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Martínez-Sellés D Oliveira Soares, Manuel

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First Name
Manuel
Last Name
Martínez-Sellés D Oliveira Soares
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https://hdl.handle.net/20.500.14352/79067
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Medicina
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Medicina
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Author: Sousa Casasnovas, Iago × Has files: true ×

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    Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
    (Journal of Clinical Medicine, 2023) Velásquez Rodríguez, Jesús; Vicent, Lourdes; Díez Delhoyo, Felipe; Valero Masa, María Jesús; Bruña, Vanesa; Sousa Casasnovas, Iago; Juárez Fernández, Miriam; Fernández-Avilés Díaz, Francisco Jesús; Martínez-Sellés D Oliveira Soares, Manuel
    Background: High-degree atrioventricular block (HAVB) is a known complication of ST-segment elevation myocardial infarction (STEMI). We aimed to determine the prevalence and prognostic impact of HAVB in a contemporary cohort of STEMI. Methods: Data were collected from the DIAMANTE registry that included STEMI patients admitted to our cardiac intensive care unit treated with urgent reperfusion. We studied the clinical characteristics and evolution in patients with and without HAVB at admission. Results: From 1109 consecutive patients, HAVB was documented in 95 (8.6%). The right coronary artery was the culprit vessel in 84 patients with HAVB (88.4%). The independent predictors of HAVB were: male sex (OR 1.9, 95% CI 1.2–2.9), age (OR 1.03, 95% CI 1.01–1.05), involvement of right coronary artery (OR 12.4, 95% CI 7.6–20.2), and creatinine value (OR 1.5, 95% CI 1.1–2.0). A transient percutaneous pacemaker was used in 37 patients with HAVB (38.9%). Patients with HAVB had higher mortality that patients without HAVB (15.8% vs. 4.1%, p < 0.001); however, in multivariate analysis, HAVB was not an independent predictor of in-hospital mortality. Conclusions: HAVB was seen in 9% of STEMI patients and was particularly frequent in elderly males with renal failure. Patients with HAVB had a poor prognosis during hospitalization, but HAVB was not an independent predictor of in-hospital mortality.
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    Nosocomial infections in adult patients supported by extracorporeal membrane oxygenation in a cardiac intensive care unit
    (Microorganisms, 2023) Mornese Pinna, Simone; Sousa Casasnovas, Iago; Olmedo, María; Machado, Marina; Juàrez Fernández, Miriam; Devesa Cordero, Carolina; Galar, Alicia; Álvarez Uría, Ana; Fernández Avilés, Francisco; García Carreño, Jorge; Martínez-Sellés D Oliveira Soares, Manuel; De Rosa, Francesco Giuseppe; Corcione, Silvia; Bouza Santiago, Emilio; Muñoz García, Patricia Carmen; Valerio Minero, Maricela
    The use of venoarterial (VA) extracorporeal membrane oxygenation therapy (ECMO) in patients admitted to cardiac intensive care units (CICU) has increased. Data regarding infections in this population are scarce. In this retrospective study, we analyzed the risk factors, outcome, and predictors of in-hospital mortality due to nosocomial infections in patients with ECMO admitted to a single coronary intensive care unit between July 2013 and March 2019 treated with VA-ECMO for >48 h. From 69 patients treated with VA-ECMO >48 h, (median age 58 years), 29 (42.0%) patients developed 34 episodes of infections with an infection rate of 0.92/1000 ECMO days. The most frequent were ventilator-associated pneumonia (57.6%), tracheobronchitis (9.1%), bloodstream infections (9.1%), skin and soft tissue infections (9.1%), and cytomegalovirus reactivation (9.1%). In-hospital mortality was 47.8%, but no association with nosocomial infections was found (p = 0.75). The number of days on ECMO (OR 1.14, 95% CI 1.01–1.30, p = 0.029) and noninfectious complications were higher in the infected patients (OR: 3.8 95% CI = 1.05–14.1). A higher baseline creatinine value (OR: 8.2 95% CI = 1.12–60.2) and higher blood lactate level at 4 h after ECMO initiation (OR: 2.0 95% CI = 1.23–3.29) were significant and independent risk factors for mortality. Conclusions: Nosocomial infections in medical patients treated with VA-ECMO are very frequent, mostly Gram-negative respiratory infections. Preventive measures could play an important role for these patients.