Arana

Researchers are evaluating an organ dysfunction scoring system adapted specifically for pregnant and early postpartum patients admitted to intensive care units (ICUs). The study aims to develop and validate this obstetric SOFA score (SOFA-OBS) to better predict ICU mortality and sepsis-related mortality in this group. The current general SOFA score does not account for physiological changes during pregnancy and early postpartum, such as reduced creatinine levels and lower blood pressure, which may affect its accuracy in these patients. This study will include about 130 female participants who are either pregnant at any stage or within three days after giving birth and require ICU care. The study will use the new SOFA-OBS score that adjusts kidney and cardiovascular measures to reflect pregnancy changes and simplifies respiratory function evaluation by using a non-invasive pulse oximeter when arterial blood gases are unavailable. The original neurologic, liver, and platelet assessments remain unchanged. Researchers will collect data routinely gathered during ICU care without additional interventions. They will track SOFA and SOFA-OBS scores daily during ICU stays, up to discharge or death, focusing on the first 24 and 48 hours, and assess various organ functions and sepsis definitions adapted to pregnancy stages. Participants will be monitored throughout their ICU stay with data recorded on organ function, infection status, interventions, and outcomes. The study will compare SOFA-OBS with the general SOFA score for predicting mortality and sepsis outcomes. Data collection will include laboratory tests, vital signs, and clinical assessments using standardized forms and electronic systems. Safety and privacy will be maintained, and consent obtained before participation. The total duration depends on ICU stay, with daily evaluations until discharge or death, or up to 28 days post-enrollment for mortality outcomes.

This research aims to better understand how spontaneous breathing affects patients recovering from Acute Respiratory Distress Syndrome (ARDS) during the transition from controlled to assisted ventilation. High respiratory drive during this phase may cause harmful lung pressure swings and worsen lung injury. The study focuses on evaluating how higher Positive End Expiratory Pressure (PEEP) might reduce these pressures and protect the lungs, though patient responses vary and are hard to predict. Researchers are investigating whether changes in breathing rate can serve as a simple bedside indicator of lung compliance improvements when PEEP is increased. Participants will receive pressure support ventilation with an inspiratory pressure set to achieve 6 to 8 ml/kg of predicted body weight and an initial PEEP of 5 cmH2O. After 5 minutes, detailed respiratory measurements including esophageal and transpulmonary pressures will be recorded. This procedure will be repeated with PEEP increased to 10 and then 15 cmH2O while keeping inspiratory pressure constant throughout the study. During the study, researchers will monitor lung compliance responses and breathing patterns over short intervals of 10 minutes. Assessments include advanced respiratory monitoring to observe pressure swings and breathing rates. The primary outcome is lung compliance response measured within 10 minutes, helping determine if changes in respiratory rate reliably reflect lung function improvements. Participants must be on invasive mechanical ventilation and meet ARDS criteria, with monitoring continuing as long as ventilation is expected for more than 24 hours after enrollment.