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  1. Article: Pediatric Acute Respiratory Distress Syndrome: Approaches in Mechanical Ventilation.

    Cruces, Pablo

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2022  Volume 24, Issue 2, Page(s) e104–e114

    MeSH term(s) Child ; Humans ; Respiration, Artificial ; Respiratory Distress Syndrome/therapy ; Intensive Care Units, Pediatric
    Language English
    Publishing date 2022-12-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000003138
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  2. Article ; Online: Sepsis desde la perspectiva de países de medianos y bajos ingresos.

    Cruces, Pablo

    Andes pediatrica : revista Chilena de pediatria

    2021  Volume 92, Issue 6, Page(s) 829–830

    Title translation Sepsis from the perspective of low- and middle-income countries.
    MeSH term(s) Developing Countries ; Humans ; Income ; Sepsis/diagnosis ; Sepsis/therapy
    Language Spanish
    Publishing date 2021-11-30
    Publishing country Chile
    Document type Editorial
    ISSN 2452-6053
    ISSN (online) 2452-6053
    DOI 10.32641/andespediatr.v92i6.4122
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  3. Article ; Online: Respiratory System Compliance Accurately Assesses the "Baby Lung" in Pediatric Acute Respiratory Distress Syndrome.

    Cruces, Pablo / Reveco, Sonia / Caviedes, Paola / Díaz, Franco

    American journal of respiratory and critical care medicine

    2024  Volume 209, Issue 7, Page(s) 890–893

    MeSH term(s) Infant ; Humans ; Child ; Respiratory Distress Syndrome/diagnosis ; Lung ; Respiration, Artificial ; Intensive Care Units, Pediatric
    Language English
    Publishing date 2024-02-06
    Publishing country United States
    Document type Letter
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202310-1890LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Reply to Pérez.

    Cruces, Pablo / Erranz, Benjamín / Diaz, Franco

    American journal of respiratory and critical care medicine

    2023  Volume 207, Issue 10, Page(s) 1407–1408

    Language English
    Publishing date 2023-03-23
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202303-0364LE
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  5. Article ; Online: Morphological Differences between Patient Self-inflicted and Ventilator-induced Lung Injury: An Experimental Study.

    Cruces, Pablo / Erranz, Benjamín / González, Carlos / Diaz, Franco

    American journal of respiratory and critical care medicine

    2023  Volume 207, Issue 6, Page(s) 780–783

    MeSH term(s) Humans ; Ventilator-Induced Lung Injury ; Lung ; Lung Injury/etiology
    Language English
    Publishing date 2023-01-15
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202207-1360LE
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  6. Article: Monitoring in Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.

    Bhalla, Anoopindar / Baudin, Florent / Takeuchi, Muneyuki / Cruces, Pablo

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2023  Volume 24, Issue 12 Suppl 2, Page(s) S112–S123

    Abstract: Objectives: Monitoring is essential to assess changes in the lung condition, to identify heart-lung interactions, and to personalize and improve respiratory support and adjuvant therapies in pediatric acute respiratory distress syndrome (PARDS). The ... ...

    Abstract Objectives: Monitoring is essential to assess changes in the lung condition, to identify heart-lung interactions, and to personalize and improve respiratory support and adjuvant therapies in pediatric acute respiratory distress syndrome (PARDS). The objective of this article is to report the rationale of the revised recommendations/statements on monitoring from the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2).
    Data sources: MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost).
    Study selection: We included studies focused on respiratory or cardiovascular monitoring of children less than 18 years old with a diagnosis of PARDS. We excluded studies focused on neonates.
    Data extraction: Title/abstract review, full-text review, and data extraction using a standardized data collection form.
    Data synthesis: The Grading of Recommendations Assessment, Development and Evaluation approach was used to identify and summarize evidence and develop recommendations. We identified 342 studies for full-text review. Seventeen good practice statements were generated related to respiratory and cardiovascular monitoring. Four research statements were generated related to respiratory mechanics and imaging monitoring, hemodynamics monitoring, and extubation readiness monitoring.
    Conclusions: PALICC-2 monitoring good practice and research statements were developed to improve the care of patients with PARDS and were based on new knowledge generated in recent years in patients with PARDS, specifically in topics of general monitoring, respiratory system mechanics, gas exchange, weaning considerations, lung imaging, and hemodynamic monitoring.
    MeSH term(s) Infant, Newborn ; Child ; Humans ; Adolescent ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/therapy ; Lung ; Acute Lung Injury/diagnosis ; Acute Lung Injury/therapy ; Monitoring, Physiologic/methods ; Respiratory Rate
    Language English
    Publishing date 2023-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000003163
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Airway Management of Critically Ill Pediatric Patients with Suspected or Proven Coronavirus Disease 2019 Infection: An Intensivist Point of View.

    Díaz, Franco / Cruces, Pablo

    Journal of pediatric intensive care

    2021  Volume 13, Issue 1, Page(s) 1–6

    Abstract: Advanced airway management of critically ill children is crucial for novel coronavirus disease 2019 (COVID-19) management in the pediatric intensive care unit, whether due to shock and hemodynamic collapse or acute respiratory failure. In this article, ... ...

    Abstract Advanced airway management of critically ill children is crucial for novel coronavirus disease 2019 (COVID-19) management in the pediatric intensive care unit, whether due to shock and hemodynamic collapse or acute respiratory failure. In this article, intubation is challenging due to the particularities of children's physiology and the underlying disease's pathophysiology, especially when an airborne pathogen, like COVID-19, is present. Unfortunately, published recommendations and guidelines for COVID-19 in pediatrics do not address in-depth endotracheal intubation in acutely ill children. We discussed the caveats and pitfalls of intubation in critically ill children.
    Language English
    Publishing date 2021-07-26
    Publishing country Germany
    Document type Journal Article ; Review
    ISSN 2146-4618
    ISSN 2146-4618
    DOI 10.1055/s-0041-1732345
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  8. Article: Plateau Pressure and Driving Pressure in Volume- and Pressure-Controlled Ventilation: Comparison of Frictional and Viscoelastic Resistive Components in Pediatric Acute Respiratory Distress Syndrome.

    Cruces, Pablo / Moreno, Diego / Reveco, Sonia / Ramirez, Yenny / Díaz, Franco

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2023  Volume 24, Issue 9, Page(s) 750–759

    Abstract: Objectives: To examine frictional, viscoelastic, and elastic resistive components, as well threshold pressures, during volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) in pediatric patients with acute respiratory distress ... ...

    Abstract Objectives: To examine frictional, viscoelastic, and elastic resistive components, as well threshold pressures, during volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) in pediatric patients with acute respiratory distress syndrome (ARDS).
    Design: Prospective cohort study.
    Setting: Seven-bed PICU, Hospital El Carmen de Maipú, Chile.
    Patients: Eighteen mechanically ventilated patients less than or equal to 15 years old undergoing neuromuscular blockade as part of management for ARDS.
    Interventions: None.
    Measurements and main results: All patients were in VCV mode during measurement of pulmonary mechanics, including: the first pressure drop (P1) upon reaching zero flow during the inspiratory hold, peak inspiratory pressure (PIP), plateau pressure (P PLAT ), and total positive end-expiratory pressure (tPEEP). We calculated the components of the working pressure, as defined by the following: frictional resistive = PIP-P1; viscoelastic resistive = P1-P PLAT

    purely elastic = driving pressure (ΔP) = P PLAT -tPEEP; and threshold = intrinsic PEEP. The procedures and calculations were repeated on PCV, keeping the same tidal volume and inspiratory time. Measurements in VCV were considered the gold standard. We performed Spearman correlation and Bland-Altman analysis. The median (interquartile range [IQR]) for patient age was 5 months (2-17 mo). Tidal volume was 5.7 mL/kg (5.3-6.1 mL/kg), PIP cm H 2 O 26 (23-27 cm H 2 O), P1 23 cm H 2 O (21-26 cm H 2 O), P PLAT 19 cm H 2 O (17-22 cm H 2 O), tPEEP 9 cm H 2 O (8-9 cm H 2 O), and ΔP 11 cm H 2 O (9-13 cm H 2 O) in VCV mode at baseline. There was a robust correlation (rho > 0.8) and agreement between frictional resistive, elastic, and threshold components of working pressure in both modes but not for the viscoelastic resistive component. The purely frictional resistive component was negligible. Median peak inspiratory flow with decelerating-flow was 21 (IQR, 15-26) and squared-shaped flow was 7 L/min (IQR, 6-10 L/min) ( p < 0.001).
    Conclusions: P PLAT , ΔP, and tPEEP can guide clinical decisions independent of the ventilatory mode. The modest purely frictional resistive component emphasizes the relevance of maintaining the same safety limits, regardless of the selected ventilatory mode. Therefore, peak inspiratory flow should be studied as a mechanism of ventilator-induced lung injury in pediatric ARDS.
    MeSH term(s) Humans ; Child ; Infant ; Respiration, Artificial/methods ; Prospective Studies ; Positive-Pressure Respiration/methods ; Respiratory Distress Syndrome/therapy ; Lung ; Tidal Volume
    Language English
    Publishing date 2023-06-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000003291
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Noninvasive Continuous Positive Airway Pressure Is a Lung- and Diaphragm-protective Approach in Self-inflicted Lung Injury.

    Cruces, Pablo / Erranz, Benjamín / Pérez, Agustín / Reveco, Sonia / González, Carlos / Retamal, Jaime / Poblete, Daniela / Hurtado, Daniel E / Díaz, Franco

    American journal of respiratory and critical care medicine

    2024  Volume 209, Issue 8, Page(s) 1022–1025

    MeSH term(s) Humans ; Continuous Positive Airway Pressure ; Diaphragm ; Lung Injury/therapy ; Lung ; Thorax
    Language English
    Publishing date 2024-02-06
    Publishing country United States
    Document type Letter
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202309-1629LE
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  10. Article ; Online: Velocity tracking of cardiac vector loops to identify signs of stress-induced ischaemia.

    Cruces, Pablo Daniel / Soria, Mariano Llamedo / Arini, Pedro David

    Medical & biological engineering & computing

    2022  Volume 60, Issue 5, Page(s) 1313–1321

    Abstract: Coronary artery disease (CAD) is among the leading causes of death worldwide. Initial studies require an electrocardiogram stress test often followed by cardiac imaging procedures. However, conventional indices still show insufficient diagnostic ... ...

    Abstract Coronary artery disease (CAD) is among the leading causes of death worldwide. Initial studies require an electrocardiogram stress test often followed by cardiac imaging procedures. However, conventional indices still show insufficient diagnostic performance. We propose quaternion methods to evaluate abnormal alterations during ventricular depolarization and repolarization. Assessment was conducted during a Bruce protocol treadmill stress test and after the end of the exercise. We developed an algorithm to automatically determine the beginning and end of exercise and then, computed the angular and linear velocities. Statistical analysis for feature selection and classification between ischaemic and non-ischaemic patients was used. The most significant markers were maximum linear velocity during ventricular depolarization (p < 5E-9) and maximum angular velocity during the second half of the repolarization loop (p < 5E-16). The latter reached sensitivity / specificity pair of 78 / 92 (AUC 0.89). A linear classifier showed a trend of reduction in cardiac vector velocity in at-risk patients after the end of exercise. The sensitivity / specificity pair reached was 86 / 100. Trajectory deviations of depolarization / repolarization loops that result from ischaemia effects, could be responsible for the observed reduction in dynamic changes during exercise. Further studies could provide non-invasive complementary tools to detect CAD risk. Graphical abstract This data is mandatory, please provide.
    MeSH term(s) Electrocardiography/methods ; Exercise Test/methods ; Heart ; Humans ; Ischemia ; Myocardial Ischemia/diagnosis
    Language English
    Publishing date 2022-03-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 282327-5
    ISSN 1741-0444 ; 0025-696X ; 0140-0118
    ISSN (online) 1741-0444
    ISSN 0025-696X ; 0140-0118
    DOI 10.1007/s11517-022-02503-5
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