Canuelas

This research analyzes the frequency of complications related to a therapeutic procedure called the alveolar opening maneuver combined with positive end-expiratory pressure PEEP in children with acute respiratory distress syndrome ARDS who are in the Pediatric Intensive Care Unit PICU. These interventions, part of standard care, aim to improve lung oxygenation and breathing mechanics in critically ill pediatric patients. The study is observational and will provide important safety information about these common treatments. The study involves pediatric patients under 14 years old who are on invasive mechanical ventilation for more than four hours and meet certain oxygenation criteria. The procedure includes carefully raising PEEP to specific pressure levels, maintaining it briefly, then lowering it to find the best setting based on lung pressures and oxygen levels. This maneuver is performed once when medically needed, guided by the treating team and following a set safety protocol with continuous monitoring. Participants will have baseline clinical data recorded before the procedure and monitored closely during and for four hours afterward to detect any complications. If repeated, monitoring continues for four hours after the last maneuver. Researchers will collect demographic and clinical information and analyze the overall rate of complications using statistical methods. The study will continue until 143 procedures have been observed, contributing data to improve care in ventilated children with ARDS.

Researchers are conducting a prospective observational study to better understand hereditary transthyretin amyloidosis ATTR, a progressive and potentially life-threatening condition caused by amyloid fibril deposits affecting multiple organs. The study aims to describe patient characteristics, explore factors influencing disease progression, and establish minimum criteria for disease onset. The trial is led by Hospital de Alta Complejidad en Red and enrolls adults over 18 years old with confirmed pathogenic TTR gene variants. Participants include those with confirmed hereditary TTR gene variants, whether they show symptoms or are asymptomatic carriers. The study excludes individuals with wild-type TTR amyloidosis. Evaluations include comprehensive medical histories, full physical exams, clinical assessments such as heart and neurological exams, ECGs, and 24-hour Holter monitoring when arrhythmias are suspected. Genetic testing is sponsored by pharmaceutical companies. During the study, participants will undergo thorough clinical evaluations including monitoring of heart rate, respiratory rate, oxygen saturation, and neurological function. Researchers will measure various outcomes over three years, such as phenotypic classification, heart function, walking capacity, biomarkers like Pro-BNP and Troponin T, neuropathy scores, quality of life, and body mass index. These assessments help characterize disease progression and patient status throughout the study period.

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.