Publications by authors named "Jorge López González"

3 Publications

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Microcirculatory Changes in Pediatric Patients During Congenital Heart Defect Corrective Surgery.

J Cardiovasc Transl Res 2021 May 4. Epub 2021 May 4.

Paediatric Intensive Care Unit, Gregorio Marañón General University Hospital, Calle Dr. Castelo 47, 28007, Madrid, Spain.

A prospective, observational single-center study was carried out. Pediatric patients undergoing congenital heart defect surgery were evaluated before, during, and after surgery. At each time point, sublingual microcirculation and clinical parameters were assessed, along with analytical variables. Twenty-four patients were included. All microcirculatory parameters worsened during cardiopulmonary bypass and returned to baseline values after surgery (p ≤ 0.001). In the intraoperative evaluation, body temperature correlated with perfused small vessel density (p = 0.014), proportion of perfused small vessels (p < 0.001), small vessel microvascular flow index (p = 0.003), and small vessel heterogeneity index (p < 0.002). Patients with cyanotic disease exhibited higher small vessel density (p < 0.008) and higher density of perfused small vessels (p < 0.022) at baseline, and a lower microvascular flow index (p = 0.022) and higher heterogeneity (p = 0.026) in the intraoperative phase. Children with congenital heart disease exhibited decreased vascular density and microvascular blood flow and increased heterogeneity during cardiopulmonary bypass. All these parameters returned to baseline values after surgery.
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http://dx.doi.org/10.1007/s12265-021-10132-wDOI Listing
May 2021

A Case of Kawasaki Disease Presenting as Severe Myositis.

Indian J Pediatr 2019 11 4;86(11):1066-1067. Epub 2019 Jul 4.

Pediatric Infectious Diseases Unit, Hospital General Universitario Gregorio Marañon, Madrid, Spain.

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http://dx.doi.org/10.1007/s12098-019-03009-zDOI Listing
November 2019

Diffuse persistent pulmonary interstitial emphysema secondary to mechanical ventilation in bronchiolitis.

BMC Pulm Med 2016 11 3;16(1):139. Epub 2016 Nov 3.

Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Red de Investigación en Salud Materno-Infantil y del Desarrollo (Red SAMYD), C/ Doctor Castelo 47, 28009, Madrid, Spain.

Background: Persistent interstitial pulmonary emphysema (PIE) is a rare disease and it is even more uncommon in full-term infants, like our patient. When conservative management is not successful, surgical treatment should be considered. In our case, ECMO support was iniciated to keep the patient ventilated in order to allow the lung to heal using lung protection strategies.

Case Presentation: We report an 18-day-old male infant with bronchiolitis that required mechanical ventilation with high positive airway pressures due to severe respiratory insufficiency. Chest X-rays and computed tomography scan revealed a severely hyperinflated left lung with extensive destructive changes and multiple small bullae. These findings were consistent with diffuse persistent interstitial emphysema (PIE), probably due to mechanical ventilation. The patient required high frequency oscillatory ventilation, inotropic support and continuous renal replacement therapy. He eventually suffered a cardiac arrest that required cardiopulmonary resuscitation and ECMO during 5 days with progressive clinical improvement and normalization of the X-ray.

Conclusion: We present a patient with diffuse persistent interstitial emphysema who, despite an unfavorable evolution with different mechanical ventilation strategies, had a good response after ECMO assistance.
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http://dx.doi.org/10.1186/s12890-016-0299-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094036PMC
November 2016