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Article: Septal myectomy after failed septal alcohol ablation.

Quintana, Eduard / Bajona, Pietro / Arguis, María José / Prat-González, Susanna

2017 Volume 6, Issue 4, Page(s) 394–401

Abstract: Despite septal myectomy remaining the gold standard septal reduction therapy for hypertrophic obstructive cardiomyopathy (HOCM), there has been a disproportionate use of alcohol septal ablation (ASA) worldwide. Absolute resolution of left ventricular ... ...

Abstract	Despite septal myectomy remaining the gold standard septal reduction therapy for hypertrophic obstructive cardiomyopathy (HOCM), there has been a disproportionate use of alcohol septal ablation (ASA) worldwide. Absolute resolution of left ventricular outflow tract (LVOT) obstruction with ASA is not achieved in a substantial proportion of patients. The mechanisms of failure from ASA are partially understood and described. Residual obstruction in hypertrophic cardiomyopathy is associated with worse clinical outcomes and mortality. There is a growing number of patients who present with significant residual gradients after ASA and require a rescue septal myectomy operation, which then carries an increased risk of perioperative complications and life-long sequelae. This contrasts with the excellent outcomes achieved by septal myectomy without previous percutaneous intervention. Despite complete resolution of obstruction in rescue myectomy, the outcomes remain compromised by the prior ASA.
Language	English
Publishing date	2017-01-28
Publishing country	China
Document type	Journal Article
ZDB-ID	2713627-9
ISSN	2304-1021 ; 2225-319X
ISSN (online)	2304-1021
ISSN	2225-319X
DOI	10.21037/acs.2017.05.11
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Article ; Online: Preoperative triage to detect SARS-CoV-2 infection in surgical patients: lessons learned for resuming surgery.

Pujol, Roger / Rivas, Eva / Gracia, Isabel / Caballero, Angel / Matute, Purificación / Cuñat, Tomas / Basora, Misericordia / Fábregas, Neus / Arguis, Maria José / Forne, Daniel Luis / Balibrea, José Maria / Besa, Anais / Laguna, Guillermo / Monsalve, Concepción / Lacy, Antonio M / Martinez-Pallí, Graciela

Surgery today

2022 Volume 53, Issue 6, Page(s) 709–717

Abstract: Purpose: To define the impact of the COVID-19 outbreak on hospital surgical activity and assess the incidence of perioperative COVID-19 within two protocolized screening pathways for elective and non-elective surgery.: Methods: We conducted a ... ...

Abstract	Purpose: To define the impact of the COVID-19 outbreak on hospital surgical activity and assess the incidence of perioperative COVID-19 within two protocolized screening pathways for elective and non-elective surgery. Methods: We conducted a prospective cohort study of adults undergoing surgery during the COVID-19 outbreak. The elective pathway included telephone surveys and a quantitative polymerase-chain-reaction test (RT-PCR) only for patients who were asymptomatic and at low risk of infection. Only patients with negative screening underwent surgery. In the non-elective pathway, preoperative screening was performed during the hospital admission. Results: Among 835 patients considered for the elective pathway, 725 had negative RT-PCR results and underwent surgery. This reflects an 83% reduction in surgical activity from 2019. Moreover, 596 patients underwent non-elective surgery, representing a 28% reduction. Preoperatively, 39 patients (6.5%) tested positive for SARS-CoV-2 and underwent surgery through the non-elective pathway, vs. none in the elective pathway (p < 0.001). Postoperatively, 1.4% of elective surgery patients and 2.2% of non-elective surgery patients tested positive (p > 0.05). Mortality was higher in non-elective surgery (0.6% vs. 2.9%, p < 0.001) and in patients with COVID-19 (0% vs. 14%, p < 0.001). Conclusions: The low incidence of COVID-19 in elective surgeries during the outbreak demonstrates the importance and effectiveness of preoperative screening, combining surveys and RT-PCR.
MeSH term(s)	Adult ; Humans ; COVID-19/diagnosis ; COVID-19/epidemiology ; SARS-CoV-2 ; Prospective Studies ; Triage ; Elective Surgical Procedures
Language	English
Publishing date	2022-10-21
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-022-02610-8
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Article ; Online: Combined Heart and Liver Transplantation for Uhl's Anomaly: A Case Report.

Landi, Filippo / Sandoval, Elena / Martinez, Julia / Blasi, Annabel / Arguis, Maria Jose / Colmenero, Jordi / Montserrat, Silvia / García-Álvarez, Ana / Martinez, Daniel / Dos, Laura / Riquelme, Francisco / Quintana, Eduard / Castellá, Manuel / Fondevila, Constantino

Transplantation proceedings

2021 Volume 53, Issue 9, Page(s) 2751–2753

Abstract: Background: Uhl's anomaly is an extremely rare congenital heart defect characterized by absence of the right ventricle myocardium and preserved left ventricular myocardium. Although the disease has a poor prognosis and is generally fatal in the ... ...

Abstract	Background: Uhl's anomaly is an extremely rare congenital heart defect characterized by absence of the right ventricle myocardium and preserved left ventricular myocardium. Although the disease has a poor prognosis and is generally fatal in the perinatal period, some patients may reach adulthood. Methods: We describe a case of Uhl's anomaly complicated with heart failure and decompensated cardiac cirrhosis in a 42-year-old man treated by combined heart-liver transplant. Results: The patient underwent heart transplant using the bicaval technique followed by subsequent liver transplant with the piggyback technique without venovenous bypass. Total ischemia time was 108 minutes for the heart and 360 and 25 minutes of cold and warm ischemia, respectively, for the liver. No intraoperative complications occurred. The patient was discharged without severe complications on postoperative day 22. Pathologic examination of the organs reported advanced cirrhosis of the liver and severe dilated myocardiopathy of right ventricle with absence of myocardium and a normal left ventricle. Twenty-seven months after the transplant the patient has been free from hospital admissions, with normal function of both transplanted organs. Conclusions: We report the first successful combined heart-liver transplant for Uhl's anomaly indication in an adult patient. Despite of the insufficient knowledge of natural history of this exceptional disease, we successfully apply the management principles of other end-stage right heart disorders complicated with liver failure.
MeSH term(s)	Adult ; Cardiomyopathy, Dilated ; Echocardiography ; Female ; Heart Defects, Congenital ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/surgery ; Humans ; Liver Transplantation ; Male ; Pregnancy
Language	English
Publishing date	2021-09-27
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.08.036
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Article: Multimodal Prehabilitation in Heart Transplant Recipients Improves Short-Term Post-Transplant Outcomes without Increasing Costs.

López-Baamonde, Manuel / Arguis, María José / Navarro-Ripoll, Ricard / Gimeno-Santos, Elena / Romano-Andrioni, Bárbara / Sisó, Marina / Terès-Bellès, Silvia / López-Hernández, Antonio / Burniol-García, Adrià / Farrero, Marta / Sebio-García, Raquel / Sandoval, Elena / Sanz-de la Garza, María / Librero, Julián / García-Álvarez, Ana / Castel, María Ángeles / Martínez-Pallí, Graciela

Journal of clinical medicine

2023 Volume 12, Issue 11

Abstract: 1) Background and aim: This study aimed to investigate the impact of prehabilitation on the postoperative outcomes of heart transplantation and its cost-effectiveness. (2) Methods: This single-center, ambispective cohort study included forty-six ... ...

Abstract	(1) Background and aim: This study aimed to investigate the impact of prehabilitation on the postoperative outcomes of heart transplantation and its cost-effectiveness. (2) Methods: This single-center, ambispective cohort study included forty-six candidates for elective heart transplantation from 2017 to 2021 attending a multimodal prehabilitation program consisting of supervised exercise training, physical activity promotion, nutritional optimization, and psychological support. The postoperative course was compared to a control cohort consisting of patients transplanted from 2014 to 2017 and those contemporaneously not involved in prehabilitation. (3) Results: A significant improvement was observed in preoperative functional capacity (endurance time 281 vs. 728 s,
Language	English
Publishing date	2023-05-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12113724
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Article ; Online: Multimodal prehabilitation as strategy for reduction of postoperative complications after cardiac surgery: a randomised controlled trial protocol.

Coca-Martinez, Miquel / Lopez-Hernandez, Antonio / Montane-Muntane, Mar / Arguis, Maria Jose / Gimeno-Santos, Elena / Navarro-Ripoll, Ricard / Perdomo, Juan / Lopez-Baamonde, Manuel / Rios, Jose / Moises, Jorge / Sanz de la Garza, Maria / Sandoval, Elena / Romano, Barbara / Sebio, Raquel / Dana, Fernando / Martinez-Palli, Graciela

BMJ open

2020 Volume 10, Issue 12, Page(s) e039885

Abstract: Introduction: Prehabilitation programmes that combine exercise training, nutritional support and emotional reinforcement (multimodal prehabilitation) have demonstrated efficacy reducing postoperative complications in the context of abdominal surgery. ... ...

Abstract	Introduction: Prehabilitation programmes that combine exercise training, nutritional support and emotional reinforcement (multimodal prehabilitation) have demonstrated efficacy reducing postoperative complications in the context of abdominal surgery. However, such programmes have seldom been studied in cardiac surgery, one of the surgeries associated with higher postoperative morbidity and mortality. This trial will assess the feasibility and efficacy in terms of reduction of postoperative complications and cost-effectiveness of a multimodal prehabilitation programme comparing to the standard of care in cardiac surgical patients. Methods and analysis: This is a single-centre, randomised, open-label, controlled trial with a 1:1 ratio. Consecutive 160 elective valve replacement and/or coronary revascularisation surgical patients will be randomised to either standard of care or 4-6 weeks of multimodal prehabilitation that will consist in (1) two times/week supervised endurance and strength exercise training sessions, (2) promotion of physical activity and healthy lifestyle, (3) respiratory physiotherapy, (4) nutrition counselling and supplementation if needed, and (5) weekly mindfulness sessions. Baseline, preoperative and 3-month postoperative data will be collected by an independent blinded evaluator. The primary outcome of this study will be the incidence of postoperative complications. Ethics and dissemination: This study has been approved by the Ethics Committee of Clinical investigation of Hospital Clinic de Barcelona (HCB/2017/0708). The results will be disseminated in a peer-reviewed journal. Trial registration number: NCT03466606.
MeSH term(s)	Cardiac Surgical Procedures/adverse effects ; Elective Surgical Procedures ; Humans ; Postoperative Complications/prevention & control ; Preoperative Care ; Preoperative Exercise
Language	English
Publishing date	2020-12-22
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2020-039885
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Article ; Online: Cost-effectiveness of a technology-supported multimodal prehabilitation program in moderate-to-high risk patients undergoing lung cancer resection: randomized controlled trial protocol.

Barberan-Garcia, Anael / Navarro-Ripoll, Ricard / Sánchez-Lorente, David / Moisés-Lafuente, Jorge / Boada, Marc / Messaggi-Sartor, Monique / González-Vallespí, Laura / Montané-Muntané, Mar / Alsina-Restoy, Xavier / Campero, Betina / Lopez-Baamonde, Manuel / Romano-Andrioni, Barbara / Guzmán, Rudith / López, Antonio / Arguis, Maria Jose / Roca, Josep / Martinez-Palli, Graciela

BMC health services research

2020 Volume 20, Issue 1, Page(s) 207

Abstract: Background: Multimodal prehabilitation is a preoperative intervention with the objective to enhance cancer patients' functional status which has been showed to reduce both postoperative morbidity and hospital length of stay in digestive oncologic ... ...

Abstract	Background: Multimodal prehabilitation is a preoperative intervention with the objective to enhance cancer patients' functional status which has been showed to reduce both postoperative morbidity and hospital length of stay in digestive oncologic surgery. However, in lung cancer surgery patients further studies with higher methodological quality are needed to clarify the benefits of prehabilitation. The main aim of the current protocol is to evaluate the cost-effectiveness of a multimodal prehabilitation program supported by information and communication technologies in moderate-to-high risk lung cancer patients undergoing thoracic surgery. Methods: A Quadruple Aim approach will be adopted, assessing the prehabilitation program at the following levels: i) Patients' and professionals' experience outcomes (by means of standardized questionnaires, focus groups and structured interviews); ii) Population health-based outcomes (e.g. hospital length of stay, number and severity of postoperative complications, peak oxygen uptake and levels of systemic inflammation); and, iii) Healthcare costs. Discussion: This study protocol should contribute not only to increase the scientific basis on prehabilitation but also to detect the main factors modulating service adoption. Trial registration: NCT04052100 (August 9, 2019).
MeSH term(s)	Clinical Protocols ; Combined Modality Therapy ; Cost-Benefit Analysis ; Humans ; Information Technology ; Lung Neoplasms/surgery ; Preoperative Care/economics ; Preoperative Care/methods ; Risk Assessment
Language	English
Publishing date	2020-03-12
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/s12913-020-05078-9
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Article ; Online: The influence of arm abduction on the anatomic relations of infraclavicular brachial plexus: an ultrasound study.

Ruíz, Ana / Sala, Xavier / Bargalló, Xavier / Hurtado, Paola / Arguis, Maria Jose / Carrera, Ana

Anesthesia and analgesia

2009 Volume 108, Issue 1, Page(s) 364–366

Abstract: Background: Distances from brachial plexus to the coracoid process and the pleura are critical for performing infraclavicular block. We evaluated the influence of arm abduction on the position of the neurovascular bundle relative to the skin, to the ... ...

Abstract	Background: Distances from brachial plexus to the coracoid process and the pleura are critical for performing infraclavicular block. We evaluated the influence of arm abduction on the position of the neurovascular bundle relative to the skin, to the coracoid process and to the pleura using ultrasonography. Methods: An ultrasound examination of the brachial plexus at the infraclavicular level was performed on 26 patients. Distances from the axillary artery to the skin, to the coracoid process and to the pleura were measured and noted with different degrees of arm abduction (0 degrees , 45 degrees , and 90 degrees ). Vertical infraclavicular brachial plexus block was then performed by means of nerve stimulation in 14 additional patients undergoing hand surgery. Results: Under ultrasound examination, the distance from the axillary artery to the skin was found to be significantly less with arm abduction (0 degrees : 32 +/- 7 mm, 45 degrees : 29 +/- 7 mm, 90 degrees : 25 +/- 5 mm, P < 0.05). The distance from the skin to the pleura was 47 +/- 5 mm with a medial deviation of 18 +/- 3 degrees and was not influenced by arm position. Brachial plexus was identified by nerve stimulation at a vertical depth of 41 +/- 7 mm from the skin. Conclusion: Abduction of the arm reduces the depth of the brachial plexus but does not change the position of the axillary artery relative to the coracoid process or the pleura. Ultrasonography may under-estimate the actual depth of the plexus.
MeSH term(s)	Adult ; Arm/innervation ; Axillary Artery/diagnostic imaging ; Brachial Plexus/diagnostic imaging ; Electric Stimulation ; Female ; Hand/innervation ; Hand/surgery ; Humans ; Male ; Motor Neurons ; Muscle Contraction ; Nerve Block ; Pleura/diagnostic imaging ; Skin/diagnostic imaging ; Ultrasonography ; Young Adult
Language	English
Publishing date	2009-01
Publishing country	United States
Document type	Clinical Trial ; Comparative Study ; Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ane.0b013e31818c94da
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Uk I Zs.78: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Contralateral neuropathic pain following a surgical model of unilateral nerve injury in rats.

Arguis, Maria Jose / Perez, Jordi / Martínez, Gloria / Ubre, Marta / Gomar, Carmen

Regional anesthesia and pain medicine

2008 Volume 33, Issue 3, Page(s) 211–216

Abstract: Background and objectives: Damage to peripheral nerves provokes chronic neuropathic pain that lasts beyond the duration of the nerve injury. The presence of pain signs have been reported in areas other than those attributed to the injured nerve, i.e., ... ...

Abstract	Background and objectives: Damage to peripheral nerves provokes chronic neuropathic pain that lasts beyond the duration of the nerve injury. The presence of pain signs have been reported in areas other than those attributed to the injured nerve, i.e., in contralateral regions. We evaluated the presence, magnitude, and chronology of mechanical and cold allodynia in the contralateral paw of rats undergoing unilateral ligation of the L5 and L6 spinal nerves. Methods: Twenty-three male Sprague-Dawley rats underwent spinal nerve ligation of the left L5 and L6 spinal nerves (SNL group) and 7 rats received a sham surgery without nerve ligation (sham group). Signs of mechanical allodynia as assessed with von Frey filaments, and cold allodynia as assessed with the acetone drop test, were studied before surgery and throughout 21 postoperative days. Responses of ipsilateral and contralateral paws of the SNL group were compared between themselves and with those in the sham group. Results: Rats in the SNL group developed mechanical and cold allodynia responses in the ipsilateral paw, and also in the contralateral paw. Allodynia in the contralateral paw appeared later, becoming statistically significant on day 10 after surgery for mechanical allodynia and on day 21 for cold allodynia as compared with the sham group. Contralateral pain was of a lower intensity than on the ipsilateral side. Conclusions: After L5 and L6 spinal nerve ligation, rats developed mechanical and cold allodynia in the contralateral paw, suggesting extraterritorial development of neuropathic signs. This finding has implications for future study design and therapeutic approaches.
MeSH term(s)	Animals ; Cold Temperature ; Disease Models, Animal ; Ligation ; Male ; Neuralgia/physiopathology ; Physical Stimulation ; Rats ; Rats, Sprague-Dawley ; Spinal Nerves/injuries ; Spinal Nerves/physiopathology ; Time Factors
Language	English
Publishing date	2008-04-16
Publishing country	England
Document type	Journal Article
ZDB-ID	1425299-5
ISSN	1532-8651 ; 1098-7339 ; 0146-521X
ISSN (online)	1532-8651
ISSN	1098-7339 ; 0146-521X
DOI	10.1016/j.rapm.2007.12.003
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Article ; Online: Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols.

Baltaxe, Erik / Cano, Isaac / Herranz, Carmen / Barberan-Garcia, Anael / Hernandez, Carme / Alonso, Albert / Arguis, María José / Bescos, Cristina / Burgos, Felip / Cleries, Montserrat / Contel, Joan Carles / de Batlle, Jordi / Islam, Kamrul / Kaye, Rachelle / Lahr, Maarten / Martinez-Palli, Graciela / Miralles, Felip / Moharra, Montserrat / Monterde, David /

Piera, Jordi / Ríos, José / Rodriguez, Nuria / Ron, Reut / Rutten-van Mölken, Maureen / Salas, Tomas / Santaeugenia, Sebastià / Schonenberg, Helen / Solans, Oscar / Torres, Gerard / Vargiu, Eloisa / Vela, Emili / Roca, Josep

BMC health services research

2019 Volume 19, Issue 1, Page(s) 370

Abstract: Background: Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery ... ...

Abstract	Background: Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016-2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011-2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation. They reflect different implementation maturity levels. While full coverage of the entire urban health district of Barcelona-Esquerra (520 k inhabitants) is the main aim of home hospitalization, demonstration of sustainability at Hospital Clinic of Barcelona constitutes the core goal of the prehabilitation service. Likewise, full coverage of integrated care services addressed to frail chronic patients is aimed at the city of Badalona (216 k inhabitants). Methods: The population-based analysis, as well as the three service-based protocols, follow observational and experimental study designs using a non-randomized intervention group (integrated care) compared with a control group (usual care) with a propensity score matching method. Evaluation of cost-effectiveness of the interventions using a Quadruple aim approach is a central outcome in all protocols. Moreover, multi-criteria decision analysis is explored as an innovative method for health delivery assessment. The following additional dimensions will also be addressed: i) Determinants of sustainability and scalability of the services; ii) Assessment of the technological support; iii) Enhanced health risk assessment; and, iv) Factors modulating service transferability. Discussion: The current study offers a unique opportunity to undertake a comprehensive assessment of integrated care fostering deployment of services at regional level. The study outcomes will contribute refining service workflows, improving health risk assessment and generating recommendations for service selection. Trials registration: NCT03130283 (date released 04/06/2018), NCT03768050 (date released 12/05/2018), NCT03767387 (date released 12/05/2018).
MeSH term(s)	Aged ; Clinical Protocols ; Cost-Benefit Analysis/standards ; Delivery of Health Care, Integrated/economics ; Delivery of Health Care, Integrated/standards ; Female ; Health Services Research ; Humans ; Male ; Observational Studies as Topic ; Outcome Assessment (Health Care) ; Spain
Language	English
Publishing date	2019-06-11
Publishing country	England
Document type	Journal Article
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/s12913-019-4174-2
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Article: High tidal volume is associated with the development of acute lung injury after severe brain injury: an international observational study.

Mascia, Luciana / Zavala, Elisabeth / Bosma, Karen / Pasero, Daniela / Decaroli, Daniela / Andrews, Peter / Isnardi, Donatella / Davi, Alessandra / Arguis, Maria Jose / Berardino, Maurizio / Ducati, Alessandro

Critical care medicine

2007 Volume 35, Issue 8, Page(s) 1815–1820

Abstract: Objective: Although a significant number of patients with severe brain injury develop acute lung injury, only intracranial risk factors have previously been studied. We investigated the role of extracranial predisposing factors, including hemodynamic ... ...

Abstract	Objective: Although a significant number of patients with severe brain injury develop acute lung injury, only intracranial risk factors have previously been studied. We investigated the role of extracranial predisposing factors, including hemodynamic and ventilatory management, as independent predictors of acute lung injury in brain-injured patients. Design: Prospective multicenter observational study. Setting: Four European intensive care units in university-affiliated hospitals. Patients: Eighty-six severely brain-injured patients enrolled in 13 months. Interventions: None. Measurements and main results: All patients with severe brain injury (Glasgow Coma Scale score <9) were studied for 8 days from admission. Ventilatory pattern, respiratory system compliance, blood gas analysis, and hemodynamic profile were recorded and entered in a stepwise regression model. Length of stay in the intensive care unit, ventilator-free days, and mortality were collected. Eighteen patients (22%) developed acute lung injury on day 2.8 +/- 1. They were initially ventilated with significantly higher tidal volume per predicted body weight (9.5 +/- 1 vs. 10.4 +/- 1.1), respiratory rate, and minute ventilation and more often required vasoactive drugs (p < .05). In addition to a lower Pao2/Fio2 (odds ratio 0.98, 95% confidence interval 0.98-0.99), the use of high tidal volume (odds ratio 5.4, 95% confidence interval 1.54-19.24) and relatively high respiratory rate (odds ratio 1.8, 95% confidence interval 1.13-2.86) were independent predictors of acute lung injury (p < .01). After the onset of acute lung injury, patients remained ventilated with similar tidal volumes to maintain mild hypocapnia and had a longer length of stay in the intensive care unit and fewer ventilator-free days (p < .05). Conclusions: In addition to a lower Pao2/Fio2, the use of high tidal volume and high respiratory rate are independent predictors of acute lung injury in patients with severe brain injury. In this patient population, alternative ventilator strategies should be considered to protect the lung and guarantee a tight CO2 control.
MeSH term(s)	Brain Injuries/complications ; Brain Injuries/therapy ; Case-Control Studies ; Disease Susceptibility ; Europe/epidemiology ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Multivariate Analysis ; Positive-Pressure Respiration/adverse effects ; Positive-Pressure Respiration/methods ; Prospective Studies ; Regression Analysis ; Respiratory Distress Syndrome, Adult/epidemiology ; Respiratory Distress Syndrome, Adult/etiology ; Respiratory Distress Syndrome, Adult/prevention & control ; Risk Factors ; Tidal Volume
Language	English
Publishing date	2007-08
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/01.CCM.0000275269.77467.DF
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