Canuelas

Researchers are evaluating the overall incidence of complications related to a therapeutic procedure called the alveolar opening maneuver and the adjustment of positive end-expiratory pressure (PEEP) in children with acute respiratory distress syndrome (ARDS) who are receiving mechanical ventilation. This research takes place in the Pediatric Intensive Care Unit (PICU) and aims to improve the safety and effectiveness of these procedures used to enhance lung oxygenation and breathing in critically ill pediatric patients. The study involves a standardized ventilatory procedure performed on children under invasive mechanical ventilation diagnosed with ARDS. The alveolar opening maneuver includes gradually increasing PEEP to a set pressure, maintaining it for two minutes, then decreasing PEEP to find the best level based on oxygenation and lung pressure. This procedure is done once when clinically needed, while continuously monitoring heart and oxygen levels according to safety guidelines. Participants will have their clinical and demographic information recorded before the procedure. During and after the alveolar opening maneuver and PEEP adjustment, complications will be monitored for four hours. If the procedure needs to be repeated within that time, monitoring continues for four hours after the last maneuver. The main outcome measured is the total rate of complications within this period. Data will be analyzed statistically to understand the safety profile of these interventions in children with respiratory distress.

Researchers are conducting a prospective observational study called the Comprehensive Program for Hereditary Transthyretin Amyloidosis. This study focuses on hereditary transthyretin amyloidosis (ATTR), a progressive and potentially fatal disease caused by amyloid fibril deposits that affect multiple organs. The study aims to describe patient characteristics, explore factors influencing disease progression, and determine the minimum criteria for disease onset in individuals with confirmed pathogenic TTR gene variants. Participants over 18 years old with hereditary ATTR will undergo extensive clinical assessments and complementary examinations. These include a complete medical history, physical exams, neurological testing, and measurements of vital signs like heart rate and oxygen saturation. Cardiac evaluations such as a 12-lead electrocardiogram (ECG) and, when indicated, 24-hour Holter monitoring will be performed. Genetic testing is supported by pharmaceutical companies as part of the evaluation. Throughout the study, researchers will monitor participants for phenotypic classification over a period of three years. Data collection involves detailed clinical and neurological exams, cardiac assessments, and other diagnostic tests to better understand the disease. This comprehensive monitoring will help characterize hereditary ATTR and provide important insights into its progression and manifestation.

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.