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Papers by matias bertozzi

Argentinian Journal of Respiratory & Physical Therapy, Oct 30, 2023

Objetivo: Describir las características y evolución de los niños que requirieron uso de cánula na... more Objetivo: Describir las características y evolución de los niños que requirieron uso de cánula nasal de alto flujo de oxigenoterapia (CAFO) para el tratamiento de una infección respiratoria aguda baja (IRAB) en la sala de internación pediátrica de un hospital general de agudos. Materiales y método: Se llevó a cabo un estudio observacional, descriptivo y retrospectivo en la sala de internación pediátrica, entre el 1ro de junio y el 30 de noviembre de 2018. Se incluyeron sujetos entre 1 y 18 meses de edad con diagnóstico de IRAB, que utilizaron CAFO. Se registraron variables demográficas, médicas, la evolución de variables clínicas durante el uso de CAFO y la estadía hospitalaria. Resultados: Veintinueve sujetos fueron analizados. La mediana de edad fue de 5 meses (rango inter-cuartílico de 1,5-11 meses). El motivo de ingreso más frecuente fue bronquiolitis. La media de días de utilización de CAFO fue de 4,5 ± 1,8; mientras que la media de días de internación fue de 6,3 ± 2,6. Dos sujetos requirieron derivación a unidades de cuidados intensivos. Conclusión: Este estudio brinda una descripción de las características demográficas y la evolución de niños que requirieron terapia de CAFO para el tratamiento de IRAB, siendo los primeros resultados encontrados en una sala de internación pediátrica de un hospital general de agudos. Palabras clave: cánula nasal de alto flujo, lactantes, infecciones respiratorias agudas bajas, oxigenoterapia, soporte ventilatorio no invasivo, sala de internación. Fuentes de financiamiento: Los autores declaran no tener ninguna afiliación financiera ni participación en ninguna organización comercial que tenga un interés financiero directo en cualquier asunto incluido en este manuscrito. Conflicto de intereses: Los autores declaran no tener ningún conflicto de intereses.

INTRODUCTION. Oxygen therapy through a high-flow nasal cannula (HFNC) decreases intubation rates,... more INTRODUCTION. Oxygen therapy through a high-flow nasal cannula (HFNC) decreases intubation rates, increases oxygenation and patients’ comfort. HFNC use in the treatment of bronchiolitis is well documented whereas in pneumonia it is discussed. Research on its use outside critical units is scarce. Objective: To describe the characteristics and evolution of children who required oxygen therapy through HFNC for the treatment of ALRI in the pediatric ward of a general acute hospital setting, with a sub analysis of those with pneumonia. MATERIALS AND METHODS. An observational, descriptive and retrospective study was carried out in the pediatric ward between 06/01/18 and 11/30/18. Subjects with a diagnosis of ALRI, who received HFNC therapy, were included. Demographic variables, clinical variables and hospital stay were recorded. RESULTS. Twenty-nine subjects were analyzed. The median age was 5 months (RIQ = 1.5 - 11). The most frequent reason for admission was bronchiolitis. The mean length of treatment with HFNC was 4.5 days (SD = 1.8), the average length of hospital stay was 6.3 days (SD = 2.6). Two subjects needed to be transferred to a pediatric intensive care unit. CONCLUSIONS. This study describes the demographic characteristics, clinical evolution, length of hospital stay, length of treatment with HFNC and destination at discharge of children treated in a general pediatric ward. In the subgroup of subjects with pneumonia, the clinical outcomes were similar to that of subjects with bronchiolitis.

Acta Colombiana de Cuidado Intensivo

Argentinian Journal of Respiratory & Physical Therapy, Oct 26, 2020

Prevalencia de los motivos de consulta y las características de los sujetos en un consultorio ext... more Prevalencia de los motivos de consulta y las características de los sujetos en un consultorio externo de kinesiología de un hospital público de la Ciudad de Buenos Aires [Prevalence of reasons for consultation and characteristics of subjects in an outpatient physical therapy clinic of a public hospital in the City of Buenos Aires]

Respiratory Care, 2019

BACKGROUND: Laboratory studies suggest applying positive pressure without endotracheal suction du... more BACKGROUND: Laboratory studies suggest applying positive pressure without endotracheal suction during cuff deflation and extubation. Although some studies reported better physiological outcomes (e.g. arterial blood gases) with this technique, the safety of positive pressure extubation technique has not been well studied. The aim of this study was to determine the safety of the positive-pressure extubation technique compared with the traditional extubation technique in terms of incidence of complications. METHODS: Adult subjects who were critically ill and on invasive mechanical ventilation who met extubation criteria were included. The subjects were randomly assigned to positive-pressure extubation (n ‫؍‬ 120) or to traditional extubation (n ‫؍‬ 120). Sequential tests for noninferiority and, when appropriate, for superiority were performed. Positive pressure was considered noninferior if the upper limit of the CI for the absolute risk difference did not exceed a threshold of 15% in favor of the traditional group, both in per protocol and intentionto-treat analyses. A P value of <.05 was considered significant. RESULTS: A total of 236 subjects were included in the primary analysis (per protocol) (119 in the positive-pressure group and 117 in the traditional group). The incidence of overall major and minor complications, pneumonia, extubation failure, and reintubation was lower in the positive-pressure group than in the traditional group, with statistical significance for noninferiority both in the per protocol (P < .001) and intention-to-treat (P < .001) analyses. The lower incidence of major complications found in the positive-pressure group reached statistical significance for the superiority comparison, both in per protocol (P ‫؍‬ .03) and intention-to-treat (P ‫؍‬ .049) analyses. No statistically significant differences were found in the superiority comparison for overall complications, minor complications, pneumonia, extubation failure, and reintubation. CONCLUSIONS: Positive pressure was safe and noninferior to traditional extubation methods. Furthermore, positive pressure has shown to be superior in terms of a lower incidence of major complications. (ClinicalTrials.gov registration NCT03174509.

Argentinian Journal of Respiratory & Physical Therapy, Aug 3, 2020

Fuentes de financiamiento: Las autoras y los autores declaran no tener ninguna afiliación financi... more Fuentes de financiamiento: Las autoras y los autores declaran no tener ninguna afiliación financiera ni participación en ninguna organización comercial que tenga un interés financiero directo en cualquier asunto incluido en este manuscrito. Conflicto de intereses: Las autoras y los autores declaran no tener ningún conflicto de intereses. Resumen Objetivo: Describir el estado funcional, calidad de vida y el grado de debilidad adquirida de los sujetos que ingresan a la sala de clínica médica (SCM) luego de haber cursado internación en área cerrada. Materiales y método: Estudio descriptivo. Se incluyeron mayores de 18 años con al menos 48 hs de internación en área cerrada, que ingresaron a un hospital público de CABA desde el 1° de junio hasta el 31 de octubre de 2019. Se registraron variables demográficas, calidad de vida y capacidad funcional. Se realizó un seguimiento telefónico al mes y tres meses del alta hospitalaria. Para la evaluación de las variables primarias se utilizaron el EuroQol 5D-5L (EQ-5D y EQ-VAS) y el Índice de Barthel (IB). Resultados: Se analizaron 36 sujetos. El EQ-VAS de ingreso fue de 50 (37,5-57,5) y de egreso 65 (50-70). El EQ-5D para sus cinco esferas se modificó positivamente durante la estadía en SCM. La mayoría se reportó como independiente previo al ingreso hospitalario, pero al ingresar a la SCM, al egreso y durante el seguimiento, mantuvieron algún nivel de dependencia. Conclusión: Este estudio describe la calidad de vida y capacidad funcional de 36 sujetos al ingreso a SCM, su evolución hasta el alta hospitalaria y un seguimiento a un mes y tres meses. Palabras clave: calidad de vida, actividades de la vida diaria, trastornos por estrés postraumático, unidades hospitalarias, cuidados críticos, efectos adversos a largo plazo.

Argentinian Journal of Respiratory & Physical Therapy, 2019

The journal of physical chemistry. A, Jan 23, 2016

Ultraviolet (UV) photodissociation dynamics of jet-cooled 1-propenyl radical (CHCHCH3) were inves... more Ultraviolet (UV) photodissociation dynamics of jet-cooled 1-propenyl radical (CHCHCH3) were investigated at the photolysis wavelengths from 224 to 248 nm using high-n Rydberg atom time-of-flight (HRTOF) technique. The 1-propenyl radicals were produced from 193 nm photolysis of 1-chloropropene and 1-bromopropene precursors. The photofragment yield (PFY) spectra of the H atom product have a broad peak centered at 230 nm. The H + C3H4 product translational energy P(ET) distribution's peak near ∼8 kcal/mol, and the fraction of average translational energy in the total available energy, ⟨fT⟩, is nearly a constant of ∼0.12 from 224 to 248 nm. The H atom product has an isotropic angular distribution with the anisotropy parameter β ≈ 0. Quasiclassical trajectory calculations were also carried out using an ab initio ground-state potential energy surface for dissociation of 1-propenyl at the excitation energy of 124 kcal/mol (230 nm). The calculated branching ratios are 60% to the methyl ...

Respiratory Care, 2021

BACKGROUND Two orotracheal extubation techniques are described in the literature: the traditional... more BACKGROUND Two orotracheal extubation techniques are described in the literature: the traditional technique and the positive-pressure technique. Although prior studies reported better clinical outcomes with the positive-pressure extubation technique, its superiority has not been extensively studied yet. This study was to determine whether the positive-pressure orotracheal extubation technique, compared with the traditional orotracheal extubation technique, reduces the incidence of major postextubation complications (up to 60 min) in critically ill adult subjects. METHODS This was a multi-center randomized clinical trial. Subjects age > 18 y, requiring invasive mechanical ventilation through an endotracheal tube, who met the orotracheal extubation criteria were included and randomized to traditional extubation group (removing the endotracheal tube by applying continuous endotracheal suctioning during the entire procedure) or positive-pressure group (application of pressure support mode at 15/10 cm H2O during cuff deflation and extubation). The primary measure was postextubation major complications, defined as the clinical evidence of at least one of the following: desaturation, upper-airway obstruction, or vomiting. RESULTS A total of 725 subjects was randomly assigned to the traditional extubation group (n = 358) and positive-pressure group (n = 367). Seventeen subjects were eliminated and not included in the per-protocol analysis. Of 708 subjects, 185 (26.1%) developed at least one major complication. The incidence was 27.8% (96/345) in the traditional group compared with 24.5% (89/363) in the positive-pressure group. No statistically significant differences were observed between the 2 groups (absolute risk 3% [95 CI -3 to 10]; relative risk, 0.88 [95 CI 0.69-1.13], P = .32). CONCLUSIONS Despite the trend toward the positive-pressure group, no statistically significant differences were observed. Our findings agree with the literature in that positive-pressure extubation is a safe procedure; therefore, both techniques may be used during extubation in critically ill adult patients.

Revista Brasileira de Terapia Intensiva, 2021

Objective To describe the usual practice of mobility therapy in the adult intensive care unit for... more Objective To describe the usual practice of mobility therapy in the adult intensive care unit for patients with and without COVID-19. Methods Online survey in which physical therapists working in an adult intensive care unit in Argentina participated. Sixteen multiple-choice or single-response questions grouped into three sections were asked. The first section addressed personal, professional and work environment data. The second section presented questions regarding usual care, and the third focused on practices under COVID-19 pandemic conditions. Results Of 351 physical therapists, 76.1% answer that they were exclusively responsible for patient mobility. The highest motor-based goal varied according to four patient scenarios: Mechanically ventilated patients, patients weaned from mechanical ventilation, patients who had never required mechanical ventilation, and patients with COVID-19 under mechanical ventilation. In the first and last scenarios, the highest goal was to optimize m...