Browsing by Author "Rojas, Mariana"

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    Early extubation in COVID-19 pneumonia patients and temporal changes in the lactate dehydrogenase profile
    (2022) Rojas, Mariana; Gignon , Lucile; Díaz, Fernando; Florea M., Andrei; Leyton, Patricio A.; Abarca Z. , Juan; Vargas Z., Javiera
    Objective: Since the beginning of the 2019 global pandemic of Coronavirus Disease, using invasive mechanical ventilation as support therapy has been a critical treatment of acute respiratory failure. In the context of a collapsed health system, having an early extubation predictor becomes a useful way of supporting clinical management, by enabling to anticipate the availability of mechanical ventilators. Hence, we assessed the relationship between the progression of lactate dehydrogenase and early extubation in patients with COVID-19. Design: A retrospective study. Setting: A single private hospital in Chile. Patients: Adults aged 18 or older diagnosed with COVID-19 pneumonia and requiring mechanical ventilation, having been admitted to an ICU during the study period. Interventions: None. Measurements and Main Results: Fifty two individuals, 73% males, were included with a median age of 47.1 years old and a median body mass index of 29. Individuals extubated within the first 5 days of mechanical ventilation, early extubation group, amounted to 34.6%. The average decrease in serum lactate dehydrogenase levels was 27.5 UI/L per day (p < 0.01) in the early extubation group compared to 14.7 UI/L per day (p < 0.01) in the late extubation group (individuals extubated after day 5). During the first 48 hours, the average daily decrease was 56.7 UI/L in the early extubation group compared to 13.2 UI/L per day in late extubation group (p < 0.01). Conclusions: Serum lactate dehydrogenase daily level decrease during the first days of mechanical ventilation is associated with earlier patient extubation.
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    Fragilidad: en busca de herramientas de evaluación preoperatoria
    (2020) Vargas, Javiera; Gálvez, María de los Ángeles; Rojas, Mariana; Honorato, Macarena; Andrade, Maricarmen; Leyton, Patricio; Mardones, Gabriela; Morales, Julián; Pérsico, Daniela; Rojas, Fernanda; Moreno, Duby; Becker, Erika; Cavada, Gabriel; Carvajal, Cristóbal
    In the perioperative context, a frailty evaluation scale must consider certain characteristics such as validation, execution speed, simplicity, the capacity to measure multiple dimensions and not being dependent on a cognitive or physical test that could not be performed prior to surgery. The test should select patients that could benefit from interventions aimed to improve their postoperative outcomes. Aim: To validate two frailty evaluation scales for the perioperative period. Material and Methods: The Risk Analysis Index with local modifications (RAI-M) were applied to 201 patients aged 73 ± 7 years (49% women) and the Edmonton frailty scale were applied in 151 patients aged 73 ± 7 years (49% women) in the preoperative period. Their results were compared with the Rockwood frailty index. Results: The Edmonton frail scale showed adequate psychometric properties and assessed multiple dimensions through 8 of the 11 original questions, achieving a discrimination power over 80% compared to the Rockwood Index. The RAI- M, demonstrated solid psychometric properties with a tool that examines 4 dimensions of frailty through 15 questions and reviewing the presence of 11 medical comorbidities. This scale had a discrimination power greater than 85% and it was significantly associated with prolongation of the planned hospital stay and mortality. Conclusions: RAI-M is a short and easily administered scale, useful to detect frailty in the preoperative period

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