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Publications (7)4.13 Total impact

  • Medicina Intensiva 04/2015; DOI:10.1016/j.medin.2015.02.009 · 1.24 Impact Factor
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    ABSTRACT: Low concentrations of plasma citrulline and arginine have been reported in children under various pathological conditions. Hypothesis: Plasma citrulline and arginine levels undergo different kinetics during the early days of critical illness in children according to the severity of symptoms and can be correlated with other clinical and laboratory parameters associated with the SIR. A single-center prospective observational study in patients 7 days to 14 years admitted to pediatric intensive care unit (PICU). Citrulline and arginine blood levels (blood in dry paper, analysis by mass spectrometry in tandem), acute phase reactants and clinical data were collected on admission, at 12 h, 24 h, 3 and 7 days. A total of 44 critically ill patients were included and control group was formed by 42 healthy children. The citrulline and arginine kinetic analysis showed: 1) Citrulline falls significantly (P<.05) at 12 h of admission; levels remain low until day 7 and begin progressive increase again. 2) Arginine is already lowered at 6h, although an earlier rise occurs (3rd day). 3. The decrease of citrulline in the first 3 days of admission positively correlates with arginine kinetics. Bivariate analysis showed: 1) Correlation of elevated citrulline on the 7th day with shorter duration of mechanical ventilation, lower PICU stay and lower occurrence of complications. The levels of citrulline still descended at day 7 are associated with increased CRP/procalcitonin elevation at first 24 h. 2) The greatest decrease of arginine in the first 12 h is associated with a longer PICU stay and greater number of complications and increase of acute phase reactants at 3 days. There are decreased levels of arginine and citrulline in the first days at PICU, with recovery at the 3rd and 7th day respectively, and a relationship between a greater decrease and a worse outcome and between a longer income and a higher serum CRP/procalcitonin. Copyright © 2015. Published by Elsevier España, S.L.U.
    02/2015; 581. DOI:10.1016/j.anpedi.2014.10.032
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    ABSTRACT: Resumen La mayoría de los casos de quilopericardio en la infancia aparecen tras cirugía torácica, especialmente tras cirugía cardiaca, aunque de forma excepcional también se producen en niños sin estos antecedentes, como los 2 pacientes presentados en este artículo. El primero se trata de un niño de 9 años con un episodio de quilopericardio como primera manifestación de una linfangiomiomatosis, y el segundo de una niña de 15 meses con antecedentes de síndrome de Down y enteropatía autoinmune, catalogado como quilopericardio congénito primario. Además, se realiza una revisión bibliográfica de los casos publicados en los últimos 13 años y se analiza el manejo de esta rara entidad. An Pediatr (Barc). 2010;73:42-6.
    Anales de Pediatría 07/2010; 73(1). DOI:10.1016/j.anpedi.2010.04.006 · 0.72 Impact Factor
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    ABSTRACT: The aim of endotracheal aspiration is to eliminate secretions in patients with an artificial airway. All children with mechanical ventilation must undergo this procedure periodically. The frequency of aspiration depends on the type and quantity of the respiratory secretions and on the patient's clinical status. Aspiration should be performed by two people to maintain a greater degree of asepsis and to optimize stability of the airway and ventilation. Closed aspiration systems are available that allow aspiration without the need to disconnect the patient through a single probe that is constantly protected by a plastic sleeve and isolated from external environment. The most important risks of endotracheal aspiration are hypoxemia, mucosal injury, bronchospasm, arrhythmias, perforation of the airway with development of pneumothorax, accidental extubation, and infections. Bronchial brushing with a protected catheter and brochoalveolar lavage are used to analyze pulmonary infections. These techniques can be performed blind or through fibrobronchoscopy. They can also be used for the diagnosis of noninfectious pulmonary diseases such as alveolar proteinosis, alveolar hemorrhage or histiocytosis. Their adverse effects are similar to those of endotracheal aspiration.
    Anales de Pediatría 12/2003; 59(5):472-7. · 0.72 Impact Factor
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    ABSTRACT: The aim of endotracheal aspiration is to eliminate secretions in patients with an artificial airway. All children with mechanical ventilation must undergo this procedure periodically. The frequency of aspiration depends on the type and quantity of the respiratory secretions and on the patient's clinical status. Aspiration should be performed by two people to maintain a greater degree of asepsis and to optimize stability of the airway and ventilation. Closed aspiration systems are available that allow aspiration without the need to disconnect the patient through a single probe that is constantly protected by a plastic sleeve and isolated from the external environment. The most important risks of endotracheal aspiration are hypoxemia, mucosal injury, bronchospasm, arrhythmias, perforation of the airway with development of pneumothorax, accidental extubation, and infections. Bronchial brushing with a protected catheter and bronchoalveolar lavage are used to analyze pulmonary infections. These techniques can be performed blind or through fibrobronchoscopy. They can also be used for the diagnosis of noninfectious pulmonary diseases such as alveolar proteinosis, alveolar hemorrhage or pulmonary histiocytosis. Their adverse effects are similar to those of endotracheal aspiration
    Anales de Pediatría 01/2003; 59(5):472–477. DOI:10.1016/S1695-4033(03)78762-1 · 0.72 Impact Factor
  • Anales espanoles de pediatria 11/2001; 55(4):387-8.
  • Anales de Pediatría 01/2001; 55(4):387–388. DOI:10.1016/S1695-4033(01)77709-0 · 0.72 Impact Factor