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Objetivo: Analizar las características y variables asociadas con la ventilación no invasiva realizada completamente en los servicios de urgencias hospitalarios (VNI-SUH) de manera prolongada y su influencia en la eficacia de la técnica. Diseño Estudio multicéntrico observacional prospectivo de cohorte multipropósito. Ámbito Registro VNICat. Participantes Pacientes en los que se realiza VNI-SUH en 11 hospitales catalanes en los meses de febrero o marzo de 2015.IntervenciónNinguna.VariablesLa variable de estudio fue la VNI-SUH, que en función del tiempo se definió como prolongada o no prolongada. La variable de eficacia fue el éxito de la técnica por mejoría. Resultados Se incluyeron 125 pacientes con una mediana de tiempo de VNI-SUH de 12h, que fue el punto de corte para los 2 grupos comparados. En 60 (48%) la VNI-SUH fue no prolongada (<12h) y en 65 (52%) prolongada (≥12h). La VNI-SUH no prolongada se asoció con la indicación de insuficiencia cardiaca aguda y la prolongada con la presencia de diabetes. Entre la VNI-SUH no prolongada y la prolongada no hubo diferencias en la eficacia, éxito por mejoría del 68,3% y del 76,9%, respectivamente, con un odds ratio ajustado de 1,49 (intervalo de confianza del 95% de 0,61-3,60).Conclusiones La VNI-SUH prolongada es una situación frecuente, pero las variables estudiadas que se asocian a ella son escasas. Su presencia no influyo en el éxito de la VNI. (AU)
Objective: To analyze the characteristics and variables associated with prolonged noninvasive ventilation performed completely in Emergency Departments (NIV-ED) and its influence upon effectiveness. Design A prospective, multicenter, observational multipurpose cohort study was carried out. Setting VNICat Registry. Subjects Patients in which NIV-ED was performed in 11 Catalan hospitals in the months of February or March 2015. Intervention No. Variables The study variable was NIV-ED, which as a function of time was defined as prolonged or not prolonged. The efficacy variable was the success of the technique in terms of patient improvement. Results A total of 125 patients were included, with a median NIV-ED duration of 12hours, which was the cut-off point for the comparator groups. In 60 cases (48%) NIV-ED was not prolonged (<12hours), while in 65 cases (52%) ventilation was prolonged (≥12hours). Non-prolonged NIV-ED was associated to the indication of acute heart failure and prolonged ventilation to the presence of diabetes. There were no differences between non-prolonged and prolonged NIV-ED in terms of efficacy, and the success rate in terms of improvement was 68.3% and 76.9%, respectively, with an adjusted odds ratio of 1.49 (95%CI 0.61-3.60). Conclusions Prolonged NIV-ED is a frequent situation, but few variables associated to it have been studied. The presence of prolonged ventilation did not influence the success rate of NIV. (AU)
Asunto(s)
Humanos , Ventilación no Invasiva , Resultado del Tratamiento , Servicio de Urgencia en Hospital , España , Estudios Prospectivos , Estudios de CohortesRESUMEN
OBJECTIVE: To analyze the characteristics and variables associated with prolonged noninvasive ventilation performed completely in Emergency Departments (NIV-ED) and its influence upon effectiveness. DESIGN: A prospective, multicenter, observational multipurpose cohort study was carried out. SETTING: VNICAT Registry. SUBJECTS: Patients in which NIV-ED was performed in 11 Catalan hospitals in the months of February or March 2015. INTERVENTION: No. VARIABLES: The study variable was NIV-ED, which as a function of time was defined as prolonged or not prolonged. The efficacy variable was the success of the technique in terms of patient improvement. RESULTS: A total of 125 patients were included, with a median NIV-ED duration of 12 h, which was the cut-off point for the comparator groups. In 60 cases (48%) NIV-ED was not prolonged (<12 h), while in 65 cases (52%) ventilation was prolonged (≥12 h). Non-prolonged NIV-ED was associated to the indication of acute heart failure and prolonged ventilation to the presence of diabetes. There were no differences between non-prolonged and prolonged NIV-ED in terms of efficacy, and the success rate in terms of improvement was 68.3% and 76.9%, respectively, with an adjusted odds ratio of 1.49 (95%CI 0.61-3.60). CONCLUSIONS: Prolonged NIV-ED is a frequent situation, but few variables associated to it have been studied. The presence of prolonged ventilation did not influence the success rate of NIV.
Asunto(s)
Ventilación no Invasiva , Insuficiencia Respiratoria , Estudios de Cohortes , Servicio de Urgencia en Hospital , Humanos , Estudios Prospectivos , Sistema de Registros , Insuficiencia Respiratoria/terapiaRESUMEN
OBJECTIVE: To analyze the characteristics and variables associated with prolonged noninvasive ventilation performed completely in Emergency Departments (NIV-ED) and its influence upon effectiveness. DESIGN: A prospective, multicenter, observational multipurpose cohort study was carried out. SETTING: VNICat Registry. SUBJECTS: Patients in which NIV-ED was performed in 11 Catalan hospitals in the months of February or March 2015. INTERVENTION: No. VARIABLES: The study variable was NIV-ED, which as a function of time was defined as prolonged or not prolonged. The efficacy variable was the success of the technique in terms of patient improvement. RESULTS: A total of 125 patients were included, with a median NIV-ED duration of 12hours, which was the cut-off point for the comparator groups. In 60 cases (48%) NIV-ED was not prolonged (<12hours), while in 65 cases (52%) ventilation was prolonged (≥12hours). Non-prolonged NIV-ED was associated to the indication of acute heart failure and prolonged ventilation to the presence of diabetes. There were no differences between non-prolonged and prolonged NIV-ED in terms of efficacy, and the success rate in terms of improvement was 68.3% and 76.9%, respectively, with an adjusted odds ratio of 1.49 (95%CI 0.61-3.60). CONCLUSIONS: Prolonged NIV-ED is a frequent situation, but few variables associated to it have been studied. The presence of prolonged ventilation did not influence the success rate of NIV.
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OBJECTIVE: The aim of this study is to analyze the effect, safety and tolerability of a specific probiotic combination of Lactobacillus and Bifidobacterium strains (Pearls IC©) on antibiotic associated diarrhea due to amoxicillin-clavulanic acid treatment. METHODS: Pilot, unicentric, randomized, double-blind, parallel group, placebo-controlled study (probiotic vs. placebo for 30 days). Target population: Adult patients, both sexes treated with amoxicillin-clavulanic acid (850mg / 125mg every 8h /orally) for 7 days who attended the Emergency Department (Dexeus Hospital, Barcelona) between January and April of 2018 with prior signed informed consent with a follow up at 30 days. Variables: The differences between day 0 and day 30 of the number of daily stools and duration of diarrhea were evaluated; Stool consistency according to Bristol Stool Form, Quality of intestinal life. Subjective evaluation and evaluation of adverse effects of the product through a specifically designed questionnaire. RESULTS: Thirty-six subjects were included (18 per group) 25 females and 11 males, average age of 38.5 years (range 19-65 years). Pearls IC© delayed between 4 and 5 days the appearance of the diarrheic episode vs. placebo (p <0.001). The results of the quality of life assessment showed an improvement at the end of the 30 days period but without difference vs placebo. The results of the subjective assessment were in favor of the probiotic with higher rate of like responses than placebo. CONCLUSIONS: Pearls IC© demonstrated its beneficial effect on antibiotic associated diarrhea by delaying the onset of diarrhea and showed a tendency to decrease the number of daily stools vs. placebo.
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Combinación Amoxicilina-Clavulanato de Potasio/efectos adversos , Antibacterianos/efectos adversos , Bifidobacterium , Diarrea/terapia , Lactobacillus , Probióticos/uso terapéutico , Adulto , Anciano , Diarrea/microbiología , Diarrea/psicología , Método Doble Ciego , Heces/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Calidad de Vida , Resultado del Tratamiento , Adulto JovenRESUMEN
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