Manuel Quintana

Manuel Quintana
Hospital Universitario La Paz · Servicio de Cuidados Intensivos

About

150
Publications
21,673
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2,353
Citations
Citations since 2017
21 Research Items
963 Citations
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2017201820192020202120222023050100150200250
2017201820192020202120222023050100150200250

Publications

Publications (150)
Article
Full-text available
Severe traumatic injury is one of the main global health issues which annually causes more than 5.8 million worldwide deaths. Uncontrolled haemorrhage is the main avoidable cause of death among severely injured individuals. Management of trauma patients is the greatest challenge in trauma emergency care, and its proper diagnosis and early managemen...
Article
Objective To describe the transfusion practice in the ICUs in Spain, according to national and international recommendations (guidelines). Design Prospective, cross-sectional, multi-centre study. Scope Data collection was carried out by means of a questionnaire sent electronically to the Heads of Service of 111 ICUs in Spain. Participants 1,448...
Article
This "Letter to the Editor" was sent as a comment of the study by Boone and Collegues ( https://doi.org/10.1016/j.jemermed.2020.05.006 ) on transfusion behaviour and iron supplementation in patients with heavy menstrual bleeding admitted to ED at their hospital.
Article
Full-text available
Aims: Extensive research regarding the association of troponin and prognosis in coronavirus disease 2019 (COVID-19) has been performed. However, data regarding natriuretic peptides are scarce. N-terminal pro B-type natriuretic peptide (NT-proBNP) reflects haemodynamic stress and has proven useful for risk stratification in heart failure (HF) and o...
Article
Objective: To describe the transfusion practice in the ICUs in Spain, according to national and international recommendations (guidelines). Design: Prospective, cross-sectional, multi-centre study. Scope: Data collection was carried out by means of a questionnaire sent electronically to the Heads of Service of 111 ICUs in Spain. Participants:...
Article
The infection by the coronavirus SARS-CoV-2, which causes the disease called COVID-19, mainly causes alterations in the respiratory system. In severely ill patients, the disease often evolves into an acute respiratory distress syndrome that can predispose patients to a state of hypercoagulability, with thrombosis at both venous and arterial levels....
Article
BACKGROUND: Asymptomatic severe iron deficiency anemia is a common finding in subjects admitted to the outpatient anemia clinic. Although the condition can be easily be reversed with intravenous iron (IVI) therapy and several guidelines have suggested a restrictive threshold for using transfusion in hemodynamically stable patients, transfusion is...
Article
Full-text available
Background: Since the confirmation of the first patient infected with SARS-CoV-2 in Spain in January 2020, the epidemic has grown rapidly, with the greatest impact on the region of Madrid. This article describes the first 2226 adult patients with COVID-19, consecutively admitted to La Paz University Hospital in Madrid. Methods: Our cohort includ...
Preprint
Full-text available
BACKGROUND Since the confirmation of the first patient infected with SARS-CoV-2 in Spain in January 2020, the epidemic has grown rapidly, with the greatest impact on the Madrid region. This article describes the first 2226 consecutive adult patients with COVID-19 admitted to the La Paz University Hospital in Madrid. METHODS Our cohort included all...
Article
Resumen La infección por el coronavirus SARS-CoV-2, causante de la enfermedad denominada COVID-19, provoca alteraciones fundamentalmente en el sistema respiratorio. En los pacientes graves, con frecuencia la enfermedad evoluciona a un síndrome de distrés respiratorio agudo que puede predisponer a los pacientes a un estado de hipercoagulabilidad, co...
Article
Increasing haemoglobin and haematocrit levels with blood transfusions has been the gold standard for treating severe anaemia; however, the indication for transfusing concentrated red blood cells is based merely on a few laboratory markers, such as haemoglobin and haematocrit levels, rather than based on the symptoms according to clinical practice g...
Article
Resumen El angioedema es un tipo de edema de piel y partes blandas generado por vasodilatación secundaria a un aumento de la permeabilidad vascular que puede asociarse o no a alteraciones del complemento y de los factores de la coagulación. Una predisposición genética, un desencadenante y un mediador (típicamente, aunque no solamente, histamina o b...
Article
Background: There are few data on hepatotoxicity induced by acute or chronic paracetamol poisoning in the pediatric population. Paracetamol poisoning data can reveal the weaknesses of paracetamol poisoning management guidelines. Methods: We retrospectively studied the patients of less than 18 years old with measurable paracetamol levels, who wer...
Article
Full-text available
Background: Transfusion of blood components continues to be an important therapeutic resource into the 21(st) century. Between 5 and 58% of transfusions carried out are estimated to be unnecessary. According to several studies, at least 20% of packed red blood cell transfusions (RBCT) are administered in hospital emergency departments (ED), but fe...
Article
Full-text available
Toxicovigilance is the active process of identifying and evaluating the toxic risks existing in a community, and evaluating the measures taken to reduce or eliminate them. Objective: Through a validated toxicovigilance program (SAT-HULP) we examined the characteristics of acute poisoning cases (APC) attended in the Emergency Department (ED) of La...
Data
Analysis of the length of stay and resources in the HULP. You can see the calculations of the indicators described in Table 1 for our hospital DRGs considered. It focuses on the consumption of resources of our hospital during the study period. (XLS)
Data
Total hospital hospitalization DRGs network SERMAS. The data from all the hospitals in the network are shown. (XLS)
Data
Analysis of the length of stay and resources. You can see the calculations of the indicators described in Table 1 for our hospital and other hospitals of the network SERMAS DRGs considered. They are calculated specifically for hospitals also considered high complexity. (XLS)
Article
Introduction Suicide causes 1.4% of deaths worldwide. Twenty times more frequent, suicide attempts entail an important source of disability and of psychosocial and medical resources use. Objective To describe main socio-demographical and psychiatric risk factors of suicide attempters treated in a general hospital's emergency room basis. Aims To i...
Article
La hemorragia masiva es una entidad frecuente que se asocia a una elevada morbimortalidad. Ante la necesidad de la implementación y estandarización de su manejo, se realizó una revisión sistemática de la literatura, con extracción de recomendaciones en base a las evidencias existentes. A partir de las mismas se redactó un documento de consenso mult...
Article
Massive haemorrhage is common and often associated with high morbidity and mortality. We perform a systematic review of the literature, with extraction of the recommendations from the existing evidences because of the need for its improvement and the management standardization. From the results we found, we wrote a multidisciplinary consensus docum...
Article
Full-text available
In recent years, several safety alerts have questioned or restricted the use of some pharmacological alternatives to allogeneic blood transfusion in established indications. In contrast, there seems to be a promotion of other alternatives, based on blood products and/or antifibrinolytic drugs, which lack a solid scientific basis. The Multidisciplin...
Article
The high incidence of trauma, especially in elderly people anticoagulated with new oral anticoagulants (NOAs), has become a major challenge, particularly in critical situations with life-threatening bleeding. Under these circumstances, urgent NOA reversion becomes mandatory. Prothrombin complex has become a frequent indication in critical situation...
Article
The high incidence of trauma, especially in elderly people anticoagulated with new oral anticoagulants (NOAs), has become a major challenge, particularly in critical situations with life-threatening bleeding. Under these circumstances, urgent NOA reversion becomes mandatory. Prothrombin complex has become a frequent indication in critical situation...
Article
Background: Human albumin solutions are used in a number of disorders, though their indications are not clear in all circumstances. These solutions are costly, and their benefit has not been established in all settings. It is therefore interesting to assess the presence of albumin solutions in the daily clinical practice of critical care professio...
Article
Describe the use of emergency departments (ED), and analyse the differences in use between residents in rural and urban areas. Using data from the National Health Survey of 2006 and 2011, the profiles of patients with ED visits by population size of place of residence were obtained. The variables associated with making one visit to the ED were also...
Article
Objectives Describe the use of emergency departments (ED), and analyse the differences in use between residents in rural and urban areas. Material and methods Using data from the National Health Survey of 2006 and 2011, the profiles of patients with ED visits by population size of place of residence were obtained. The variables associated with mak...
Article
Full-text available
Introducción Los concentrados de complejo protrombínico (CCP) son derivados del plasma humano que proce-den de donaciones sanguíneas. En la actualidad, la mayoría de los CCP contienen cuatro factores de co-agulación dependientes de vitamina K (II, VII, IX y X), y anticoagulantes como la proteína C y S 1 . Su principal indicación es la reversión de...
Article
Background and objective The frequency of left ventricular failure (LVF) in the early stages of non-ST-segment elevation acute coronary syndrome (NSTE ACS) has not been described so far. The objective of this study is to describe for the first time the frequency of LVF in the early course of NSTE ACS and to assess its association with other interve...
Article
Objective: The aim was to develop and validate a tool for automatic, systematic recording of acute poisoning cases attended in the emergency department of our tertiary care teaching hospital and to analyze the system's performance during the first 7 months of active surveillance. Methods: The active poisoning surveillance system performs a daily se...
Article
The aim of the present study is to describe the clinical and epidemiological characteristics, complications and outcome of patients with haemophilia and acute head injury (AHI) at the emergency department (ED), and develop a protocol to prevent early and late complications. This is a retrospective cohort study including all patients with haemophili...
Article
Full-text available
New oral anticoagulants (NOACs) are being implemented for use in daily clinical practice, anticoagulants that should theoretically replace the well-known vitamin K antagonists in the near future. Based on their inhibitory properties, NOACs can be classified into two main groups: direct thrombin
Article
Full-text available
1 General coordinator, 2 General Vice-coordinator, 3 Topic coordinator (in alphabetical order). Paper commissioned and endorsed by (in alphabetical order Summary of recommendations on alternatives to reduce allogeneic blood transfusion (in descending order of strength) Grade 1A recommendations We recommend: -The use of restrictive transfusion strat...
Article
Background The aim of this study was to evaluatethe efficacy of an structured interventionbased on a medical advice versus to the ordinaryanti-tobacco advice in patients with miocardialinfarction who are attended in an IntensiveCare Unit (ICU). Patients and methods 90 patients were randomlyselected to receive either the specific intervention(inter...
Article
Full-text available
Background and objectiveTo assess the post-Intensive Care Unit (ICU) mortality (in-hospital and one year after hospital discharge) and the associated factors.Patients and methodCohort design in medical-surgical patients with multi-organ dysfunction syndrome (MODS) during the first 24 h of admission to ICU. We recorded the following data: personal b...
Article
Full-text available
As allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to TSA (AABT) have emerged, but there is a huge variability with respect to their indications and appropriate use. This variability results from the interplay of a number of factors, which include physicians specialty, knowledge and preferences, degree of anaemia, transfus...
Article
Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, trans...
Article
Background and objective: The frequency of left ventricular failure (LVF) in the early stages of non-ST-segment elevation acute coronary syndrome (NSTE ACS) has not been described so far. The objective of this study is to describe for the first time the frequency of LVF in the early course of NSTE ACS and to assess its association with other inter...
Article
Thromboembolic disease is a potentially severe pathology, which can represent a life threat if it is not diagnosed early, especially when the cardiopulmonary backup is limited. When its clinical feature implies a massive occlusion of the arterial pulmonary tree and a cardiac failure is ensued, it can be seriously life threatening, even for young pa...
Article
Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, trans...
Article
Full-text available
BACKGROUND AND OBJECTIVE: To assess the post-Intensive Care Unit (ICU) mortality (in-hospital and one year after hospital discharge) and the associated factors. PATIENTS AND METHOD: Cohort design in medical-surgical patients with multi-organ dysfunction syndrome (MODS) during the first 24h of admission to ICU. We recorded the following data: person...
Article
Background Human albumin solutions are used in a number of disorders, though their indications are not clear in all circumstances. These solutions are costly, and their benefit has not been established in all settings. It is therefore interesting to assess the presence of albumin solutions in the daily clinical practice of critical care professiona...
Article
Full-text available
Background Hemorrhagic events are frequent in patients on treatment with antivitamin-K oral anticoagulants due to their narrow therapeutic margin. Studies performed with acenocoumarol have shown the relationship between demographic, clinical and genotypic variants and the response to these drugs. Once the influence of these genetic and clinical fac...
Article
Objective To design a probability model for prolonged mechanical ventilation (PMV) using variables obtained during the first 24 hours of the start of MV.DesignAn observational, prospective, multicenter cohort study.ScopeThirteen Spanish medical-surgical intensive care units.PatientsAdult patients requiring mechanical ventilation for more than 24 ho...
Article
Objectives: To determine whether the alveolar-arterial oxygen gradient (Grad[A-a]O₂) helps confirm the influence of PEEP on PaFi (PaO₂/FiO₂). Design: Observational study; we used linear regression to perform a multivariate study to improve the PaFi formula by taking PEEP into account. Setting: Tertiary hospital. Patients: We included all pat...
Article
Objective: To analyze the prognosis of mechanically ventilated elderly patients in the Intensive Care Unit (ICU). Design and scope: Sub-analysis of a prospective multicenter observational cohort study conducted over a period of two years in 13 medical-surgical ICUs in Spain. Patients: Adult patients who required mechanical ventilation (MV) for...
Article
Full-text available
Objective To evaluate the frequency of severe thrombocytopenia (STCP) (≤ 50.000/μl) in the first 24 hours in patients with multiple organ dysfunction syndrome, and the factors that influence its occurrence.DesignA retrospective, observational study.AreaMedical-surgical intensive care unit (ICU). Tertiary hospital.PatientsThose with failure of at le...
Article
OBJECTIVE: To design a probability model for prolonged mechanical ventilation (PMV) using variables obtained during the first 24hours of the start of MV. DESIGN: An observational, prospective, multicenter cohort study. SCOPE: Thirteen Spanish medical-surgical intensive care units. PATIENTS: Adult patients requiring mechanical ventilation for more t...
Article
Full-text available
To evaluate the frequency of severe thrombocytopenia (STCP) (≤ 50,000/μl) in the first 24 hours in patients with multiple organ dysfunction syndrome, and the factors that influence its occurrence. A retrospective, observational study. AREA: Medical-surgical intensive care unit (ICU). Tertiary hospital. Those with failure of at least two organs, acc...
Article
Recibido el 25 de julio de 2010; aceptado el 27 de septiembre de 2010 Disponible en Internet el 1 de abril de 2011 PALABRAS CLAVE Gripe A; H1N1; Radiografía de tórax Resumen Objetivos: Determinar si existen diferencias en los hallazgos de la radiografía de tórax inicial entre un grupo de pacientes con gripe A y pacientes con síntomas gripales en pe...
Article
We review the relations between the radiology department and the clinicians that attend emergency patients, complementing our opinions with a survey conducted in the emergency departments of hospitals in the autonomous region of Madrid. A dedicated emergency radiology section is present in 63.2% of hospitals. Radiologists are readily available to c...
Article
We review the relations between the radiology department and the clinicians that attend emergency patients, complementing our opinions with a survey conducted in the emergency departments of hospitals in the autonomous region of Madrid. A dedicated emergency radiology section is present in 63.2% of hospitals. Radiologists are readily available to c...
Article
Full-text available
The aim of this study was to determine the radiologic findings associated with admission to the intensive care unit (ICU) and the development of acute respiratory distress syndrome (ARDS) in patients with pH1N1 infection. One hundred and four patients (15-96 years) with laboratory-confirmed pH1N1 infection seen at the Emergency Department from July...
Article
Thromboembolic disease is a potentially severe pathology, which can represent a life threat if it is not diagnosed early, especially when the cardiopulmonary backup is limited. When its clinical feature implies a massive occlusion of the arterial pulmonary tree and a cardiac failure is ensued, it can be seriously life threatening, even for young pa...