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G Vazquez-Mata

Publications and source records attributed to G Vazquez-Mata.

3 recordsLinked to original sources

Tiss 76 and Tiss 28: correlation of two therapeutic activity indices on a Spanish multicenter ICU database.

OBJECTIVES: To evaluate the performance of the Simplified Therapeutic Intervention Scoring System (TISS 28) on an independent database and to determine its relation to the original Therapeutic Intervention Scoring System (TISS 76). DESIGN: Analysis of the database of the Spanish prospective multicenter study PAEEC (Project for the Epidemiological Analysis of Critical Care Patients). SETTING: 86 intensive care units (ICUs) in Spain. PATIENTS: Data on 8838 patients admitted to the ICUs. MEASUREMENTS AND RESULTS: Administrative data, main diagnostic category, severity score [Acute Physiology and Chronic Health Evaluation (APACHE) II and III] and data for the calculation of the TISS 76 and TISS 28 were collected during the first 24 h after the patient's ICU admission. TISS 76 and TISS 28 scores were calculated and analyzed on how they varied according to other variables (diagnostic group, severity level, hospital size and age). The association between TISS 76 and TISS 28 was studied. The TISS 76 score was 21 +/- 10.5 points and the TISS 28 score 23.3 +/- 8.8 points. There was a good correlation between TISS 76 and TISS 28 (r = 0.85). The regression equation was: TISS 28 = 8.35 + (0.712 x TISS 76). The TISS 28 score behaved similarly to the TISS 76 score in relation to the other variables, with a positive correlation between the therapeutic and the severity level (APACHE II and III) and a negative correlation between therapeutic activity and age, with very similar correlation coefficients. Both TISS 28 and TISS 76 scores were higher in larger hospitals. CONCLUSIONS: There is a strong correlation between TISS 28 and TISS 76 scores in the PAEEC database and TISS 28 works correctly in our setting.

APACHE↗

PEEP and low tidal volume ventilation reduce lung water in porcine pulmonary edema.

This study analyzed the effect of both positive end-expiratory pressure (PEEP) and reduction in tidal volume (VT) on extravascular lung water (EVLW) in a permeability model of pulmonary edema. Immediately after producing a pulmonary edema with oleic acid, 21 pigs were randomized into three groups. Group I (n = 8): PEEP of 0 cm H2O (ZEEP), VT of 12 ml/kg; Group II (n = 6): PEEP of 10 cm H2O, VT of 12 ml/kg; Group III (n = 7): PEEP of 10 cm H2O, VT of 6 ml/kg. EVLW was measured by the double indicator method (DI) at baseline (time 0) and after 30, 60, 120, 180, and 240 min and by the gravimetric method (G) at 240 min. Both methods correlated excellently (r = 0.94, p < 0.0001). EVLW-DI was significantly less with PEEP application (Group II versus Group I) at 180 min and thereafter. Likewise, EVLW-DI was less throughout the experimental period with reduced VT once PEEP was applied (Group III versus Group II). EVLW-G was less in Group II than in Group I at 16.3 +/- 2.7 and 23.2 +/- 4.2 ml/kg, respectively (p < 0.0001), and less in Group III than in Group II at 10.7 +/- 0.9 and 16.3 +/- 2.7 ml/kg (p < 0.0001). We conclude that early application of 10 cm H2O of PEEP reduces EVLW in permeability pulmonary edema. The lowering of VT reduced EVLW even further.

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