Franco Díaz

Franco Díaz
Hospital El Carmen de Maipú · Unidad de Paciente Crítico Pediátrico

MD

About

177
Publications
52,906
Reads
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974
Citations
Citations since 2016
108 Research Items
889 Citations
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2016201720182019202020212022050100150200250
2016201720182019202020212022050100150200250
2016201720182019202020212022050100150200250
Additional affiliations
January 2019 - present
Hospital El Carmen Maipú
Position
  • Residente UPCP
January 2019 - present
Hospital Clínico La Florida
Position
  • Residente UPCP
June 2012 - June 2015
University of Alabama at Birmingham
Position
  • Fellow

Publications

Publications (177)
Article
Full-text available
Background: Mechanical power is a composite variable for energy transmitted to the respiratory system over time that may better capture risk for ventilator-induced lung injury than individual ventilator management components. We sought to evaluate if mechanical ventilation management with a high mechanical power is associated with fewer ventilator...
Preprint
Full-text available
Background: Low tidal volume (Vt) strategy is currently the standard of care for ARDS. However, this approach may result in harmful airway pressures in severe ARDS. We report the feasibility of a combined approach of very low-VT and mild therapeutic hypothermia (MTH) to decrease the ventilatory load in a very severe COVID-19-related ARDS cohort. Me...
Article
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Vigorous spontaneous breathing has emerged as a promotor of lung damage in acute lung injury, an entity known as “patient self-inflicted lung injury”. Mechanical ventilation may prevent this second injury by decreasing intrathoracic pressure swings and improving regional air distribution. Therefore, we aimed to determine the effects of spontaneous...
Article
Full-text available
Acute flaccid myelitis (AFM) is a neuroinflammatory disease characterized by acute asymmetric weakness of the limbs associated with lesions of the gray matter of the spinal cord. It mainly affects children and has been increasingly identified since 2014. Objective: To describe a severe emerging neurological disease in Chile. Clinical Case: Three...
Preprint
Background Strong social distancing measures were quickly implemented in Chile during the SARS-CoV-2 outbreak. One of the aims of non-pharmaceutical interventions (NPI) mandates was to decrease overcrowding, thus is usually measured as mobility changes. Methods we gather data from national health statistics for pediatric emergency (PED) visits for...
Article
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Background To understand critical paediatric coronavirus disease 2019 (COVID-19) and evaluate factors associated with mortality in children from high and low-middle income countries. Methods Prospective, observational study of critically ill children hospitalised for COVID-19 in 18 countries throughout North America, Latin America, and Europe betw...
Article
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Objective To describe the editorial processing time of published COVID-19 research articles and compare this with a similar topic, human influenza, and analyze the number of publications, withdrawals, and retractions. Methods A descriptive-analytical study using PubMed on research articles with the MeSH terms human influenza and COVID-19. Time to...
Article
Purpose We aim to describe the action plan and clinical results of a COVID-19 unit for adult patient care in units intended for critically ill children, proposing a clinical/administrative framework. Methods We reviewed the preparedness of the PICU team before the surge of cases of COVID-19 and the organizational/administrative issues to increase...
Data
Abstract Childhood and COVID-19: The indirect effects of the COVID-19 pandemic on the well-being of children and adolescents. The impact of the COVID-19 pandemic has been overlooked in children and adolescents. Many of the adverse effects have resulted from containment and mitigation measures and will only be measurable in the medium and long term....
Article
Full-text available
El impacto de la pandemia COVID-19 ha sido invisibilizado en niños, niñas y adolescentes, ya que muchos de los efectos negativos han sido producto de las medidas de contención y mitigación, y sólo serán cuantificables a mediano y largo plazo. Aunque la respuesta mundial ha sido exitosa en disminuir la letalidad de la enfermedad, el efecto nocivo en...
Article
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These guidelines seek to generate recommendations based on the best available evidence, including local and regional studies in countries with limited resources, which do not replace individual clinical judgement in the care of children with sepsis. The intention is not to replace the SSC or other existing guidelines; on the contrary, the purpose i...
Article
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Objective The aim of this study was to develop evidence-based recommendations for the diagnosis and treatment of sepsis in children in low- and middle-income countries (LMICs), more specifically in Latin America. Design: A panel was formed consisting of 27 experts with experience in the treatment of pediatric sepsis and two methodologists working i...
Article
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The Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-associated Organ Dysfunction in Children was released in 2020 and is intended for use in all global settings that care for children with sepsis. However, practitioners managing children with sepsis in resource-limited settings (RLS) face several cha...
Article
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Importance: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with SARS-CoV-2 infection is thought to be driven by a post-viral dysregulated immune response, where interleukin 6 (IL-6) might have a central role. In this setting, IL-6 inhibitors are prescribed as immunomodulation in cases refractory to standard therapy. Objective: To...
Article
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Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Onlin...
Preprint
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Background Globally, critical illness results in millions of deaths every year. Although many of these deaths are potentially preventable, the basic, life-saving care of critically ill patients can be overlooked in health systems. Essential and Emergency Care (EECC) has been devised as the care that should be provided to all critically ill patients...
Preprint
Full-text available
Objectives: To understand the international epidemiology of critical pediatric COVID-19 and compare presentation, treatments, and outcomes of younger (<2 years) and older (>2 years) children. Design: Prospective, observational study from April 1 to December 31, 2020 Setting: International multicenter study from 55 sites from North America, Latin Am...
Preprint
Full-text available
Evidence before this study: The COVID-19 pandemic exposed the world's lack of preparedness for such a catastrophe. The classical models of response to disasters were deficient due to the characteristics of COVID-19, such as the uncertain community spread speed and waves of contagion, duration of respiratory failure, and requirement for critical bed...
Article
Advanced airway management of critically ill children is crucial for novel coronavirus disease 2019 (COVID-19) management in the pediatric intensive care unit, whether due to shock and hemodynamic collapse or acute respiratory failure. In this article, intubation is challenging due to the particularities of children's physiology and the underlying...
Article
Full-text available
Multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection is an infrequent and poorly understood illness. It can present as severe multiorgan failure in children, potentially lethal. Immunomodulation is the empiric treatment because a dysregulated immune response is the primary pathophysiologic mechanism. We present...
Article
Introduction : Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique used in a wide spectrum of diseases. We aim to review the indications, complications, and outcomes of critically ill children who received TPE and to compare a membrane versus centrifugal method in this cohort. Methods .A retrospective observational...
Article
Objectives: To compare the new tools to evaluate the energy dissipated to the lung parenchyma in mechanically ventilated children with and without lung injury. We compared their discrimination capability between both groups when indexed by ideal body weight and driving pressure. Design: Post hoc analysis of individual patient data from two previo...
Article
Several challenges exist for referral and transport of critically ill children in resource-limited regions such as Latin America; however, little is known about factors associated with clinical outcomes. Thus, we aimed to describe the characteristics of critically ill children in Latin America transferred to pediatric intensive care units for acute...
Article
Full-text available
Objetivos: describir las características clínicas y epidemiológicas de niños admitidos por bronquiolitis en 13 unidades de cuidados intensivos pediátricos (UCIP) del Uruguay y comparar los resultados asistenciales finales entre UCIP de Montevideo (UM) y del interior del país (UI). Material y método: estudio observacional retrospectivo multicéntrico...
Preprint
Full-text available
Background Globally, critical illness results in millions of deaths every year. Although many of these deaths are potentially preventable, the basic, life-saving care of critically ill patients can be overlooked in health systems. Essential and Emergency Care (EECC) has been devised as the care that should be provided to all critically ill patients...
Poster
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Aims & Objectives: To describe the epidemiology, therapeutic management and outcomes of children admitted to pediatric ICU (PICU) for acute respiratory failure (ARF) in a contemporary multinational PICU cohort. Methods: Retrospective analysis using prospectively collected clinical data within the LARed Network ARF clinical registry (35 hospitals,...
Poster
Aims & Objectives: to describe contemporary invasive mechanical ventilation (IMV) practices in children admitted to Latin American PICUs with acute respiratory failure (ARF). Methods: Retrospective analysis within LARed Network ARF Registry. We analyzed all children who were prescribed IMV between May 2017 and October 2019. Data described as median...
Poster
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Aims & Objectives: To determine risk factors of non-invasive ventilation techniques (NIV) failure in children admitted with acute respiratory failure (ARF) and to compare their outcomes with children treated successfully or with invasive ventilation alone (IMV). Methods: Retrospective analysis within LARed Network ARF multicenter registry. We inclu...
Poster
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Aims & Objectives: To determine risk factors and outcomes for prolonged invasive mechanical ventilation (pIMV) in infants admitted to pediatric ICU (PICU) due to acute respiratory failure (ARF). Methods: Retrospective analysis using prospectively collected data within LARed Network ARF registry (33 hospitals, 8 countries). All PICU encounters in ch...
Poster
Full-text available
Aims & Objectives: To compare the epidemiology, therapeutic management and clinical outcomes of infants with bronchiolitis admitted to 13 PICUs from Uruguay (UY) using a multinational Latin-American (LATAM) PICU cohort. Methods: Retrospective analysis using prospectively collected clinical data within LARed Network Acute Respiratory Failure registr...
Presentation
Full-text available
Aims & Objectives: To compare Bedside Physician Diagnosis (BPD) for pediatric sepsis with the new infection associated organ failure Consensus Criteria (CC) on a large Latin American registry To describe the clinical outcomes of ventilated patients with a respiratory infection. Methods:Design: Retrospective analysis within LARed Network’s Pediatric...
Article
Aims & Objectives: To develop a comprehensive description of multisystem inflammatory syndrome temporally associated with SARS -Cov-2 (PIMS-TS) by conducting a case series quantitative systematic review. Methods: PIMS-TS studies were identified by searching Pub Med and Embase from May 1st to July 1st 2020.We extracted data on demographics, clinica...
Article
Background COVID-19 is a disease associated with an intense systemic inflammation that could induce severe acute respiratory distress syndrome (ARDS), with life-threatening hypoxia and hypercapnia. We present a case where mild therapeutic hypothermia was associated with improved gas exchange, facing other therapies' unavailability due to the pandem...
Article
Background: Care variability for children with severe acute asthma has been well documented in high‐income countries, yet data from low‐ and middle‐income regions are lacking. We sought to characterize the magnitude of practice variability in the care of Latin American children to identify opportunities for standardization of care. Methods: A cross...
Article
Full-text available
Background: Protective mechanical ventilation (MV) aims at limiting global lung deformation and has been associated with better clinical outcomes in acute respiratory distress syndrome (ARDS) patients. In ARDS lungs without MV support, the mechanisms and evolution of lung tissue deformation remain understudied. In this work, we quantify the progre...
Article
Full-text available
Deterioration of lung function during the first week of COVID-19 has been observed when patients remain with insufficient respiratory support. Patient self-inflicted lung injury (P-SILI) is theorized as the responsible, but there is not robust experimental and clinical data to support it. Given the limited understanding of P-SILI, we describe the p...
Article
Full-text available
Pediatric inflammatory multisystem syndrome associated with SARS-CoV-2 (PIMS-TS) is infrequent, but children might present as a life-threatening disease. In a systematic quantitative review, we analyzed 11 studies PIMS-TS, including 468 children reported before Jul 1st. We found a myriad of clinical features, but we were able to describe common cha...
Article
Full-text available
Multisystem inflammatory syndrome temporally related to COVID-19 in children and adolescents is a clinical presentation of SARS-CoV-2 infection. It shares some features with Kawasaki disease, toxic shock, sepsis, macrophage activation syndrome, and myocarditis. Few publications have addressed its initial management, which is similar to that propose...
Article
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Background: The COVID-19 pandemic reached the Southern Hemisphere in the autumn of 2020, thus coinciding with its expected annual viral respiratory season. The potential impact of national strategies aimed at mitigating COVID-19 during the pandemic on the incidence of other critical viral lower respiratory tract infections (LRTIs) in children is un...
Article
The appearance of SARS-CoV-2 from December 2019 and its rapid expansion in the world reaching Pandemic status, has become a great challenge for health teams. Although the evidence of infection in children is still scarce compared to that of adults, it has become evident that at the pediatric po pulation level, most of the time the infection is asym...
Article
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Background Hospitalized pediatric hematology‐oncology (PHO) patients are at high risk for critical illness, especially in resource‐limited settings. Unfortunately, there are no established quality indicators to guide institutional improvement for these patients. The objective of this study was to identify quality indicators to include in PROACTIVE...
Article
Full-text available
La aparición del SARS-CoV-2 a partir de diciembre de 2019 y su rápida expansión en el mundo alcanzando el estatus de Pandemia, se ha convertido en un gran desafío para los equipos de salud. Aunque la evidencia de la infección en niños aún es escasa comparada a la de los adultos, se ha hecho evidente que a nivel de la población pediátrica, la mayor...
Article
Full-text available
Critical care management of patients with COVID-19 has been influenced by a mixture of public, media and societal pressure, as well as clinical and anecdotal observations from many prominent researchers and key opinion leaders. These factors may have affected the principles of evidence-based medicine and encouraged the widespread use of non-tested...
Article
INTRODUCCIÓN. La Bronquiolitis grave (BG) es causa principal mundial de ingreso a unidades de cuidado intensivo pediátrico (UCIP). La variabilidad de prácticas en su manejo es extendida y en Colombia aún no ha sido descrita. OBJETIVO. Caracterización epidemiológica de niños admitidos por BG en 3 UCIP adscritas a una red colaborativa (LARed Network...
Article
Full-text available
Objetivo: Describir terapias utilizadas lactantes con bronquiolitis aguda admitidos en 20 Unidades de Cuidados Intensivos (UCI) pediátricos miembros de LARed en 5 países latinoamericanos. Pacientes y métodos: Estudio observacional retrospectivo, multicéntrico, de datos recabados en forma prospectiva en Registro Latinoamericano de Falla Respiratori...