974-13.559, p < 0.001). Hospital stay in days was 24.2 ± 24.1 with acute kidney injury vs. 21.5 ± 0.7, p = 0.429; stay in the intensive care unit in days was 10.9 ± 14.4 with acute kidney injury vs. 7.3 ± 9.6, p = 0.357, and days of non-invasive ventilation 3.4 ± 3.0 with acute kidney injury vs. 2.7 ± 1.9, p = 0.569, in those patients not affected by the presence of acute kidney injury. In conclusion, the presence of acute kidney injury is an independent factor of mortality in patients with acute respiratory failure requiring noninvasive ventilation.
Keywords	acute respiratory failure ; acute kidney injury ; noninvasive ventilation ; intensive care unit ; chronic obstructive pulmonary disease ; acute pulmonary edema ; Medicine ; R ; Immunologic diseases. Allergy ; RC581-607 ; Infectious and parasitic diseases ; RC109-216
Language	English
Publishing date	2019-10-01T00:00:00Z
Publisher	Fundación Revista Medicina
Document type	Article ; Online
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Article ; Online: Relación entre la movilidad diafragmática medida por ecografía y la presión parcial arterial de CO2 en pacientes con insuficiencia respiratoria aguda hipercápnica tras el inicio de la ventilación mecánica no invasiva en urgencias.

Sánchez-Nicolás, José Andrés / Cinesi-Gómez, César / Villén-Villegas, Tomás / Piñera-Salmerón, Pascual / García-Pérez, Bartolo

Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

2016 Volume 28, Issue 5, Page(s) 345–348

Abstract: Objectives: To evaluate the correlation between variations in ultrasound-measured diaphragm movement and changes in the arterial partial pressure of carbon dioxide (PCO2) after the start of noninvasive ventilation (NIV).: Material and methods: ... ...

Title translation	Relation between ultrasound-measured diaphragm movement and partial pressure of carbon dioxide in blood from patients with acute hypercapnic respiratory failure after the start of noninvasive ventilation in an emergency department.
Abstract	Objectives: To evaluate the correlation between variations in ultrasound-measured diaphragm movement and changes in the arterial partial pressure of carbon dioxide (PCO2) after the start of noninvasive ventilation (NIV). Material and methods: RDescriptive study of a prospective case series comprised of nonconsecutive patients aged 18 years or older with hypercapnic respiratory failure who were placed on NIV in an emergency department. We recorded clinical data, blood gas measurements, and ultrasound measurements of diaphragm movement. Results: Twenty-one patients with a mean (SD) age of 83 (13) years were studied; 11 (52.4%) were women. The mean (SD) range of diaphragm movement and PCO2 values at 4 moments were as follows: 1) at baseline: diaphragm movement, 13.90 (7.7) mm and PCO2, 71.75 (11.4) mm Hg; 2) after 15 minutes on NIV: diaphragm movement, 17.10 (9.1) mm; 3) at 1 hour: diaphragm movement, 22.40 (10.4) mm and PCO2, 63.45 (16.0) mm Hg; and 4) at 3 hours: diaphragm movement, 26.60 (19.5) mm and PCO2, 61.85 (13.0) mm Hg. We detected a statistically significant correlation between the difference in range of diaphragm movement at baseline and at 15 minutes and the decrease in PCO2 after 1 hour of NIV (r=-0.489, P=.035). Conclusion: In patients with hypercapnic respiratory failure, the increase in range of diaphragm movement 15 minutes after starting NIV is associated with a decrease in PCO2 after 1 hour.
Language	Spanish
Publishing date	2016-10
Publishing country	Spain
Document type	English Abstract ; Journal Article
ZDB-ID	2127173-2
ISSN	2386-5857 ; 1137-6821
ISSN (online)	2386-5857
ISSN	1137-6821
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Article ; Online: Satisfacción de los usuarios de las urgencias hospitalarias.

Burillo-Putze, Guillermo / Expósito-Rodríguez, Marcos / Cinesi-Gómez, César / Piñera-Salmerón, Pascual

Gaceta sanitaria

2013 Volume 27, Issue 2, Page(s) 185

Title translation	User satisfaction with hospital emergency services.
MeSH term(s)	Emergency Service, Hospital/statistics & numerical data ; Female ; Hospitals, Public/statistics & numerical data ; Humans ; Male ; Patient Satisfaction
Language	Spanish
Publishing date	2013-03
Publishing country	Spain
Document type	Comment ; Letter
ZDB-ID	1038713-4
ISSN	1578-1283 ; 0213-9111
ISSN (online)	1578-1283
ISSN	0213-9111
DOI	10.1016/j.gaceta.2012.06.004
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Article ; Online: Yatrogenia tras la tecnica de puncion lumbar. Estudio de prevalencia de cefalea y factores asociados.

Bauset-Navarro, José Luis / Sánchez-Ortuño, Isabel M / Gómez-Cárdenas, Claudia / Sanz-Monllor, Ainara / Cinesi-Gómez, César / Piñera-Salmerón, Pascual

Revista de neurologia

2014 Volume 58, Issue 5, Page(s) 193–198

Abstract: Aim: To determine the prevalence of headache following a transdural lumbar puncture and the risk factors involved.: Patients and methods: The method used was a prospective observation-based cohort study. Patients were recruited from the A and E ... ...

Title translation	Iatrogenic after spinal puncture technique. Prevalence study of headache and associated factors.
Abstract	Aim: To determine the prevalence of headache following a transdural lumbar puncture and the risk factors involved. Patients and methods: The method used was a prospective observation-based cohort study. Patients were recruited from the A and E Department, Neurology Service and Day Care Clinic. The following data were collected: physician's experience, number of punctures, variations in the plane, patient's posture, local anaesthetic, needle calibre and bevel, degrees of inclination, amount of liquid, fluid overload and whether or not rest is indicated after the puncture. After 48 hours, the appearance of headache (or not) was determined. Results: The sample consisted of 59 patients, 31 (52.5%) of whom were males. Mean age: 47 years; 32 patients (54.2%) came from A and E, 18 (30.5%) from Neurology and 9 (15.3%) from the Day Care Clinic. Forty-one (69.5%) received the lumbar puncture in a lateral decubitus position and 7 (11.9%) in a seated position. All the needles were bevelled, 21 (35.6%) with a calibre of 20 and 38 (64.4%) of calibre 22. Eight patients (13.56%) were without repose and 18 (33.3%) had no fluid overload. Twenty-three (38.98%) had post-lumbar-puncture headache, 12 (52.2%) of them females, with a mean age of 38.3 ± 16.4 years. The median of the headache intensity was 2.6. The mean time of appearance was seven hours. There were no differences for any of the factors studied, except the observed tendency towards a higher incidence of headache at younger ages. Conclusions: Rates of post-lumbar-puncture headache in our series are high, and no differences were found in terms of the service where it was performed or experience. No influence was observed due to the amount of liquid extracted, the patient's position, the indication of repose or fluid overload.
MeSH term(s)	Adult ; Aged ; Cerebrospinal Fluid Pressure ; Female ; Hospital Departments/statistics & numerical data ; Hospitals, General/statistics & numerical data ; Hospitals, University/statistics & numerical data ; Humans ; Iatrogenic Disease ; Male ; Middle Aged ; Patient Positioning ; Post-Dural Puncture Headache/epidemiology ; Post-Dural Puncture Headache/etiology ; Postoperative Nausea and Vomiting/epidemiology ; Postoperative Nausea and Vomiting/etiology ; Prevalence ; Prospective Studies ; Risk Factors ; Spain/epidemiology ; Spinal Puncture/adverse effects ; Spinal Puncture/methods
Language	Spanish
Publishing date	2014-03-01
Publishing country	Spain
Document type	English Abstract ; Journal Article ; Observational Study
ZDB-ID	1468278-3
ISSN	1576-6578 ; 0210-0010
ISSN (online)	1576-6578
ISSN	0210-0010
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