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Argudo E, Hernández-Tejedor A, Belda Hofheinz S, Fuset MP, Sanchez Galindo A, Burgueño P, Ballcels J, Duerto J, Morales Martínez A, Martínez-Martínez M, Morteruel Arizcuren E, Pérez F, Díaz Vico A, Rubio Mateo-Sidrón JA. Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Spanish Society of Pediatric Intensive Care (SECIP) consensus recommendations for ECMO transport. Med Intensiva 2022; 46:446-454. [PMID: 35752606 DOI: 10.1016/j.medine.2022.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/04/2022] [Indexed: 06/03/2023]
Abstract
The evolution of extracorporeal membrane oxygenation treatment and the transport of patients receiving this treatment has changed dramatically in the last decade unevenly in different regions. The creation of specialized referral centers has been shown to improve outcomes. For all these reasons, it has been necessary to create networks of specialized teams and the number of secondary transports of patients with this treatment is increasing. In order to improve the quality of treatment and offer a guide to the services involved in these transports, the critical transport working groups of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Spanish Society of Pediatric Intensive Care (SECIP) have carried out a joint effort to prepare these recommendations, focused on the following aspects: indications, reference center systems, means of transport, characteristics and equipment, human teams, training and clinical safety.
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Affiliation(s)
- E Argudo
- Servicio de Medicina Intensiva, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
| | | | - S Belda Hofheinz
- Servicio de Cuidados Intensivos Pediátricos, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M P Fuset
- Servicio de Medicina Intensiva, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - A Sanchez Galindo
- Servicio de Medicina Intensiva Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - P Burgueño
- Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Ballcels
- Servicio de Cuidados Intensivos Pediátricos, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - J Duerto
- Servicio de Medicina Intensiva, Hospital Clínico San Carlos, Madrid, Spain
| | - A Morales Martínez
- Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - M Martínez-Martínez
- Servicio de Medicina Intensiva, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - E Morteruel Arizcuren
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario de Cruces, Barakaldo, Spain
| | - F Pérez
- Servicio de Medicina Intensiva, Hospital Universitario La Fe, Valencia, Spain
| | - A Díaz Vico
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Affiliation(s)
- A García-de-Lorenzo
- Servicio de Medicina Intensiva, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
| | - J M Añón
- Servicio de Medicina Intensiva, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; CIBER de Enfermedades Respiratorias, ISCIII, Madrid, Spain
| | - M J Asensio
- Servicio de Medicina Intensiva, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - P Burgueño
- Servicio de Medicina Intensiva, Hospital 12 de Octubre, Madrid, Spain
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Argudo E, Hernández-Tejedor A, Belda Hofheinz S, Fuset M, Sanchez Galindo A, Burgueño P, Ballcels J, Duerto J, Morales Martínez A, Martínez-Martínez M, Morteruel Arizcuren E, Pérez F, Díaz Vico A, Rubio Mateo-Sidrón J. Recomendaciones de consenso sobre el transporte de pacientes en ECMO de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) y la Sociedad Española de Cuidados Intensivos Pediátricos (SECIP). Med Intensiva 2022. [DOI: 10.1016/j.medin.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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García-de-Lorenzo A, Añón JM, Asensio MJ, Burgueño P. Chronic critical illness, how to manage it? Med Intensiva 2021; 46:S0210-5691(21)00107-8. [PMID: 34158191 DOI: 10.1016/j.medin.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 11/20/2022]
Affiliation(s)
- A García-de-Lorenzo
- Servicio de Medicina Intensiva. Hospital Universitario La Paz, IdiPAZ, Madrid, España; Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España.
| | - J M Añón
- Servicio de Medicina Intensiva. Hospital Universitario La Paz, IdiPAZ, Madrid, España; CIBER de Enfermedades Respiratorias, ISCIII, Madrid, España
| | - M J Asensio
- Servicio de Medicina Intensiva. Hospital Universitario La Paz, IdiPAZ, Madrid, España
| | - P Burgueño
- Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España
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Burgueño P, González C, Sarralde A, Gordo F. Transporte interhospitalario con membrana de oxigenación extracorpórea: cuestiones a resolver. Med Intensiva 2019; 43:90-102. [DOI: 10.1016/j.medin.2018.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 01/07/2018] [Accepted: 01/19/2018] [Indexed: 12/22/2022]
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Valbuena J, Burgueño P, Teja J, Gutierrez J, Arnaiz A. Hyperbaric oxygen treatment on diabetic foot and associated risk factors of lower limb amputation: Descriptive study. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.1134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chaparro M, Zanotti C, Burgueño P, Vera I, Bermejo F, Marín-Jiménez I, Yela C, López P, Martín MD, Taxonera C, Botella B, Pajares R, Ponferrada A, Calvo M, Algaba A, Pérez L, Casis B, Maté J, Orofino J, Lara N, García-Losa M, Badia X, Gisbert JP. Health care costs of complex perianal fistula in Crohn's disease. Dig Dis Sci 2013; 58:3400-6. [PMID: 24026400 DOI: 10.1007/s10620-013-2830-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 07/27/2013] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the use of health care resources and the associated costs of complex perianal Crohn's disease (CD) from the National Health System perspective. METHODS We conducted a multicenter, retrospective, observational study in which gastroenterologists from 11 hospitals in the Community of Madrid took part. Data was collected on the direct healthcare resources (pharmacological treatments, surgical procedures, laboratory/diagnostic tests, visits to specialists and emergency departments, and hospitalizations) consumed by 97 adult patients with complex perianal CD which was active at some point between January 1, 2005, and case history review. RESULTS We recorded 527 treatments: 73.1% pharmacological (32.3% antibiotic, 20.5% immunomodulator, 20.3% biological) and 26.9% surgical. Mean annual global cost was €8,289/patient, 75.3% (€6,242) of which was accounted for by pharmacological treatments (€13.44 antibiotics; €1,136 immunomodulators; €5,093 biological agents), 12.4% (€1,027) by hospitalizations and surgery, 7.7% (€640) by medical visits, 4.2% (€350) by laboratory/diagnostic tests, and 0.4% (€30) by emergency department visits. CONCLUSIONS Pharmacological therapies, and in particular biological agents, are the main cost driver in complex perianal CD; costs due to surgery and hospitalizations are much lower.
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Affiliation(s)
- M Chaparro
- Servicio de Aparato Digestivo del Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Playa de Mojácar 29. Urb Bonanza, 28669, Boadilla del Monte, Madrid, Spain,
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Chaparro M, Burgueño P, Iglesias E, Panés J, Muñoz F, Bastida G, Castro L, Jiménez C, Mendoza JL, Barreiro-de Acosta M, Senent SG, Gomollón F, Calvet X, García-Planella E, Gómez M, Hernández V, Hinojosa J, Mañosa M, Nyssen OP, Gisbert JP. Infliximab salvage therapy after failure of ciclosporin in corticosteroid-refractory ulcerative colitis: a multicentre study. Aliment Pharmacol Ther 2012; 35:275-83. [PMID: 22142227 DOI: 10.1111/j.1365-2036.2011.04934.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Ciclosporin has proven to be effective in patients with corticosteroid-refractory ulcerative colitis (UC). When therapy with this drug fails, infliximab can be considered to avoid colectomy. The efficacy and safety of this sequential approach remain unknown. AIM To assess the efficacy and safety profile of treatment with infliximab after failure of ciclosporin in patients with a corticosteroid-refractory flare of UC. METHODS Retrospective review of medical records of patients with a corticosteroid-refractory flare of UC who did not respond to ciclosporin and received salvage therapy with infliximab within a month of discontinuing ciclosporin. The severity of the flare and response to the treatment were graded using the Lichtiger index. Cumulative rates of colectomy were calculated using Kaplan-Meier analysis. Cox regression analysis was performed to identify predictors of colectomy. To evaluate the safety profile of this treatment strategy, any adverse event occurring after the first infusion of infliximab was considered. RESULTS The study population comprised 47 patients with corticosteroid-refractory UC treated with infliximab after failure of ciclosporin. The median baseline Lichtiger index was 13. The mean time from the last ciclosporin dose to the first infliximab infusion was 6 days. After the first infliximab infusion, 13% of patients achieved remission, and 74% partial response. Of the 35 patients who received the third infliximab infusion, 60% achieved remission, and 37% partial response. Fourteen patients (30%) underwent colectomy. The rate of adverse events was 23%. One death occurred in a 40-year-old man who failed ciclosporin and infliximab and underwent surgery 10 days after the first infliximab infusion; he died of nosocomial pneumonia. CONCLUSIONS Treatment with infliximab makes it possible to avoid colectomy in two-thirds of corticosteroid-refractory UC patients in whom ciclosporin fails. However, the rates of adverse events and mortality mean that the decision to administer sequential therapy (ciclosporin-infliximab) should be taken on an individual basis.
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Affiliation(s)
- M Chaparro
- Gastroenterology Department, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa, Madrid, Spain.
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