Juan Mayordomo-Colunga

• Doctor of Medicine
• Medical Doctor at Hospital Universitario Central de Asturias

Objectives (1) To assess how main pulmonary artery peak Doppler velocity (MPAVpeak) correlates with right ventricular output (RVO) and superior vena cava flow (SVCf), (2) to assess the reproducibility of MPAVpeak and (3) to test the prognostic accuracy of MPAVpeak to predict high-grade intraventricular haemorrhage (IVH) or death at seventh day of l...

Rationale: Lung ultrasound may be useful for prognostication of acute lung disease. Objectives: To assess whether the lung ultrasound score is associated with the severity of lung disease and may predict prolonged invasive mechanical ventilation in critically ill children. Methods: Prospective observational multicenter study in children aged 1...

Aim Recent emergence of airway clearance devices (ACDs) as a treatment alternative for foreign body airway obstructions (FBAO) lacks substantial evidence on efficacy and safety. This study aimed to assess pediatric residents’ knowledge and skills in managing a simulated pediatric choking scenario, adhering to recommended protocols, and using LifeVa...

Objective To determine whether early echocardiography screening of low systemic blood flow reduces intraventricular hemorrhage in preterm infants. Study design Prospective multicenter study in preterm infants below 33 weeks of gestational age at nine neonatal units. Five units performed early echocardiography screening for low systemic blood flow...

Background: The objective of this study was to analyze the effects of sedation administration on clinical parameters, comfort status, intubation requirements, and the pediatric intensive care unit (PICU) length of stay (LOS) in children with acute respiratory failure (ARF) receiving noninvasive ventilation (NIV). Methods: Thirteen PICUs in Spain pa...

Objective To determine whether early screening for low systemic blood flow is associated with reduced intraventricular hemorrhage in preterm infants. Study design Prospective, observational multicenter study in nine neonatal intensive care units. Preterm infants younger than 33 weeks of gestational age were eligible. The exposure was protocolized e...

Purpose:To determine whether the application of a protocolized early echocardiographic screening for low systemic blood flow and guided inotropic therapy is associated with reduced intraventricular hemorrhage in preterm infants. Methods: Prospective, observational multicenter study between September 2020 and September 2021 in nine neonatal intensiv...

Objectives: The worldwide practice and impact of noninvasive ventilation (NIV) in pediatric acute respiratory distress syndrome (PARDS) is unknown. We sought to describe NIV use and associated clinical outcomes in PARDS. Design: Planned ancillary study to the 2016/2017 prospective Pediatric Acute Respiratory Distress Syndrome Incidence and Epide...

Introduction People with a reduced nighttime dip in blood pressure have an increased cardiovascular risk. Our objective was to describe the different patterns in blood pressure (BP) among pediatricians who work in long on-duty shifts in relation with sex, medical rank and sleeping time. Methods Descriptive, cross-sectional, two-center study. On du...

Introduction: People with a reduced nighttime dip in blood pressure have an increased cardiovascular risk. Our objective was to describe the different patterns in blood pressure (BP) among pediatricians who work in long on-duty shifts in relation with sex, medical rank and sleeping time. Methods: Descriptive, cross-sectional, two-center study. On d...

Introduction. The mortality risk in children admitted to Pediatric Intensive Care Units (PICU) is usually estimated by means of validated scales, which only include objective data among their items. Human perceptions may also add relevant information to prognosticate the risk of death, and the tool to use this subjective data is fuzzy logic. The ob...

Background: Variants in IFIH1, a gene coding the cytoplasmatic RNA sensor MDA5, regulate the response to viral infections. We hypothesized that IFIH1 rs199076 variants would modulate host response and outcome after severe COVID-19. Methods: Patients admitted to an intensive care unit (ICU) with confirmed COVID-19 were prospectively studied and r...

Background: Mechanical stretch of cancer cells can alter their invasiveness. During mechanical ventilation, lungs may be exposed to an increased amount of stretch, but the consequences on lung tumours have not been explored. Methods: To characterise the influence of mechanical ventilation on the behaviour of lung tumours, invasiveness assays and...

Background Cardiogenic pulmonary oedema (CPE) may contribute to ventilator-associated lung injury (VALI) in patients with cardiogenic shock. The appropriate ventilatory strategy remains unclear. We aimed to evaluate the impact of ultra-low tidal volume ventilation with tidal volume of 3 ml/kg predicted body weight (PBW) in patients with CPE and ven...

Point-of-care ultrasound (POCUS) refers to the use of portable ultrasound (US) applications at the bedside, performed directly by the treating physician, for either diagnostic or procedure guidance purposes. It is being rapidly adopted by traditionally non-imaging medical specialties across the globe. Recent international evidence-based guidelines...

A previously healthy 12-year-old boy had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related multisystem inflammatory syndrome (MIS-C) that was rapidly fatal. Autopsy revealed the presence of a large intracardiac thrombus. SARS-CoV-2 spike protein was detected in intestinal cells, supporting the hypothesis that viral presence in th...

Background: Cat scratch disease (CSD) is an infectious disorder caused by Bartonella henselae. The infection usually presents as local lymphadenopathy, fever, and mild constitutional symptoms. Systemic or severe disease is reported in 5-20% of patients with CSD. We report a case of disseminated CSD with osteomyelitis and hepatosplenic disease and...

Study design: This is a prospective, multicenter, and observational study with the aim of describing physiological characteristics, respiratory management, and outcomes of children with acute hypoxemic respiratory failure (AHRF) from different etiologies receiving invasive mechanical ventilation (IMV) compared with those affected by SARS-CoV-2. M...

Rationale: Outcomes in patients with severe SARS-CoV-2 infection (COVID-19) are conditioned by virus clearance and regulation of inflammation. Variants in IFIH1, a gene coding the cytoplasmatic RNA sensor MDA5, regulate the response to viral infections. Objective: To characterize the impact of IFIH1 rs199076 variants on host response and outcomes a...

Background: Point-of-care ultrasound (POCUS) is nowadays an essential tool in critical care. Its role seems more important in neonates and children where other monitoring techniques may be unavailable. POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) aimed to provide evidence-based clinical guidelines...

Introduction: Ultrasound (US) guidance increases the success rate and decreases complications during central venous catheterisation (CVC). The benefits of US guidance in arterial catheterisation are less clear. The aim of this study is to compare the outcomes of US-guided arterial catheterisation with the traditional landmark (LM) technique in crit...

Patient safety has become a central component of quality of care. One of the best known and most widely used security tools in all work settings is the checklists. The checklist is a tool that helps to not forget any step during the performance of a procedure, to do tasks with an established order, to control the fulfillment of a series of requirem...

Resumen La seguridad de los pacientes se ha convertido en un componente central de la calidad asistencial. Una de las herramientas de seguridad más conocidas y extendidas en todos los ámbitos laborales son las listas de verificación (LV). Una LV es una herramienta que ayuda a no olvidar ningún paso durante la realización de un procedimiento, hacer...

Introduction There are numerous scales in intensive care units that are used to quantify the severity of patients. Most of them are very useful, although sometimes laborious to complete, thus limiting their use in usual practice. One of these scales, the Therapeutic Intervention Scoring System (TISS-76), has been validated in adult and paediatric u...

Objective: To describe the management of anemia at PICU discharge by pediatric intensivists. Design: Self-administered, online, scenario-based survey. Setting: PICUs in Australia/New Zealand, Europe, and North America. Subjects: Pediatric intensivists. Interventions: None. Measurements and main results: Respondents were asked to report t...

Introduction: Ultrasound (US) guidance increases the success rate and decreases complications during central venous catheterisation (CVC). The benefits of US guidance in arterial catheterisation are less clear. The aim of this study is to compare the outcomes of US-guided arterial catheterisation with the traditional landmark (LM) technique in cri...

A three-month old baby girl is presented with fever without source and with signs of worsening of this episode. Fundoscopy showed a solitary choroidal lesión in her left eye and extraocular lesions suggesting disseminated tuberculosis (TB). A favorable outcome was achieved after quadruple antibiotic therapy and corticotherapy. Disseminated TB shoul...

Purpose To evaluate the consequences of using nebulized drugs in patients subjected to noninvasive ventilation (NIV) with total face mask (TFM) and helmet. Design A descriptive analytical study of a prospective patient cohort was carried out. Ambit Pediatric intensive care unit (PICU) of a tertiary hospital. Patients Consecutive sampling was use...

A three-month old baby girl presented with fever of unknown origin and with signs of worsening of this episode. Funduscopy showed a solitary choroidal lesion in her left eye, as well as extraocular lesions suggesting disseminated tuberculosis. A favourable outcome was achieved after quadruple antibiotic course and cortisone therapy. Disseminated tu...

Introduction: There are numerous scales in intensive care units that are used to quantify the severity of patients. Most of them are very useful, although sometimes laborious to complete, thus limiting their use in usual practice. One of these scales, the Therapeutic Intervention Scoring System (TISS 76), has been validated in adult and paediatric...

Resumen La ecografía a pie de cama (EPC) se ha convertido en los últimos años en una herramienta imprescindible para la práctica clínica. La EPC debe entenderse como una extensión de la exploración física habitual que, sin sustituirla, la complementa y la enriquece. La EPC permite al clínico responder preguntas concretas sobre el diagnóstico, enten...

Point-of-care ultrasound (POCUS) has become an essential tool for clinical practice in recent years. It should be considered as an extension of the standard physical examination, which complements and enriches it without substituting it. POCUS enables the physician to answer specific clinical questions about the diagnosis, to understand better the...

Objectives: Increasing evidence supports the association of fluid overload with adverse outcomes in different diseases. To our knowledge, few studies have examined the impact of fluid balance on clinical outcome in severe bronchiolitis. Our aim was to determine whether fluid overload was associated with adverse clinical outcomes in critically ill...

Objectives: Staff in PICUs shows high burnout, posttraumatic stress disorder symptoms, and posttraumatic growth levels. However, their levels of satisfaction with life and how positive and negative posttrauma outcomes relate to each other and contribute to predict satisfaction with life remain unknown. Thus, we attempted to explore these aspects a...

Purpose: To evaluate the consequences of using nebulized drugs in patients subjected to noninvasive ventilation (NIV) with total face mask (TFM) and helmet. Design: A descriptive analytical study of a prospective patient cohort was carried out. Ambit: Pediatric intensive care unit (PICU) of a tertiary hospital. Patients: Consecutive sampling...

Objectives To describe the diversity in practice in non‐invasive ventilation (NIV) in European pediatric intensive care units (PICUs). Working hypothesis No information about the use of NIV in Pediatrics across Europe is currently available, and there might be a wide variability regarding the approach. Study design Cross‐sectional electronic surv...

Introduction: Our aims were (1) to explore the prevalence of burnout syndrome (BOS) and posttraumatic stress disorder (PTSD) in a sample of Spanish staff working in the paediatric intensive care unit (PICU) and compare these rates with a sample of general paediatric staff and (2) to explore how resilience, coping strategies, and professional and d...

Background: Nasal prongs are frequently used to deliver noninvasive CPAP in bronchiolitis, especially in the youngest children. A helmet interface is an alternative that might be comparable to nasal prongs. We sought to compare these interfaces. Methods: We performed a prospective, randomized, crossover, single-center study in an 8-bed multidisc...

Purpose: To assess whether ultrasound guidance improves central venous catheter placement outcomes compared to the landmark technique in critically ill children. Methods: A prospective multicentre observational study was carried out in 26 paediatric intensive care units over 6 months. Children 0-18 years old who received a temporary central veno...

We performed an online survey regarding critical care treatment preferences for status asthmaticus amongst all public PICU´s in Spain, UK and Ireland (UK-I). One response per centre was required from a senior medical member of staff. Currently, paediatric severe asthma treatment is not homogeneous across European countries; further research to info...

Objective . To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design . Descriptive, prospective, multicentre study. Setting . Sixteen Spanish PICUs. Patients . Patients with severe AB who required admission to any of the participati...

Objective: Staff in pediatric intensive care units (PICU) are inherently exposed to potentially traumatic events. Posttraumatic growth (PTG) is the occurrence of positive changes after experiencing a traumatic event. This study aims (a) to evaluate the prevalence of PTG in PICU staff, and whether their scores are different from those reported by p...

Objective: To determine whether high levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin, and procalcitonin (PCT) plasma concentrations are associated with increased mortality risk. Methods: Prospective observational study including 254 critically ill children. MR-proANP, copeptin and PCT were compared between children with...

A 12-year-old male with status asthmaticus developed subcutaneous emphysema and pneumomediastinum. He was transferred to our unit, where he received noninvasive ventilation (NIV). This respiratory support technique is not an absolute contraindication in these cases. After 2 h on NIV, he worsened sharply and the subcutaneous emphysema got bigger sud...

Objective: To determine whether high levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin, and procalcitonin (PCT) plasma concentrations are associated with increased mortality risk. Methods: Prospective observational study including 254 critically ill children. MR-proANP, copeptin and PCT were compared between children wi...

Despite being frequently used in many pediatric intensive care units (PICUs) for some years, published data regarding noninvasive ventilation (NIV) use after extubation in children are scarce. Many studies have analyzed NIV episodes in patients with no previous invasive ventilation together with other episodes in children who received NIV after ext...

Purpose: Management of mechanical ventilation in severely obstructed patients remains controversial. Pressure-regulated volume control ventilation (PRVCV) has been suggested to be the best option, as it should ensure a prefixed tidal volume at the lowest peak inspiratory pressure. We sought to determine the accuracy of the delivered volume, compar...

Purpose: Our objective was to assess whether SpO₂/FiO₂ (SF) ratio could be a useful NIV outcome predictor in children with acute respiratory failure (ARF) and tried to develop a predictive model of NIV failure. Methods: Prospective, observational, multicenter study. Episodes of ARF-fulfilling inclusion criteria from 15 January 2010 to 14 January...

Objective: To analyse the incidence of thrombosis and obstruction associated with central venous lines (CVL) inserted in critically ill children, and to determine their risk factors. Design: Prospective observational study in a Pediatric Intensive Care Unit in a University Hospital. Material and method: An analysis was made of 825 CVL placed i...

Purpose: Oxygen saturation as measured by pulse oximetry (Spo2)/fraction of inspired oxygen (Fio2) (SF) ratio has demonstrated to be an adequate marker for lung disease severity in children under mechanical ventilation. We sought to validate the utility of SF ratio in a population of critically ill children under mechanical ventilation, noninvasiv...

Non-invasive ventilation (NIV) has been shown to be effective in different causes of respiratory failure in both adult and pediatric patients. However, its role in status asthmaticus (SA) remains unclear. We designed a prospective study to assess the feasibility of NIV in children with SA. Prospective observational study, over a 4.5-year period. Ch...

Primary hyperoxaluria type 1 is a rare disorder caused by a defect in the hepatic metabolism of glyoxylate. Cases presenting in infancy are very uncommon and often have a severe course leading to early end-stage renal failure. We treated a case of early presentation of primary hyperoxaluria type 1 and reviewed the relevant literature. A 4-month-old...

Application of continuous positive airway pressure (CPAP) during respiratory insufficiency through a helmet interface is not well known in the Pediatric practice. The objective of this paper is to describe the necessary elements for it assembly, management and nursing care. The advantages and disadvantages of helmet compared to other interfaces are...

Identification of catheter-related bloodstream infection (CR-BSI) risk factors and determination of whether intervention related to identified risk factors would reduce CR-BSI rates. Prospective, observational, interventional and interrupted time-series study. Pediatric Intensive Care Unit (PICU) in a university hospital. During a 7-year period, 60...

We present the case of a 4-month-old girl with PHACES syndrome and severe upper respiratory airway obstruction secondary to multiple subglottic and tracheal hemangiomas effectively treated with heliox-CPAP delivered by helmet (HH-CPAP). Pediatr Pulmonol. 2011; 46:306–308. © 2011 Wiley-Liss, Inc.

Objective To evaluate if the inclusion of the transcutaneous CO2 tension measurement (PtcCO2) can improve partial pressure of oxygen/ fraction of inspired oxygen ratio [PaO2/FiO2 (P/F)] prediction from pulse oximetry saturation/FiO2 ratio [SpO2/FiO2 (S/F)].Methods Retrospective analysis of blood gas data from critically ill children. PaO2, SpO2, Fi...

Objective: To compare the efficacy and safety of CPAP delivered by helmet interface (HI) and CPAP delivered by Infant-Flow® system (IF) with nasal prongs.

Objective: Non invasive ventilation (NIV) has been shown to be effective in different causes of respiratory failure in both adult and pediatric patients. However, its role in status asthmaticus (SA) remains unclear. We designed a prospective study to assess the response of children with SA to NIV.

IntroductionOne of the main limitations to running mechanical ventilation courses is the lack of cheap, interactive, and easily reproducible lung simulators.

Non-invasive ventilation (NIV) may be useful after extubation in children. Our objective was to determine postextubation NIV characteristics and to identify risk factors of postextubation NIV failure. A prospective observational study was conducted in an 8-bed pediatric intensive care unit (PICU). Following PICU protocol, NIV was applied to patient...

Introducción: Existen diferentes formas clínicas de drepanocitosis, siendo la homocigosis la más grave. Es especialmente frecuente en la raza negra. Los actuales movimientos migratorios hacen que su manejo sea cada vez más frecuente en nuestro ámbito. Presentamos dos casos de crisis vasooclusivas en niños afectos de drepanocitosis homocigota. Caso...

The objective of this study was to check the feasibility and efficacy of helmet-delivered heliox-continuous positive airway pressure (CPAP) in infants with bronchiolitis. Children <3 months of age diagnosed with respiratory syncytial virus bronchiolitis and recurrent apnoeas or a venous PCO(2) >55 mmHg or a transcutaneous oxygen saturation <92% in...

N-acetylcysteine has proven to be effective in paracetamol intoxications, but there is no consensus regarding its way of administration. Here, we report a case to highlight the importance of careful management of intravenous n-acetylcysteine. A two-month old infant was seen in our paediatric emergency department due to paracetamol poisoning after r...

Identification of early mechanical complications (EMC) of central venous catheterizations (CVC) in pediatric patients and determination of EMC risk factors. Prospective observational study. Pediatric intensive-care unit in a university hospital. Eight-hundred and twenty-five CVC were performed in 546 patients. Age, weight, gender, mechanical ventil...

Two cases of iatrogenic tension pneumothorax in children are reported. Case 1: A 2-year-old boy with suspected brain death after suffering multiple trauma suddenly developed intense cyanosis, extreme bradycardia and generalized subcutaneous emphysema during apnea testing. He received advanced cardiopulmonary resuscitation and urgent bilateral needl...

The objective was to identify predictive factors for non-invasive ventilation (NIV) failure and to describe its use in bronchiolitis. Prospective observational study that included patients diagnosed with bronchiolitis with a modified Wood's Clinical Asthma Score 5, or oxygen saturation <92%, or venous CO(2) partial pressure (PCO(2)) 60 mm Hg, with...

IntroductionThe objective was to identify predictive factors for non-invasive ventilation (NIV) failure and to describe its use in bronchiolitis.

El déficit de alfa-1 antitripsina es una enfermedad genética causada por la alteración del gen de un inhibidor de la proteasa de los neutrófilos localizado en el cromosoma 14. Su expresividad clínica es variable: hepatitis colestásica neonatal, ictericia, hipertransaminasemia o incluso cirrosis juvenil. El diagnóstico de sospecha se basa en la dete...

Identification of predictive factors for non-invasive ventilation (NIV) failure and determination of NIV characteristics. Prospective observational study. Paediatric Intensive Care Unit in a University Hospital. A total of 116 episodes were included. Clinical data collected were respiratory rate (RR), heart rate and FiO(2) before NIV began. Same da...

Hemophagocytic syndrome (HFS) is a potentially lethal disorder due to an uncontrolled immune response to a triggering agent. Our objective is to raise the importance of HFS early diagnosis by presenting a representative case. A sixteen-year-old girl with Still disease diagnosis developed a progressive multiorgan failure including acute respiratory...

Increased intestinal calcium absorption may play an important role in the pathogenesis of idiopathic hypercalciuria in children. Calcium absorption was assessed by an oral strontium load test in 22 prepubertal children (13 male) with idiopathic hypercalciuria, urinary calcium excretion 6.48 +/- 0.60 mg/kg per day (range 4.12-13.40 mg/kg per day), a...

Adolescent sudden death during sport participation is commonly due to cardiac causes. Survival is more likely when an automated external defibrillator (AED) is used soon after collapse. We describe a case of sudden death in a 14 year old boy with two remarkable points, successful resuscitation at school using an AED and diagnosis of arrhythmogenic...