Arana

Researchers are evaluating an organ dysfunction score adapted specifically for pregnant and early postpartum patients up to 3 days after birth admitted to intensive care units ICU. This observational study aims to determine if this adjusted score, called SOFA-OBS, better predicts ICU mortality compared to the general SOFA score. The study also assesses whether a non-invasive pulse oximeter can effectively evaluate respiratory function instead of the standard arterial blood gas test, which is more painful and invasive. The study involves following pregnant and postpartum patients admitted to the ICU for at least 24 hours. Researchers will collect routine clinical data and laboratory results already used in ICU care, without requiring extra interventions. The SOFA-OBS score adjusts kidney function and blood pressure measurements to reflect the physiological changes during pregnancy and postpartum. It also replaces arterial blood gas oxygen measurements with pulse oximetry when blood gas analysis is unavailable. Data will be recorded daily during the ICU stay. Participants will be monitored for organ dysfunction and mortality outcomes during their ICU stay or up to 28 days after enrollment. Researchers will evaluate and compare the predictive ability of the SOFA-OBS and general SOFA scores for ICU mortality and sepsis-related death. Data quality will be carefully checked, and privacy will be protected by anonymizing patient information. The study is approved by ethical boards and requires informed consent from participants, with a planned enrollment of 130 patients.

Researchers are studying patients recovering from Acute Respiratory Distress Syndrome ARDS who require invasive mechanical ventilation. The study evaluates how spontaneous breathing during the switch from controlled to assisted ventilation may worsen lung injury due to strong inspiratory effort and high respiratory drive. It focuses on the effects of higher Positive End Expiratory Pressure PEEP to reduce lung stress and inspiratory effort, while exploring simple ways to predict patient responses to PEEP by monitoring respiratory rate and lung compliance. Patients will be ventilated using pressure support ventilation with inspiratory pressure adjusted to achieve specific lung volume targets and a starting PEEP of 5 cmH2O. After initial measurements, PEEP will be increased to 10 and 15 cmH2O while keeping inspiratory pressure constant. During these steps, advanced respiratory monitoring including esophageal and transpulmonary pressure swings will be collected to assess lung compliance response and respiratory rate changes. Participants will be monitored continuously during the ventilation adjustments, with detailed respiratory assessments taken after 5 minutes at each PEEP level. Researchers will measure lung compliance as the primary outcome within 10 minutes, along with esophageal pressure, transpulmonary pressure swings, and respiratory rate as secondary outcomes. The study involves patients ventilated in pressure support mode expected to remain on ventilation for more than 24 hours after enrollment, with ongoing safety and lung function monitoring throughout participation.