0000000000414139

AUTHOR

Alfonso Ambrós

showing 5 related works from this author

Stratification for Identification of Prognostic Categories In the Acute RESpiratory Distress Syndrome (SPIRES) Score.

2021

OBJECTIVES: To develop a scoring model for stratifying patients with acute respiratory distress syndrome into risk categories (Stratification for identification of Prognostic categories In the acute RESpiratory distress syndrome score) for early prediction of death in the ICU, independent of the underlying disease and cause of death. DESIGN: A development and validation study using clinical data from four prospective, multicenter, observational cohorts. SETTING: A network of multidisciplinary ICUs. PATIENTS: One-thousand three-hundred one patients with moderate-to-severe acute respiratory distress syndrome managed with lung-protective ventilation. INTERVENTIONS: None. MEASUREMENTS AND MAIN …

AdultMalemedicine.medical_specialtyOrgan Dysfunction ScoresPsychological interventionMEDLINECritical Care and Intensive Care MedicineLogistic regressionSeverity of Illness IndexstratificationInternal medicinemedicineHumansProspective StudiesCause of deathAPACHEclinical trialsRespiratory Distress SyndromeReceiver operating characteristicbusiness.industryphenotypesscoring systemacute respiratory distress syndromeMiddle AgedPrognosisRespiration ArtificialIntensive Care UnitsROC CurveSpainArea Under CurveCohortBreathingoutcomeObservational studyFemalebusinessCritical care medicine
researchProduct

Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial

2020

Background There is no proven specific pharmacological treatment for patients with the acute respiratory distress syndrome (ARDS). The efficacy of corticosteroids in ARDS remains controversial. We aimed to assess the effects of dexamethasone in ARDS, which might change pulmonary and systemic inflammation and result in a decrease in duration of mechanical ventilation and mortality. Methods We did a multicentre, randomised controlled trial in a network of 17 intensive care units (ICUs) in teaching hospitals across Spain in patients with established moderate-to-severe ARDS (defined by a ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen of 200 mm Hg or less assesse…

Pulmonary and Respiratory MedicineAdultMaleARDSmedicine.medical_treatmentSeverity of Illness IndexDexamethasonelaw.invention03 medical and health sciences0302 clinical medicineRandomized controlled triallawFraction of inspired oxygenIntensive careSeverity of illnessmedicineData monitoring committeeHumans030212 general & internal medicineGlucocorticoidsDexamethasoneAgedMechanical ventilationRespiratory Distress Syndromebusiness.industryMiddle Agedmedicine.diseaseRespiration ArtificialIntensive Care UnitsTreatment Outcome030228 respiratory systemAnesthesiaAdministration IntravenousFemalebusinessmedicine.drug
researchProduct

Whole-Blood Mitochondrial DNA Copies Are Associated With the Prognosis of Acute Respiratory Distress Syndrome After Sepsis

2021

Acute respiratory distress syndrome (ARDS) is an inflammatory process of the lungs that develops primarily in response to pulmonary or systemic sepsis, resulting in a disproportionate death toll in intensive care units (ICUs). Given its role as a critical activator of the inflammatory and innate immune responses, previous studies have reported that an increase of circulating cell-free mitochondrial DNA (mtDNA) is a biomarker for fatal outcome in the ICU. Here we analyzed the association of whole-blood mtDNA (wb-mtDNA) copies with 28-day survival from sepsis and sepsis-associated ARDS. We analyzed mtDNA data from 687 peripheral whole-blood samples within 24 h of sepsis diagnosis from unrelat…

MaleMitochondrial DNAARDSTime FactorsMedicinaImmunologyDNA MitochondrialRisk AssessmentsurvivalSepsisPathogenesisPredictive Value of TestsRisk FactorsIntensive careSepsismedicineImmunology and AllergyHumansHospital MortalityOriginal ResearchAgedRespiratory Distress SyndromeDAMPsProportional hazards modelbusiness.industrymtDNAHazard ratiowhole bloodMiddle AgedRC581-607medicine.diseasePrognosismitochondriaSpainImmunologyBiomarker (medicine)FemaleARDSImmunologic diseases. AllergybusinessBiomarkersFrontiers in Immunology
researchProduct

A Prognostic Enrichment Strategy for Selection of Patients With Acute Respiratory Distress Syndrome in Clinical Trials.

2019

Incomplete or ambiguous evidence for identifying high-risk patients with acute respiratory distress syndrome for enrollment into randomized controlled trials has come at the cost of an unreasonable number of negative trials. We examined a set of selected variables early in acute respiratory distress syndrome to determine accurate prognostic predictors for selecting high-risk patients for randomized controlled trials.A training and testing study using a secondary analysis of data from four prospective, multicenter, observational studies.A network of multidisciplinary ICUs.We studied 1,200 patients with moderate-to-severe acute respiratory distress syndrome managed with lung-protective ventil…

AdultMalemedicine.medical_specialtyOrgan Dysfunction ScoresMEDLINEAcute respiratory distressCritical Care and Intensive Care Medicinelaw.inventionRandomized controlled triallawMedicineHumansProspective StudiesIntensive care medicineProspective cohort studySelection (genetic algorithm)AgedRandomized Controlled Trials as TopicRespiratory Distress Syndromebusiness.industryPatient SelectionAge FactorsMiddle AgedPrognosisClinical trialMulticenter studyObservational studyFemalebusinessCritical care medicine
researchProduct

Is Overall Mortality the Right Composite Endpoint in Clinical Trials of Acute Respiratory Distress Syndrome?

2018

Objectives Overall mortality in patients with acute respiratory distress syndrome is a composite endpoint because it includes death from multiple causes. In most acute respiratory distress syndrome trials, it is unknown whether reported deaths are due to acute respiratory distress syndrome or the underlying disease, unrelated to the specific intervention tested. We investigated the causes of death after contracting acute respiratory distress syndrome in a large cohort. Design A secondary analysis from three prospective, multicenter, observational studies. Setting A network of multidisciplinary ICUs. Patients We studied 778 patients with moderate-to-severe acute respiratory distress syndrome…

Malemedicine.medical_specialtyCritical Care and Intensive Care MedicineHypoxemia03 medical and health sciences0302 clinical medicineInternal medicineCause of DeathmedicineHumans030212 general & internal medicineProspective StudiesProspective cohort studyCause of deathRandomized Controlled Trials as TopicRespiratory Distress SyndromeLungbusiness.industryMiddle AgedClinical trialmedicine.anatomical_structure030228 respiratory systemRelative riskCohortBreathingmedicine.symptombusinessCritical care medicine
researchProduct