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Introduction
Education
March 2020 - March 2022
March 2018 - February 2020
Publications
Publications (71)
BACKGROUND
Pulmonary atelectasis is present even before surgery in patients with obesity. We aimed to estimate the prevalence and extension of preoperative atelectasis in patients with obesity undergoing bariatric surgery and to determine if variation in preoperative Sp o 2 values in the seated position at room air is explained by the extent of ate...
Background: Pulmonary atelectasis is present even before surgery in patients with obesity. No study has reported the prevalence of preoperative atelectasis in obese patients to date. We aimed to estimate the prevalence and extension of preoperative atelectasis in patients with obesity undergoing bariatric surgery and to determine if variation in pr...
Background
Patients with hypotension usually receive intravenous fluids, but only 50% will respond to fluid administration. We aimed to assess the intra and interobserver agreement to evaluate fluid tolerance through diverse ultrasonographic methods.
Methods
We prospectively included critically ill patients on mechanical ventilation. One trained i...
Spirometry is a lung function test, whose main objective is to evaluate lung mechanics. It is a test that is currently easily accessible, but little used by anesthesiologists. One cause may be that they are not familiar with the analysis and understanding of said test or the lack of a pulmonary physiology laboratory in their hospitals. The proper a...
Background: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS), serious complications of diabetes, have significant morbidity and mortality. Objectives: To identify risk factors, epidemiological and pathophysiological bases of Hyperglycemic Crises (HC) and describe the proper management of HC. Inclusion criteria: Scientific arti...
Introducción: el síndrome de burnout (SBO) y el riesgo elevado de burnout (REBO) representan un riesgo latente en los medicos anestesiólogos, exacerbado por la pandemia Covid-19, esto, debido a la sobrecarga de trabajo, estrés laboral y miedo al contagio entro otros factores. El Maslach Burnout Inventory (MBI) es un instrumento para el diagnóstico,...
Pain management is one of the greatest challenges in critical care. It is necessary to carry out a timely and optimal treatment with the least possible adverse effects, which is why multimodal analgesia is at the core of the critically ill patient. For this article, we did a search on PubMed based on an analysis of 7,109 indexed articles, from whic...
Objective:
The objective of this study was to assess the association and interaction of laboratory parameters, Simplified Acute Physiology Score II (SAPSII), Modified Shock Index (MSI), and Mannheim Peritonitis Index (MPI) with in-hospital mortality.
Material and methods:
We conducted a single-center case-control study. Adult patients with abdom...
La pancreatitis aguda es una enfermedad grave y causa frecuente de ingreso a los servicios de emergencias en México y los Estado Unidos de América debido a los factores de riesgo de la población, como obesidad, alcoholismo y hábitos dietéticos. Presenta una alta morbilidad y mortalidad, con una incidencia global de 33.74 casos por cada 100,000 pers...
The awake prone position (AP) strategy for patients with acute respiratory distress syndrome (ARDS) is a safe, simple, and cost-effective technique used to improve hypoxemia. We aimed to evaluate intubation and mortality risk in patients with coronavirus disease (COVID-19) who underwent AP during hospitalisation.
In this retrospective, multicentre...
Ultrasound focused on the critical patient or «Point-Of-Care ultrasound» (POCUS) is a tool used at the patient’s bedside in different areas of critical medicine and emergency services due to its practicality as it provides great information quickly and non-invasive for diagnostic and therapeutic approaches. Cardiac arrest (CA) is a critical situati...
The use of the end inspiratory pause (EIP) in mechanical ventilation has been going on for more than 50 years and with greater momentum in the 1970s, an improvement in the partial pressure of arterial oxygen (PaO2) is attributed to the increase mean airway pressure, greater clearance of partial pressure of arterial carbon dioxide and allows monitor...
Introduction: Computed tomography (chest CT scan) may be a valuable preoperative COVID-19 screening method for bariatric and metabolic surgery candidates during this COVID-19 pandemic.
Methods: A descriptive, incidence single-center study was conducted in June 2020. Two study groups were evaluated: surgical team group and bariatric patient group....
The use of the prone position (PP) has been proposed for awake, non-intubated patients hospitalized for pneumonia and respiratory failure. This therapy is not new, it has been described for two decades. However, observational and some prospective clinical studies have been conducted with a limited number of patients, and a significant improvement i...
Objective:
Determine whether the levels of glycated hemoglobin (HbA1c) measured on admission to the intensive care unit (ICU) are associated with mortality in patients with severe SARS-CoV-2 pneumonia with invasive mechanical ventilation.
Design:
cohort study, retrospective, observational. A single center.
Place:
ICU of a second level care hos...
Critically ill patients are often presumed to be in a state of “constant dehydration” or in need of fluid, thereby justifying a continuous infusion with some form of intravenous (IV) fluid, despite their clinical data suggesting otherwise. Overzealous fluid administration and subsequent fluid accumulation and overload are associated with poorer out...
The disease caused by the SARS-CoV-2 or COVID-19 virus has a high rate of contagion and transmissibility, surpassing the health systems in the world. In Mexico there are 1’771,740 positive cases, 150,273 deaths, 204,070 infections, and 2,687 of these deaths represent health personnel. Orotracheal intubation represents one of the events with the hig...
Early mobilization (EM) is the implementation of physical exercise in patients admitted to the Intensive Care Unit (ICU), with important benefits being observed such as reduction of ventilator-associated pneumonia, deep vein thrombosis, pressure ulcers and ICU-acquired weakness (ICU-AW). It also has a financial impact by reducing hospital length of...
We have read the article by Kimura et al (1) with exceptional interest published in the recent issue of Critical Care Explorations. It should be considered that not all anions and cations are measured in daily clinical practice in seriously ill patients, of the measured ions sodium (Na+) represents the highest percentage of cations and chloride (Cl...
For eons, the study on the management of positive end-expiratory pressure (PEEP) has been exponential and fundamental for the study of pulmonary pathologies, mainly due to its direct relationship with acute respiratory distress syndrome (ARDS) presenting changes and advances in pulmonary protection goals including low tidal volume (Vt), plateau pre...
Purpose: The awake prone position (PP) strategy for patients with acute respiratory distress syndrome (ARDS) is a safe, simple, and cost-effective technique used to improve hypoxemia. We aimed to evaluate the relationship between awake PP (AP) and endotracheal intubation in patients with coronavirus disease (COVID-19).
Methods: In this retrospectiv...
Introduction: Given that obesity is a risk factor for adverse outcomes in COVID-19, bariatric and metabolic surgery (BMS) has become increasingly critical. Computed tomography (chest CT scan) may be a valuable preoperative screening method for BMS candidates during this COVID-19 pandemic.
Methods: A prospective, single-center study was conducted in...
Background
As of June 15, 2020, a cumulative total of 7,823,289 confirmed cases of COVID-19 have been reported across 216 countries and territories worldwide. However, there is little information on the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to intensive care units (ICUs) in Latin Ame...
Introducción:
El síndrome de distrés respiratorio agudo (SDRA) se caracteriza por una heterogeneidad del daño en el parénquima pulmonar; la asociación entre el volumen tidal (Vt) y la distensibilidad pulmonar estática (Cst) puede ser evaluada mediante la presión de distensión (PD). Se desconoce hasta el día de hoy si el control de la PD impacta en...
Protocolo de atención para COVID-19 (SARS-CoV-2) de la Sociedad Mexicana de Medicina de Emergencias.
El protocolo de atención de la Sociedad Mexicana de Medicina de Emergencias servirá de guía para manejo para pacientes con COVID-19 (SARS-CoV-2)
The objective of these recommendations is that they are within the reach of any anesthesiologist, in order to carry out protective ventilation in the patient during the COVID-19 pandemic, in which a patient with unique characteristics is confronted, with difficult ventilatory management in a setting crisis of scarcity of resources, lack and fatigue...
The state of shock is a frequent diagnosis in the critical areas, prehospital, emergency, operating room and intensive care unit, clinical hemodynamic monitoring is essential to make the diagnosis of tissue hypoperfusion and its causes, in addition to guiding therapeutics, the challenge It consists of performing adequate monitoring with the tools a...
The hemodynamic monitoring is a fundamental part of the patient in the perioperative period, during the last decade the monitoring at the patient’s bedside has grown at giant steps, from the emergency area, operating room, to the Intensive Care area. One of its most important advances is the decrease in the use of pulmonary artery catheter, which i...
Los informes documentaron que muchos de los pa-cientes, en un inicio notificados en el conglomerado identificado, tenían como vínculo un mercado de ali-mentos, principalmente mariscos y otros animales en Wuhan, China; sin embargo, en otros pacientes no se pudo establecer este vínculo, lo que evidenció la posi-bilidad de propagación ilimitada de una...
Resumen
El manejo avanzado de la vía aérea en el paciente crítico es un reto para cualquier profesional de la salud debido a la dificultad técnica que implica la colocación de un dispositivo avanzado de vía aérea especialmente en situaciones de vía aérea difícil. Un proceso de secuencia de inducción rápida (SIR) consiste en una serie de estrategias...
El arresto cardio-respiratorio puede presentarse en cualquier área, desde pre-hospital, sala de urgencias, sala de quirófano, unidad de cuidados intensivos y hospitalización, para el clínico es vital determinar su causa y si esta es reversible, la ecografía juega un papel importante en esta situación, dado que podemos obtener diagnósticos ecográfic...
El estado de choque en un diagnóstico frecuente en las áreas críticas, prehospital, urgencias, quirófano y la unidad de cuidados intensivos, el monitoreo hemodinámico clínico es imprescindible para realizar el diagnóstico de hipoperfusión tisular y sus causas, además de guiar la terapéutica, el reto consiste en, realizar un adecuado monitoreo con l...
El estado de choque en un diagnóstico frecuente en las áreas críticas, prehospital, urgencias, quirófano y la unidad de cuidados intensivos, el monitoreo hemodinámico clínico es imprescindible para realizar el diagnóstico de hipoperfusión tisular y sus causas, además de guiar la terapéutica, el reto consiste en, realizar un adecuado monitoreo con l...
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PEEP: Presión positiva al final de la espiración. Lo bueno, lo malo. Efectos sistémicos benéficos y adversos.
The woman during pregnancy, delivery and puerperium presents anatomical changes, physiological and ventilatory dynamics, so one of the complications that may present is the acute respiratory distress syndrome (ARDS) representing a challenge for the clinician, and complications may appear in pregnancy as chorioamnionitis, abortion, amniotic fluid em...
Resumen El electrocardiograma (ECG) es un método no invasivo de monitoreo, que consiste en un registro grafico de la actividad eléctrica cardiaca durante las distintas fases del ciclo cardiaco, pudiendo ofrecer diagnósticos tales como taquicardias, bradicardias, trastornos del ritmo, infarto, bloqueos de rama, entre otras; siendo fundamental su com...
Introduction:
Retinopathy is a frequent complication of diabetes, causing visual impairment in 10% and blindness in 2% of diabetic patients. The aim of this study is to describe the clinical profile of diabetic patients in an ophthalmologic unit in Tijuana, México.
Methods:
Retrospective study of a random sample of 500 clinical charts of patient...
