C Hermosa Gelbard

Hospital Universitario Henares, Madrid, Madrid, Spain

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Publications (4)5.29 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To describe and evaluate the impact of a system for early detection and intervention in patients at risk outside the ICU upon the outcome of patients admitted to the ICU and the number of cases of hospital cardiopulmonary arrest.SettingA second-level hospital in the Community of Madrid (Spain) with electronic clinical histories.Methods An intensivist reviewed each of the patients meeting the inclusion criteria, and decided the need or not for intervention. Posteriorly, in collaboration with the physician supervising the patient, the needed level of care was decided, along with the subsequent management protocol.DesignA descriptive and quasi-experimental “before-after” study was made.ResultsA total of 202 patients were intervened during the study period, With the inclusion of 147 after detecting altered laboratory test results through our software application. During the control period, the mortality rate in the ICU was 9%, versus 4.4% during the intervention period (P = .03). In the multivariate analysis, the two factors significantly related to mortality were admission during the intervention period (OR = 0.42; 95%CI: 0.18-0.98; P = .04) and SAPS 3 (OR = 1.11; 95%CI: 1.07-1.14; P < 0.05). There were 10 cardiopulmonary arrest alerts during the control period, versus three in the intervention period (P = .07).Conclusions Early detection activities in patients at risk outside the ICU can have beneficial effects upon the patients admitted to the ICU, and can contribute to reduce the number of hospital cardiopulmonary arrests.
    Medicina Intensiva 01/2013; 37(1):12–18. · 1.32 Impact Factor
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    ABSTRACT: OBJECTIVES: To describe and evaluate the impact of a system for early detection and intervention in patients at risk outside the ICU upon the outcome of patients admitted to the ICU and the number of cases of hospital cardiopulmonary arrest. SETTING: A second-level hospital in the Community of Madrid (Spain) with electronic clinical histories. METHODS: An intensivist reviewed each of the patients meeting the inclusion criteria, and decided the need or not for intervention. Posteriorly, in collaboration with the physician supervising the patient, the needed level of care was decided, along with the subsequent management protocol. DESIGN: A descriptive and quasi-experimental "before-after" study was made. RESULTS: A total of 202 patients were intervened during the study period, With the inclusion of 147 after detecting altered laboratory test results through our software application. During the control period, the mortality rate in the ICU was 9%, versus 4.4% during the intervention period (P=.03). In the multivariate analysis, the two factors significantly related to mortality were admission during the intervention period (OR=0.42; 95%CI: 0.18-0.98; P=.04) and SAPS 3 (OR=1.11; 95%CI: 1.07-1.14; P<0.05). There were 10 cardiopulmonary arrest alerts during the control period, versus three in the intervention period (P=.07). CONCLUSIONS: Early detection activities in patients at risk outside the ICU can have beneficial effects upon the patients admitted to the ICU, and can contribute to reduce the number of hospital cardiopulmonary arrests.
    Medicina Intensiva 10/2012; · 1.32 Impact Factor
  • Medicina Intensiva 07/2012; · 1.32 Impact Factor
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    ABSTRACT: There are many causes of a low level of consciousness following cardiac surgery. A highly infrequent cause is infarction or hemorrhage of a pituitary adenoma that has usually been overlooked. We describe the case of a woman who presented torpid course in the postoperative period after cardiac surgery with multiple complications including low level of consciousness. A diagnosis of pituitary macroadenoma and hypopituitarism was made. Clinical course was favorable with hormone replacement therapy.
    Medicina Intensiva 27(8):563–565. · 1.32 Impact Factor