Mercedes Ibarz's research while affiliated with Hospital Universitari Sagrat Cor and other places

Publications (39)

Article
Full-text available
Background Non-invasive oxygenation strategies have a prominent role in the treatment of acute hypoxemic respiratory failure during the coronavirus disease 2019 (COVID-19). While the efficacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-flow oxygen therapy by na...
Article
Purpose: Although there is evidence supporting the benefits of corticosteroids in patients affected with severe coronavirus disease 2019 (COVID-19), there is little information related to their potential benefits or harm in some subgroups of patients admitted to the intensive care unit (ICU) with COVID-19. We aim to investigate to find candidate v...
Article
Full-text available
la mayor parte de los errores en medicina del laboratorio se producen durante la fase preanalítica y postanalítica del proceso analítico total (PAT). En 2014, la Sociedad Española de Medicina de Laboratorio (SEQCML) lanzó el Programa de Garantía Externa de la Calidad (EQA) de Preanalítica, con el propósito de ofrecer una herramienta para mejorar la...
Article
Objectives Most errors in laboratory medicine occur in the pre- and post-analytical phases of the total testing process (TTP). In 2014, the Spanish Society of Laboratory Medicine (SEQC ML ) started the current Preanalytical Phase EQA Programme, with the objective of providing a tool for the improvement of the preanalytical phase. The aim of this st...
Article
Full-text available
Since the beginning of laboratory medicine, the main focus was to provide high quality analytics. Over time the importance of the extra-analytical phases and their contribution to the overall quality became evident. However, as the initial preanalytical processes take place outside of the laboratory and mostly without its supervision, all professio...
Article
Full-text available
Purpose: Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group. Methods: The COVIP study is a prospective internatio...
Article
Full-text available
Background: Non-invasive oxygenation strategies have a prominent role in the treatment of acute hypoxemic respiratory failure during the coronavirus disease 2019 (COVID-19). While the efficacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-flow oxygen therapy by n...
Article
Full-text available
Background Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods Multicenter, observational, cohor...
Article
Objectives Serum indices included in clinical chemistry instruments are widely used by laboratories to assess the quality of samples. Instruments that report quantitative results allow an evaluation of their diagnostic performance in a similar way to other biochemical tests. The Spanish Society of Laboratory Medicine (SEQC-ML) launched a monthly Ex...
Article
Full-text available
Background: The current models developed to predict hospital-acquired AKI (HA-AKI) in non-critically ill fail to identify the patients at risk of severe HA-AKI stage 3. Objective: To develop and externally validate a model to predict the individual probability of developing HA-AKI stage 3 through the integration of electronic health databases....
Article
Full-text available
Background: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score...
Article
Full-text available
Background Models developed to predict hospital-acquired AKI (HA-AKI) in non-critically ill patients have a low sensitivity, do not include dynamic changes of risk factors and do not allow to establish a time relationship between exposure to risk factors and AKI. We developed and externally validated a predictive model of HA-AKI, integrating electr...
Article
Full-text available
Background Sepsis is one of the most frequent reasons for acute intensive care unit (ICU) admission of very old patients and mortality rates are high. However, the impact of pre-existing physical and cognitive function on long-term outcome of ICU patients ≥ 80 years old (very old intensive care patients (VIPs)) with sepsis is unclear. Objective To...
Article
Resumen Antecedentes y objetivos Actualmente, la situación basal del paciente es un factor pronóstico más importante que la edad. El propósito de este estudio es estimar el valor pronóstico de ISAR score (Identification of Senior at Risk) en pacientes ≥ 75 años ingresados en Cuidados Intensivos (UCI). Pacientes y métodos Estudio multicéntrico pro...
Article
Full-text available
Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determ...
Article
Full-text available
Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determi...
Article
Full-text available
Objectives The stability of the analytes most commonly used in routine clinical practice has been the subject of intensive research, with varying and even conflicting results. Such is the case of alanine aminotransferase (ALT). The purpose of this study was to determine the stability of serum ALT according to different variables. Methods A multice...
Article
Full-text available
Resumen Introducción Existen multitud de estudios de estabilidad de magnitudes de interés clínico, aunque con resultados muy diferentes o incluso contradictorios, como es el caso de la alanina aminotransferasa (ALT). El objetivo de este estudio fue evaluar la estabilidad de la ALT en suero incluyendo múltiples variables. Métodos Se realizó un est...
Article
Full-text available
Introduction: Diabetes mellitus (DM) is one of the most prevalent diseases worldwide. The objective of this study was to find out under what preanalytical conditions routine and diagnostic glucose tests are performed across Spanish laboratories; and also what criteria are used for DM diagnosis. Materials and methods: An online survey was perform...
Article
Background Laboratory tests are an essential aspect of current medical practice and their use has grown exponentially. Several studies however have demonstrated inappropriate use of laboratory testing. This inappropriateness can lead to delayed or wrong diagnosis, negatively impacting patient safety and an increase in health care expenditure. The a...
Article
Niniejszy dokument zawiera zalecenia dotyczące pobierania krwi żylnej, opracowane wspólnie przez European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) oraz Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry...
Article
Full-text available
Background Age has been traditionally considered a risk factor for mortality in elderly patients admitted to intensive care units. The aim of this prospective, observational, multicenter cohort study is to determine the risk factors for mortality in elderly and very elderly critically ill patients with sepsis. Results A total of 1490 patients with...
Article
Full-text available
This document provides a joint recommendation for venous blood sampling of the European federation of clinical chemistry and laboratory medicine (EFLM) Working Group for preanalytical phase (WG-PRE) and Latin American working group for preanalytical phase (WG-PRE-LATAM) of the Latin America confederation of clinical biochemistry (COLABIOCLI). It of...
Article
It has been well documented over recent years that the pre-analytical phase is a leading contributor to errors in the total testing process (TTP). There has however been great progress made in recent years due to the exponential growth of working groups specialising in the field. Patient safety is clearly at the forefront of any healthcare system a...
Article
Full-text available
Background The inappropriate use of laboratory resources, due to excessive number of tests not really necessary for patient care or by failure to order the appropriate diagnostic test, may lead to wrong, missed or delayed diagnosis, thus potentially jeopardizing patient safety. It is estimated that 5–95% of tests are currently used inappropriately,...
Article
Background Nowadays over-the-counter (OTC) drugs and dietary supplements are widely used. Their use can have a significant impact on the validity of laboratory results. The aim of this multicenter European study was to determine the frequency of consumption of various dietary products and OTC drugs among patients and explore their level of knowledg...
Article
Full-text available
This document provides a joint recommendation for venous blood sampling of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) and Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI). It of...
Article
Background The stability limit of an analyte in a biological sample can be defined as the time required until a measured property acquires a bias higher than a defined specification. Many studies assessing stability and presenting recommendations of stability limits are available, but differences among them are frequent. The aim of this study was t...
Research
Full-text available
4th European Federation of Clinical Chemistry and Laboratory Medicine (EFCC)-BD European Conference on Preanalytical Phase.
Article
It has been well reported over recent years that most errors within the total testing process occur in the pre-analytical phase (46%–68.2%), an area that is usually outside of the direct control of the laboratory and which includes sample collection (phlebotomy). National and international (WHO, CLSI) guidelines recommend that the order of draw of...
Article
Patient safety is a leading challenge in healthcare and from the laboratory perspective it is now well established that preanalytical errors are the major contributor to the overall rate of diagnostic and therapeutic errors. To address this, the EFLM WG-PRE was established to lead in standardization and harmonization of preanalytical policies and p...
Article
Venous blood sampling (phlebotomy) is the most common invasive procedure performed in patient care. Guidelines on the correct practice of phlebotomy are available, including the H3-A6 guideline issued by the Clinical Laboratory Standards Institute (CLSI). Since the quality of practices and procedures related to venous blood sample collection in Eur...
Article
Full-text available
Laboratory diagnostics develop through different phases that span from test ordering (pre-preanalytical phase), collection of diagnostic specimens (preanalytical phase), sample analysis (analytical phase), results reporting (postanalytical phase) and interpretation (post-postanalytical phase). Although laboratory medicine seems less vulnerable than...

Citations

... Additionally, increasing experience in the treatment of acute hypoxemic respiratory failure due to COVID-19 in hospital wards including more advanced non-invasive respiratory support strategies and the progressive use of awake prone positioning might have postponed or completely avoided ICU admission [8,29,30]. This time lag could also explain the more pronounced hypoxemia and higher dead space at ICU admission in the later months of the pandemic possibly induced by patient self-inflicted lung injury (P-SILI) and contrasting with the lower overall severity scores [12,31]. Furthermore, as previously mentioned, early initiation of dexamethasone and remdesivir, but also the increasing use of intermediate and therapeutic anticoagulation after the first wave might be responsible for the delayed ICU admission [4,5,23]. ...
... In the past 2 years, critical care services worldwide have admitted a large number of critically ill COVID-19 patients presenting with severe respiratory failure who often require prolonged treatment in the intensive care unit (ICU). Unfortunately, despite the support provided, mortality remains high, particularly in ventilated patients [2]. Although many groups and societies have studied diagnostic, therapeutic and prognostic aspects of COVID-19 in the critically ill, these studies were mostly limited to a group of hospitals or geographical areas, and very few reports offer a global perspective. ...
... It is just suggested to aim at a tidal volume of 6-8 mL/kg ideal body weight [25]. This is consequent to the availability of a limited number of studies for this specific population, and especially on the lack of data in literature of more advanced and specific parameters (such as driving pressure and mechanical power) [14], which have shown in other groups of patients to have a potential effect on outcome, but not in cardiac arrest [26][27][28][29][30][31][32]. Although recent literature has highlighted the importance of protective ventilation in ARDS and non-ARDS patients [33][34][35], some strategies may be potentially detrimental in patients after cardiac arrest; high PEEP might further aggravate cerebral edema by increasing intrathoracic pressure while reducing jugular outflow, and low tidal volume and consequent permissive hypercapnia can cause cerebral vasodilation [36,37]. ...
... Wu L. et al. recently published an article where the risk factors that predict the presentation of severe AKI were defined, but they included both ICU and non-ICU patients and no external validation was performed [27]. Our group recently developed a model that overcame some of those limitations and provides an accurate dynamic assessment of the individual risk of suffering AKI along the whole hospital stay period in patients admitted into non-critical hospitalization wards [28]. However, although this model allows AKI to be accurately predicted, because of a lack of statistical power, it does not allow to detect the risk of developing AKI-3 severity stage, which is the one associated with greater morbidity, related to the severity of complications and, in many cases, to the need for replacement of kidney function. ...
... Due to multimorbidity and frailty, critically ill elderly patients have a particularly poor prognosis [13]. Similar analyses among patients with COVID-19 confirmed that increasing age and degree of frailty are related to worse outcomes in this population [14]. ...
... Frail patients are indeed at high risk of functional and cognitive decline, falls, disability, and mortality after hospitalization [14]. In the Intensive Care Units (ICU), measures of frailty demonstrated to be accurate in stratifying the prognosis of older people affected by sepsis and other critical illnesses [15][16][17][18]. However, sepsis is common also in other acute hospital wards. ...
... We found that the SOFA score, and CRP serum levels were the best predictors of in-hospital mortality in our population. This is not surprising given that previous studies have repeatedly demonstrated their association with short-term mortality, both in medical wards and ICU [19,[42][43][44][45][46]. Lactate serum levels also showed good ability to predict in-hospital mortality in the AUROC analyses, but this finding was not confirmed by the multivariate logistic regression. ...
... A recent survey in 9 European countries demonstrated that such support would be appreciated by most clinicians. 44 Of course, it would be out of range to assist in the appropriate use of laboratory tests in each single case personally. Therefore, semiautomated clinical decision support software systems, programmed and maintained by laboratory specialists, could be most helpful in the future. ...
... These procedures are poorly tolerated by pregnant women, who often have vomiting that prevents the process from ending. Additionally, other drawbacks of these procedures are the lead time to complete the OGTT, frequent vomiting that compromises the technique and pre-analytical glycolysis in the plasma glucose samples that can underestimate the GDM diagnosis [4,6,[12][13][14][15][16]. ...
... To our knowledge, this is the first study demonstrating frailty as a risk factor for adverse midterm clinical outcomes for stable elderly CAD patients. Along with the increase of society's life expectancy, the number of critically ill elderly patients has been increasing [18] . Frailty carries a relative morbidity and mortality risk of > 2 across a spectrum of ACS, CCS, and transcatheter or surgical interventions [6] . ...