Ricard Mellado‐Artigas
A5021226874- Respiratory Support and Mechanisms
- Intensive Care Unit Cognitive Disorders
- Cardiac Arrest and Resuscitation
- Long-Term Effects of COVID-19
- Airway Management and Intubation Techniques
- Family and Patient Care in Intensive Care Units
- COVID-19 Clinical Research Studies
- Sepsis Diagnosis and Treatment
- Thermal Regulation in Medicine
- Intracranial Aneurysms: Treatment and Complications
- Nosocomial Infections in ICU
- Traumatic Brain Injury and Neurovascular Disturbances
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Emergency and Acute Care Studies
- Cardiac, Anesthesia and Surgical Outcomes
- Pediatric Pain Management Techniques
- Respiratory viral infections research
- Musculoskeletal pain and rehabilitation
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Intracerebral and Subarachnoid Hemorrhage Research
- Pain Mechanisms and Treatments
- Neurosurgical Procedures and Complications
- Influenza Virus Research Studies
- Heart Rate Variability and Autonomic Control
- Pneumothorax, Barotrauma, Emphysema
Hospital Clínic de Barcelona
2009-2024
Consorci Institut D'Investigacions Biomediques August Pi I Sunyer
2020-2024
St. Michael's Hospital
2020-2024
University of Toronto
2019-2024
Universitat de Barcelona
2020-2024
Instituto de Salud Carlos III
2022-2024
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
2022-2024
Hasanuddin University
2024
The Scarborough Hospital
2024
Fundació Clínic per a la Recerca Biomèdica
2024
The main characteristics of mechanically ventilated ARDS patients affected with COVID-19, and the adherence to lung-protective ventilation strategies are not well known. We describe outcomes confirmed in COVID-19 managed invasive mechanical (MV).
Whether the use of high-flow nasal oxygen in adult patients with COVID-19 associated acute respiratory failure improves clinically relevant outcomes remains unclear. We thus sought to assess effect on ventilator-free days, compared early initiation invasive mechanical ventilation, COVID-19.We conducted a multicentre cohort study using prospectively collected database admitted 36 Spanish and Andorran intensive care units (ICUs). Main exposure was (conservative group), while ventilation...
Abstract Background Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether combination high-flow nasal oxygen therapy (HFNO) with awake-PP prevents need for intubation when compared HFNO alone. Methods Prospective, multicenter, adjusted observational cohort study consecutive COVID-19 acute respiratory failure (ARF)...
Abstract Background Flow starvation is a type of patient-ventilator asynchrony that occurs when gas delivery does not fully meet the patients’ ventilatory demand due to an insufficient airflow and/or high inspiratory effort, and it usually identified by visual inspection airway pressure waveform. Clinical diagnosis cumbersome prone underdiagnosis, being opportunity for artificial intelligence. Our objective develop supervised intelligence algorithm identifying deformation during square-flow...
We aimed to describe the use of high-flow nasal oxygen (HFNO) in patients with COVID-19 acute respiratory failure and factors associated a shift invasive mechanical ventilation.This is multicenter, observational study from prospectively collected database consecutive admitted 36 Spanish Andorran intensive care units (ICUs) who received HFNO on ICU admission during 22-week period (March 12-August 13, 2020). Outcomes interest were day need for endotracheal intubation. used multivariable...
Abstract Background There are no specific generally accepted therapies for the coronavirus disease 2019 (COVID-19). The full spectrum of COVID-19 ranges from asymptomatic to mild respiratory tract illness severe pneumonia, acute distress syndrome (ARDS), multisystem organ failure, and death. efficacy corticosteroids in viral ARDS remains unknown. We postulated that adjunctive treatment established caused by with intravenous dexamethasone might change pulmonary systemic inflammatory response...
The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with coronavirus disease 2019 (COVID-19)-associated respiratory failure. We also analysed both impact such throughout first four pandemic waves influence prior noninvasive support on outcomes.This is a secondary analysis multicentre, observational prospective cohort that included all consecutive undergoing invasive mechanical ventilation due COVID-19...
Abstract Background Reverse triggering (RT) is a dyssynchrony defined by respiratory muscle contraction following passive mechanical insufflation. It potentially harmful for the lung and diaphragm, but its detection challenging. Magnitude of effort generated RT currently unknown. Our objective was to validate supervised methods automatic using only airway pressure (Paw) flow. A secondary describe magnitude efforts during RT. Methods We developed algorithms Paw flow waveforms. Experts having...
The original version of this article unfortunately contained mistakes in Figures 1 and 3.
Pain is a clinical feature of COVID-19, however, data about persistent pain after hospital discharge, especially among ICU survivors scarce. The aim this study was to explore the incidence and characteristics new-onset its impact on Health-Related Quality Life (HRQoL), quantify presence mood disorders in critically ill COVID-19 survivors.This preliminary report PAIN-COVID trial (NCT04394169) presenting descriptive analysis survivors, following person interview 1 month discharge. assessed...
Abstract Purpose Invasive ventilation is a fundamental treatment in intensive care but its precise timing difficult to determine. This study aims at assessing the effect of initiating invasive versus waiting, patients with hypoxemic respiratory failure without immediate reason for intubation on one-year mortality. Methods Emulation target trial estimate benefit immediately failure, among within first 48-h hypoxemia. The eligible population included non-intubated SpO 2 /FiO ≤ 200 and 97%. was...
Reverse triggering is a delayed asynchronous contraction of the diaphragm triggered by passive insufflation ventilator in sedated mechanically ventilated patients. The incidence reverse unknown. This study aimed at determining critically ill patients under controlled ventilation.In this ancillary study, were continuously monitored with catheter measuring electrical activity diaphragm. A method for automatic detection using was developed derivation sample and validated subsequent sample....
In patients intubated for mechanical ventilation, prolonged diaphragm inactivity could lead to weakness and poor outcome. Time resume a minimal activity may be related sedation practice patient severity.Prospective observational study in critically ill patients. Diaphragm electrical (EAdi) was continuously recorded after intubation looking resumption of level (beginning the first 24 h period with median EAdi > 7 µV, threshold based on literature correlations thickening fraction). Recordings...
The purpose of this study was to identify optimal target propofol and remifentanil concentrations avoid a gag reflex in response insertion an upper gastrointestinal endoscope.Patients presenting for endoscopy received target-controlled infusions (TCI) both sedation-analgesia. Patients were randomized 4 groups fixed effect-site concentrations: 1 ng•mL (REMI 1) or 2 2) μg•mL (PROP 3 3). For each group, the other drug (propofol REMI vice versa) increased decreased using "up-down" method based...
Critically ill patients with COVID-19 are an especially susceptible population to develop post-intensive care syndrome (PICS) due acute respiratory distress (ARDS). Patients can suffer severe pain and may have long-term mental, cognitive, functional health deterioration after discharge. However, few controlled trials evaluating interventions for the prevention treatment of PICS. The study hypothesis is that a specific program based on early therapeutic education psychological intervention...
Abstract Background Tidal expiratory flow limitation (EFL T ) complicates the delivery of mechanical ventilation but is only diagnosed by performing specific manoeuvres. Instantaneous analysis resistance (Rex) can be an alternative way to detect EFL without changing ventilatory settings. This study aimed determine agreement detection Rex and PEEP reduction manoeuvre using contingency table coefficient. The patterns were explored. Methods Medical patients ≥ 15-year-old receiving underwent a...
OBJECTIVES: Intubation is a common procedure in acute hypoxemic respiratory failure (AHRF), with minimal evidence to guide decision-making. We conducted survey of when intubate patients AHRF measure the influence clinical variables on intubation decision-making and quantify variability. DESIGN: Factorial vignette-based asking “Would you recommend intubation?” Respondents selected an ordinal recommendation from 5-point scale ranging “Definite no” yes” for up ten randomly allocated vignettes....
Abstract Purpose Despite the benefits of mechanical ventilation, its use in critically ill patients is associated with complications and had led to growth noninvasive techniques. We assessed effect early intubation (first 8 h after vasopressor start) septic shock patients, as compared non-early intubated subjects (unexposed), regarding in-hospital mortality, intensive care hospital length stay. Methods This study involves secondary analysis a multicenter prospective study. To adjust for...
Abstract Background Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether combination high-flow nasal oxygen therapy (HFNO) with awake-PP prevents need for intubation when compared HFNO alone. Methods Prospective, multicentre, adjusted observational cohort study consecutive COVID-19 acute respiratory failure (ARF)...