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Article: End-of-life decision-making in the neonatal intensive care unit.

Morillo Palomo, Ana / Esquerda Aresté, Montse / Riverola de Veciana, Ana / Cambra Lasaosa, Francisco José

2024 Volume 11, Page(s) 1352485

Abstract: Most paediatric deaths occur in the neonatal period, many of them in neonatal intensive care units after withdrawal of life support or the decision not to initiate new treatments. In these circumstances, discussions with families and decision-making are ... ...

Abstract	Most paediatric deaths occur in the neonatal period, many of them in neonatal intensive care units after withdrawal of life support or the decision not to initiate new treatments. In these circumstances, discussions with families and decision-making are fundamental elements of the care and attention given to newborn babies. In this context, bioethical deliberation can help us to identify the values at stake, the different courses of action to be taken, and the means to ensure that family-shared decision-making is appropriate to the patient's situation and in accordance with the family's values.
Language	English
Publishing date	2024-01-08
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2023.1352485
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Article: Lung Recruitment Maneuvers Assessment by Bedside Lung Ultrasound in Pediatric Acute Respiratory Distress Syndrome.

Mor Conejo, Mireia / Guitart Pardellans, Carmina / Fresán Ruiz, Elena / Penela Sánchez, Daniel / Cambra Lasaosa, Francisco José / Jordan Garcia, Iolanda / Balaguer Gargallo, Mònica / Pons-Òdena, Martí

Children (Basel, Switzerland)

2022 Volume 9, Issue 6

Abstract: The use of recruitment maneuvers (RMs) is suggested to improve severe oxygenation failure in patients with acute respiratory distress syndrome (ARDS). Lung ultrasound (LUS) is a non-invasive, safe, and easily repeatable tool. It could be used to monitor ... ...

Abstract	The use of recruitment maneuvers (RMs) is suggested to improve severe oxygenation failure in patients with acute respiratory distress syndrome (ARDS). Lung ultrasound (LUS) is a non-invasive, safe, and easily repeatable tool. It could be used to monitor the lung recruitment process in real-time. This paper aims to evaluate bedside LUS for assessing PEEP-induced pulmonary reaeration during RMs in pediatric patients. A case of a child with severe ARDS due to
Language	English
Publishing date	2022-05-27
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children9060789
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Article ; Online: Comparison in the Management of Respiratory Failure due to Bronchiolitis in a Pediatric ICU Between 2010 and 2016.

Toni, Flavia / Cambra Lasaosa, Francisco José / Conti, Giorgio / Escuredo, Laura / Benito, Sergio / Gelabert, Gemma / Pons-Òdena, Martí

Respiratory care

2019 Volume 64, Issue 10, Page(s) 1270–1278

Abstract: Background: In recent years, respiratory support in severe bronchiolitis has changed in several aspects: increased use of noninvasive ventilation, new equipment, and implementation of high-flow nasal cannula therapy.: Objective: To analyze the ... ...

Abstract	Background: In recent years, respiratory support in severe bronchiolitis has changed in several aspects: increased use of noninvasive ventilation, new equipment, and implementation of high-flow nasal cannula therapy. Objective: To analyze the effectiveness of the changes progressively introduced in the respiratory support of patients with bronchiolitis to reduce the intubation rate. Methods: This was a retrospective, observational, descriptive study. Patients admitted to the pediatric ICU of Hospital Sant Joan de Déu (Barcelona, Spain) with respiratory failure due to bronchiolitis in the 2010-2011 and 2016-2017 periods were included. Exclusion criteria were the following: patients who were previously intubated and tracheostomized and patients > 1 y. Data collected were demographic, clinical, and ventilatory variables, including the type, equipment used, and length of the respiratory support received. Results: A total of 161 subjects were included: 53 in the 2010-2011 period and 108 in the 2016-2017 period. No clinical differences were observed except the incidence of previous apnea, a diagnosis of sepsis, and procalcitonin values on admission that were higher in the first period. High-flow nasal cannula use before pediatric ICU admission was significantly higher in 2016-2017. A significant increase in the use of the total face mask was observed. The need for invasive ventilation decreased from 37.7% to 17.5%. In the multivariate study, use of interfaces other than the total face mask was identified as the only independent predictive factor for noninvasive ventilation failure, with an odds ratio of 2.5, 95% CI 1.04-6.2 ( Conclusions: An important reduction in invasive ventilation was observed. An independent predictive factor for noninvasive ventilation failure was in using an interface other than the total face mask. Implementation of high-flow nasal cannula has not been identified as an independent protective factor for intubation.
MeSH term(s)	Bronchiolitis/complications ; Bronchiolitis/therapy ; Cannula ; Female ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Intubation, Intratracheal/statistics & numerical data ; Length of Stay ; Male ; Masks ; Noninvasive Ventilation/instrumentation ; Noninvasive Ventilation/trends ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; Retrospective Studies ; Treatment Failure
Language	English
Publishing date	2019-06-04
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.06608
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Article: Non-invasive ventilation in bronchiolitis: Analysis according to a chronologic classification.

Pons-Ódena, Martí / Fuente, Alexandre Escribá de la / Cambra Lasaosa, Francisco José / Matute, Susana Segura / Rico, Antonio Palomeque / Modesto, Vicent

Journal of pediatric intensive care

2018 Volume 1, Issue 4, Page(s) 193–200

Abstract: OBJECTIVE: ...

Abstract	OBJECTIVE:
Language	English
Publishing date	2018-12-12
Publishing country	Germany
Document type	Journal Article
ISSN	2146-4618
ISSN	2146-4618
DOI	10.3233/PIC-12032
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Article ; Online: Severe Pulmonary Hypertension as the Debut of Metabolic Disease.

Estepa Pedregosa, Lorena / Guitart Pardellans, Carmina / Baucells Lokyer, Benjamin Jaume / Prada Martínez, Fredy Hermógenes / García Cazorla, Àngels / Cambra Lasaosa, Francisco José / Segura Matute, Susana

Archivos de bronconeumologia

2020 Volume 56, Issue 12, Page(s) 820–821

Title translation	Hipertensión pulmonar grave como inicio de la enfermedad metabólica.
MeSH term(s)	Humans ; Hypertension, Pulmonary/etiology ; Metabolic Diseases ; Sexual Behavior
Language	Spanish
Publishing date	2020-08-10
Document type	Case Reports
ZDB-ID	733126-5
ISSN	1579-2129 ; 0300-2896
ISSN (online)	1579-2129
ISSN	0300-2896
DOI	10.1016/j.arbres.2020.06.020
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Article ; Online: Más de 3 horas y menos de 3 años: Seguridad de procedimientos anestésicos en menores de 3 años sometidos a cirugía de más de 3 horas.

Álvarez Escudero, Julián / Paredes Esteban, Rosa María / Cambra Lasaosa, Francisco José / Vento, Máximo / López Gil, Maite / de Agustín Asencio, Juan Carlos / Moral Pumarega, María Teresa

Anales de pediatria (Barcelona, Spain : 2003)

2017 Volume 87, Issue 4, Page(s) 236.e1–236.e6

Abstract: An FDA alert in December 2016 on the safety of general anesthesia and sedations in patients less than 3 years of age and pregnant women has raised doubts in relation to the attitude that professionals implicated in these procedures should adopt in ... ...

Title translation	More than 3 hours and less than 3 years: Safety of anaesthetic procedures in infants less than 3 years old subected to surgery for more the 3 hours.
Abstract	An FDA alert in December 2016 on the safety of general anesthesia and sedations in patients less than 3 years of age and pregnant women has raised doubts in relation to the attitude that professionals implicated in these procedures should adopt in relation to these specific group of patients. Confronted with this situation, the following medical scientific societies: Sociedad Española de Anestesia y Reanimación (SEDAR), Sociedad Española de Cirugía Pediátrica (SECP), Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y Sociedad Española de Neonatología (SENeo), have established a working group to analyze and clarify the safety of these techniques. In the present article we conclude that at present both general anesthesia and profound sedation are considered safe procedures because there is no evidence of the opposite in studies with human beings. However, this ascertained safety should not obviate the problem which still needs to be followed with attention, especially in patients less than 3 years of age undergoing anesthetic procedures for more than 3 hours or prolonged sedation in the Neonatal or Pediatric Intensive Care Units.
MeSH term(s)	Anesthesia/methods ; Anesthesia/standards ; Humans ; Infant ; Infant, Newborn ; Patient Safety/standards ; Surgical Procedures, Operative ; Time Factors
Language	Spanish
Publishing date	2017-07-29
Publishing country	Spain
Document type	Journal Article ; Practice Guideline
ISSN	1695-9531
ISSN (online)	1695-9531
DOI	10.1016/j.anpedi.2017.04.012
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Article ; Online: Actitudes éticas de los pediatras de Cuidados Intensivos ante pacientes con atrofia muscular espinal tipo 1.

Agra Tuñas, María Carmen / Hernández Rastrollo, Ramón / Hernández González, Arturo / Ramil Fraga, Carmen / Cambra Lasaosa, Francisco José / Quintero Otero, Sebastián / Ruiz Extremera, Angela / Rodríguez Núñez, Antonio

Anales de pediatria (Barcelona, Spain : 2003)

2017 Volume 86, Issue 3, Page(s) 151–157

Abstract: Introduction: Spinal muscular atrophy type 1 (SMA-1) is a progressive and fatal disease that leads to ethical problems for Paediatric professionals. Our objective was to determine the ethical options of Paediatric Intensive Care Unit (PICU) ... ...

Title translation	Ethical attitudes of intensive care paediatricians as regards patients with spinal muscular atrophy type 1.
Abstract	Introduction: Spinal muscular atrophy type 1 (SMA-1) is a progressive and fatal disease that leads to ethical problems for Paediatric professionals. Our objective was to determine the ethical options of Paediatric Intensive Care Unit (PICU) paediatricians as regards a child with SMA-1 and respiratory failure. Material and methods: A cross-sectional descriptive study was conducted using an anonymous questionnaire sent to PICUs in Spain (which can be accessed through the Spanish Society of Paediatric Critical Care web page). Results: Of the 124 responses analysed, 70% were from women, 51% younger than 40 years, 54% from a PICU with more than 10 beds, 69% with prior experience in such cases, and 53% with religious beliefs. In the last patient cared for, most paediatricians opted for non-invasive mechanical ventilation (NIV) and limitation of therapeutic effort (LET) in case of NIV failure. Confronted with a future hypothetical case, half of paediatricians would opt for the same plan (NIV+LET), and 74% would support the family's decision, even in case of disagreement. Age, prior experience and sex were not related to the preferred options. Paediatricians with religious beliefs were less in favour of initial LET. Less than two-thirds (63%) scored the quality of life of a child with SMA-1 and invasive mechanical ventilation as very poor. Conclusions: Faced with child with SMA-1 and respiratory failure, most paediatricians are in favour of initiating NIV and LET when such support is insufficient, but they would accept the family's decision, even in case of disagreement.
Language	Spanish
Publishing date	2017-03
Publishing country	Spain
Document type	English Abstract ; Journal Article
ISSN	1695-9531
ISSN (online)	1695-9531
DOI	10.1016/j.anpedi.2016.01.014
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Article ; Online: Is a nasopharyngeal tube effective as interface to provide bi-level noninvasive ventilation?

Velasco Arnaiz, Eneritz / Cambra Lasaosa, Francisco José / Hernández Platero, Lluïsa / Millán García Del Real, Núria / Pons-Òdena, Martí

Respiratory care

2014 Volume 59, Issue 4, Page(s) 510–517

Abstract: Background: The nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its ... ...

Abstract	Background: The nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its effectiveness. Methods: Prospective observational study from January 2007 to December 2010, including all patients ≤ 6 months old admitted to the pediatric ICU (PICU) and treated with NIV with two levels of pressure using the NT. Clinical data collected before starting NIV, and at 2, 8, 12 and 24 h, were analyzed following NIV initiation: first-line or initial NIV (i-NIV), elective postextubation NIV (e-NIV), and rescue postextubation NIV (r-NIV). The need for intubation was considered to be NIV failure. Results: One hundred fifty-one episodes of NIV were included in the study, with 65% of patients having bronchiolitis. e-NIV was most frequently used (48%) (i-NIV 44%, r-NIV 8%), and the failure rate, 27% in total, was highest in the i-NIV group (37%) (e-NIV 18%, r-NIV 25%). Case patients with successful outcomes had shorter PICU stays (8.5 vs. 13 d, P = .001) and hospital stays (17 vs. 23 d, P = .03) stays. The NT needed to be changed for another interface in only 5 case patients, few complications (4 of 151 patients) were observed, and mortality (2 of 151 patients) was unrelated to NIV. Conclusions: Use of the NT showed 73% effectiveness, with few complications. The effectiveness was higher in e-NIV than i-NIV.
MeSH term(s)	Airway Extubation ; Bronchiolitis/therapy ; Cardiovascular Surgical Procedures ; Heart Rate ; Humans ; Hypnotics and Sedatives/therapeutic use ; Infant ; Infant, Newborn ; Inspiratory Capacity ; Intensive Care Units, Pediatric ; Intubation/instrumentation ; Length of Stay/statistics & numerical data ; Noninvasive Ventilation/instrumentation ; Noninvasive Ventilation/methods ; Prospective Studies ; Respiratory Tract Infections/therapy
Chemical Substances	Hypnotics and Sedatives
Language	English
Publishing date	2014-04
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.02556
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Article ; Online: Association of Polymorphisms in IRAK1, IRAK4 and MyD88, and Severe Invasive Pneumococcal Disease.

Carrasco-Colom, Jaume / Jordan, Iolanda / Alsina, Laia / Garcia-Garcia, Juan-José / Cambra-Lasaosa, Francisco José / Martín-Mateos, María Anunciación / Juan, Manel / Muñoz-Almagro, Carmen

The Pediatric infectious disease journal

2015 Volume 34, Issue 9, Page(s) 1008–1013

Abstract: Background: Severe invasive pneumococcal disease (SIPD) has high morbidity and mortality, conditioned by pneumococcus and host factors, such as Toll-like receptors and their Toll-IL1R common signaling pathway. The objectives of this study are (1) to ... ...

Abstract	Background: Severe invasive pneumococcal disease (SIPD) has high morbidity and mortality, conditioned by pneumococcus and host factors, such as Toll-like receptors and their Toll-IL1R common signaling pathway. The objectives of this study are (1) to correlate single nucleotide polymorphisms (SNPs) involved in some Toll-IL1R signaling pathway proteins (IRAK1, IRAK4, IRAKM and MyD88) with SIPD by comparing patients versus healthy controls. (2) To determine whether these SNPs influence SIPD outcome. Methods: Case-control prospective observational study: 60 pediatric patients with IPD and systemic inflammatory response syndrome, and 120 healthy volunteers. Well-known immunodeficiencies were excluded. Independent variables: SNPs genotypes and alleles. Other variables: demographic, previous infections, and clinical, analytical and microbiological evolution data. Results: We have detected significant disequilibrium of SNPs frequencies between SIPD patients and controls in rs1059701-CC (IRAK1; P = 0.0067), rs4251513-CC (IRAK4; P < 0.0001), rs1461567-T (IRAK4; P = 0.0158) and rs6853-AA (MyD88; P < 0.0001). SIPD patients showed significant association between: leukocytosis > 15,000/mmc and rs1059702-nonTT (IRAK1; P = 0.0460), pleuropneumonia and rs1624395-G (IRAKM; P = 0.0147), and rs1370128-C (IRAKM; P = 0.0055), sequelae, and rs4251513-nonGG (IRAK4; P = 0.0055), death and rs6853-nonAA (P = 0.0054) and rs6853-G (P = 0.0065; MyD88). Conclusions: This is the first study to show an association between SNPs in IRAK1, IRAK4 and MyD88, and the presence of SIPD. Our data showed that some SNPs may lead to a higher risk of developing SIPD while other are related with the outcome in SIPD patients. Following PIRO score (predisposition, insult, response, organ dysfunction), identifying SNPs predisposing to infectious diseases, such as SIPD might help stratify patients with severe infectious diseases and design specific treatments.
MeSH term(s)	Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Interleukin-1 Receptor-Associated Kinases/genetics ; Male ; Myeloid Differentiation Factor 88/genetics ; Pneumococcal Infections/genetics ; Pneumococcal Infections/pathology ; Polymorphism, Single Nucleotide ; Prospective Studies ; Sepsis/genetics ; Sepsis/pathology
Chemical Substances	MYD88 protein, human ; Myeloid Differentiation Factor 88 ; IRAK1 protein, human (EC 2.7.11.1) ; IRAK4 protein, human (EC 2.7.11.1) ; Interleukin-1 Receptor-Associated Kinases (EC 2.7.11.1)
Language	English
Publishing date	2015-09
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000000779
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Article ; Online: Guias de ingreso, alta y triage para las unidades de cuidados intensivos pediátricos en España.

de la Oliva, Pedro / Cambra-Lasaosa, Francisco José / Quintana-Díaz, Manuel / Rey-Galán, Corsino / Sánchez-Díaz, Juan Ignacio / Martín-Delgado, María Cruz / de Carlos-Vicente, Juan Carlos / Hernández-Rastrollo, Ramón / Holanda-Peña, María Soledad / Pilar-Orive, Francisco Javier / Ocete-Hita, Esther / Rodríguez-Núñez, Antonio / Serrano-González, Ana / Blanch, Luis

Anales de pediatria

2018 Volume 88, Issue 5, Page(s) 287.e1–287.e11

Abstract: A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and ... ...

Title translation	Admission, discharge and triage guidelines for paediatric intensive care units in Spain.
Abstract	A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition.
MeSH term(s)	Child ; Humans ; Intensive Care Units, Pediatric/standards ; Patient Admission/standards ; Patient Discharge/standards ; Spain ; Triage/standards
Language	Spanish
Publishing date	2018-05-01
Publishing country	Netherlands
Document type	Journal Article ; Practice Guideline
ZDB-ID	2830901-7
ISSN	2341-2879 ; 2341-2879
ISSN (online)	2341-2879
ISSN	2341-2879
DOI	10.1016/j.anpedi.2017.10.008
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