Pilar Fernández-Segoviano

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BACKGROUND The American-European Consensus Conference definition for the acute respiratory distress syndrome (ARDS) has never been validated. OBJECTIVE To compare clinical criteria for ARDS with autopsy findings. DESIGN Independent comparison of autopsy findings with clinical characteristics retrospectively abstracted from medical records. SETTING(More)
OBJECTIVE To determine and compare the diagnostic accuracy of three clinical definitions of acute respiratory distress syndrome (ARDS): (1) the American-European consensus conference definition; (2) the lung injury score; and (3) a recently developed Delphi definition. A second objective was to determine the accuracy of clinical diagnoses of ARDS made in(More)
RATIONALE A revised definition of clinical criteria for acute respiratory distress syndrome (ARDS), the Berlin definition, was recently established to classify patients according to their severity. OBJECTIVE To evaluate the accuracy of these clinical criteria using diffuse alveolar damage (DAD) at autopsy as the reference standard. METHODS All patients(More)
A prospective study of 100 autopsies was carried out. The clinical and pathologic diagnoses were made independently by intensivists and pathologists; at the end of the study, the differences were determined. There were seven Class I errors (which if detected before death, would probably have led to a change in management that might have resulted in cure or(More)
BACKGROUND Diffuse alveolar damage is the histological hallmark of acute respiratory distress syndrome (ARDS). However, the chronology of histological lesions is not well established. We aimed to determine the time to onset of exudative or proliferative changes and end-stage fibrosis in ARDS. METHODS We analysed all patients who died between Jan 1, 1991,(More)
The search for reliable diagnostic biomarkers of sepsis remains necessary. Assessment of global metabolic profiling using quantitative nuclear magnetic resonance (NMR)-based metabolomics offers an attractive modern methodology for fast and comprehensive determination of multiple circulating metabolites and for defining the metabolic phenotype of sepsis. To(More)
OBJECTIVE To determine whether mechanical ventilation using high tidal volume is associated with nonpulmonary organ dysfunction that can be attenuated by dexamethasone. DESIGN Prospective randomized animal intervention study. SETTING Animal care facility in a university hospital. SUBJECTS Sedated and tracheostomized male Sprague-Dawley rats. (More)
Dear Editor, A new pandemic was originated by a novel influenza A (H1N1) virus [1– 3]. Severe cases were characterized by acute respiratory distress syndrome (ARDS), shock, and acute kidney injury (AKI) [3]. Lung histopathological changes in fatal cases showed signs of diffuse alveolar damage, necrotizing bronchiolitis, and occasional alveolar hemorrhage(More)
To test the hypothesis that aging increases the susceptibility to organ dysfunction and systemic inflammation induced by injurious mechanical ventilation. Experimental study in an animal model of ventilator-induced lung injury in the animal research laboratory in a university hospital. Young (3–4 months old) and old (22–24 months old) anesthetized Wistar(More)
To demonstrate that increased formation of reactive oxygen (ROS) and nitrogen species (RNS) is involved in VILI-induced vascular dysfunction. Male Sprague-Dawley anesthetized rats were ventilated for 60 min using low VT ventilation [VT 9 ml/kg, positive end-expiratory pressure (PEEP) 5 cmH2O, n = 18], and high VT ventilation (VT 35 ml/kg, zero PEEP, n =(More)