Repositorio Institucional Académico. Universidad Andrés Bello. Chile :: Examinando por Autor "Gutierrez-Arias, Ruvistay"

Examinando por Autor "Gutierrez-Arias, Ruvistay"

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Assessing swallowing disorders in adults on high-flow nasal cannula in critical and non-critical care settings. A scoping review protocol
(Public Library of Science, 2023-10) Gutierrez-Arias, Ruvistay; Salgado-Maldonado, Gabriel; Letelier Valdivia, Paola; Salinas-Barahona, Francisco; Echeverría-Valdebenito, Carmen; Seron, Pamela
Introduction The high-flow nasal cannula (HFNC) has become a widely used respiratory support system, which has proven to be effective in different populations. The facilitation of oral communication and feeding have been described as advantages of this support. Nevertheless, swallowing disorders associated with the use of HFNC have been postulated. However, such evidence is scattered in the literature, not systematically searched, and needs to be adequately summarised. This review aimed to explore the literature, to identify and map the evidence, regarding the frequency and methods of assessment of swallowing disorders in adult HFNC users, in both critical and non-critical units. Materials and methods A scoping review will be conducted. A systematic search in MEDLINE (Ovid), Embase (Ovid), CENTRAL, CINAHL (EBSCOhost), and other resources will be conducted. Primary studies, in any language or publication status, assessing the incidence of swallowing disorders in adults with HFNC support will be included. Two reviewers will independently select studies and extract data. Disagreements will be resolved by consensus or a third reviewer. The results will be reported narratively, using tables and figures to support them. Discussion Positive end-expiratory pressure generated in the airway by HFNC could impair the proper swallowing performance. Knowing the methodological characteristics, the instruments or scales used to assess the presence of dysphagia, and the results of the studies may contribute to considering swallowing assessment in this population on a routine basis, as well as to guide the conduct of new studies that may respond to less researched areas in this topic.
assessment of activities and participation of people by rehabilitation-focused clinical registries: a systematic scoping review
(Edizioni Minerva Medica, 2023-10) Gutierrez-Arias, Ruvistay; Neculhueque-Zapata, Ximena; Valenzuela-Suazo, Raúl; Oliveros, Maria-Jose; Morales, Camilo; Vásquez, Luis; Jalil, Yorschua; Marzuca-Nassr, Gabriel N.; Inostroza Quiroz, Jacqueline L.; Fuentes-Aspe, Rocío; Solano, Ricardo; SalGado-Maldonado, Gabriel; Aguilera-Eguía, Raúl; Águila-Villanueva, Camilo; Garcés-Burgos, Carolina; Seron, Pamela
INTRODUCTION: Rehabilitation is considered a key intervention in health care. Clinical registries, defined as an organized system that uses observational methods to collect information to assess specific outcomes in a defined population, can contribute to assessing the impact of the rehabilitation intervention. This review aims to identify and describe rehabilitation-specific registry systems with an emphasis on identifying outcomes that enable the assessment of vital areas and activities of daily living. EVidEncE acQuisition: a systematic scoping review was conducted. a systematic search was conducted up to august 2022 in MEdlinE/ pubMed, Embase, cochrane library, Epistemonikos, and other search resources. studies related to rehabilitation registries presented data on people with health problems that could limit their functioning were selected. the inclusion of studies/clinical registries was not limited by methodological design, year of publication, country, or language. the unit of analysis was rehabilitation registries. the measurement instruments used to assess the outcomes were explored to estimate the domain assessed from the vital areas related to functioning and disability as described by the International Classification of Functioning, Disability and Health (ICF). The vital areas were classified according to activities of daily living (adls). EVIDENCE SYNTHESIS: Seventy-one registries in rehabilitation were identified. The registries included a median of 3 (IQR 2-5) assessment instruments designed to assess the impact of different rehabilitation programs. in total, 137 different assessment scales or instruments were identified. Each rehabilitation registry assessed 6 (IQR 2-8) domains of the ICF, and 15.4% of registries assessed all domains. The most assessed domain was “Mobility” (89.7%), and the least assessed was “General Tasks and Demands” (25.6%). In addition, 92.3% of rehabilitation registries assessed basic ADLs, 76.9% advanced ADLs, and 71.8% instrumental ADLs. conclusions: although clinical registries do not claim to directly assess the impact of rehabilitation programs on people’s functioning according to the ICF framework, it was identified that a low percentage of them assessed the nine vital areas through different outcome assessment instruments. However, most rehabilitation registries directly or indirectly assess some basic, instrumental, and advanced ADLs. The findings of this review highlight the need to improve the design of clinical registries focused on assessing the impact of rehabilitation programs to assess people in all areas of their lives. © 2023 Edizioni Minerva Medica. All rights reserved.
Assessment of redundancy, methodological and reporting quality, and potential discrepancies of results of systematic reviews of early mobilisation of critically ill adults: A meta-research protocol
(BMJ Publishing Group, 2023-07) Gutierrez-Arias, Ruvistay; Pieper, Dawid; Nydahl, Peter; González-Seguel, Felipe; Jalil, Yorschua; Oliveros, Maria-Jose; Torres-Castro, Rodrigo; Seron, Pamela
Introduction Several systematic reviews (SRs) have been conducted to determine the effectiveness of early mobilisation in critically ill adults with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading new SRs or updating, and discordant results of SRs on the same research question may generate research waste that makes it difficult for clinicians to keep up to date with the best available evidence. This meta-research aims to assess the redundancy, methodological and reporting quality, and potential reasons for discordance in the results reported by SRs conducted to determine the effectiveness of early mobilisation in critically ill adult patients. Methods and analysis A meta-research of early mobilisation SRs in critically ill adult patients will be conducted. A search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos and other search resources will be conducted. Two independent reviewers will perform study selection, data extraction and quality appraisal. Discrepancies will be resolved by consensus or a third reviewer. The redundancy of SRs will be assessed by the degree of overlap of primary studies. In addition, the justification for conducting new SRs will be evaluated with the 'Evidence-Based Research' framework. The methodological quality of the SRs will be assessed with the A MeaSurement Tool to Assess systematic Reviews 2 tool, and the quality of the reports through compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. To assess the potential reasons for discordance in the results of the SRs considering divergence in results and their interpretation. Ethics and dissemination As meta-research, this study does not involve the participation of people whose rights may be violated. However, this overview will be developed rigorously and systematically to achieve valid and reliable results. The findings of this meta-research study will be presented at conferences and published in a peer-reviewed journal related to rehabilitation, critical care or research methodology. Trial registration number osf.io/kxwq9. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Considerations for ensuring safety during telerehabilitation of people with stroke. A protocol for a scoping review
(Public Library of Science, 2023-01) Gutierrez-Arias, Ruvistay; González-Mondaca, Camila; Marinkovic-Riffo, Vinka; Ortiz-Puebla, Marietta; Paillán-Reyes, Fernanda; Seron, Pamela
Introduction Exercise interventions have a positive impact on people with stroke. However, access to exercise interventions is variable, and there may be a delay in the start of rehabilitation. Telerehabilitation has enabled the delivery of exercise interventions replacing the traditional face-to-face approach. Aspects related to the safety of people with stroke should be considered to avoid adverse events during the delivery of exercise interventions remotely. However, such information is scattered in the literature, and the detail with which measures taken during the implementation of exercise interventions for people with stroke are reported is unknown. Objective To summarise measures or aspects targeted at reducing the incidence of adverse events during the delivery of exercise interventions through telerehabilitation in patients after stroke. Materials and methods A scoping review will be conducted. A systematic search in MEDLINE-Ovid, Embase-Ovid CENTRAL, CINAHL Complete (EBSCOhost), and other resources will be carried out. We will include primary studies, published in full text in any language, involving people with stroke who undergo telerehabilitation where exercise is the main component. Two reviewers will independently select studies and extract data, and disagreements will be resolved by consensus or a third reviewer. The results will be reported in a narrative form, using tables and figures to support them. Discussion To implement this strategy within rehabilitation services, one of the first aspects to be solved is to ensure the safety of people. The results of this scoping review could contribute an information base for clinicians and decision-makers when designing remotely delivered exercise intervention programs. Copyright: © 2023 Gutierrez-Arias et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Effectiveness of physical rehabilitation interventions in critically ill patients-A protocol for an overview of systematic reviews
(Public Library of Science, 2023-04) Gutierrez-Arias, Ruvistay; Nydahl, Peter; Pieper, Dawid; González- Segue, Felipe; Jalil, Yorschua; Oliveros, Maria-Jose; Torres-Castro, Rodrigo; Seron, Pamela
Introduction Adult and pediatric patients admitted to intensive care units (ICUs) requiring invasive ventilatory support, sedation, and muscle blockade may present neuromusculoskeletal deterioration. Different physical rehabilitation interventions have been studied to evaluate their effectiveness in improving critically ill patients' outcomes. Given that many published systematic reviews (SRs) aims to determine the effectiveness of different types of physical rehabilitation interventions, it is necessary to group them systematically and assess the methodological quality of SRs to help clinicians make better evidence-based decisions. This overview of SRs (OoSRs) aims to map the existing evidence and to determine the effectiveness of physical rehabilitation interventions to improve neuromusculoskeletal function and other clinical outcomes in adult and pediatric critically ill patients. Methods An OoSRs of randomized and non-randomized clinical trials involving critically ill adult and pediatric patients receiving physical rehabilitation intervention will be conducted. A sensitive search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos, and other search resources will be conducted. Two independent reviewers will conduct study selection, data extraction, and methodological quality assessment. Discrepancies will be resolved by consensus or a third reviewer. The degree of overlap of studies will be calculated using the corrected covered area. The methodological quality of the SRs will be measured using the AMSTAR-2 tool. The GRADE framework will report the certainty of evidence by selecting the "best"SR for each physical rehabilitation intervention and outcome. Discussion The findings of this overview are expected to determine the effectiveness and safety of physical rehabilitation interventions to improve neuromusculoskeletal function in adult and pediatric critically ill patients based on a wide selection of the best available evidence and to determine the knowledge gaps in this topic by mapping and assessing the methodological quality of published SRs. © 2023 Gutierrez-Arias et al.
Exertional Desaturation and Ambulatory Oxygen Therapy Requirements in People with Idiopathic Pulmonary Fibrosis. A Retrospective Study
(Revista de Investigacion e Innovacion en Ciencias de la Salud, Volume 7, Issue 12025 Article number e-v7n1a342, 2025) Soler, Tamara; Cabrera, Osvaldo; Gutierrez-Arias, Ruvistay; Lara, Francisca; Benavides, María Guacolda
Introduction. Exertional desaturation (ED) is common in advanced idiopathic pulmonary fibrosis (IPF) stages. Ambulatory O2 therapy could increase physical activity by preventing ED in people with IPF. Objective. This study aimed to assess ED and ambulatory O2 requirements in people with IPF using a protocol that involved up to four 6-minute walking tests (6MWT). Method. An observational study of a dynamic retrospective cohort from a high-complexity hospital was conducted. The ambulatory O2 requirement assessment protocol involves performing up to four 6MWT depending on ED. All participants performed the baseline test (no additional O2). If ED (SpO2 < 90%) was observed, up to three additional 6MWTs were performed with two, four, and six O2 liters/minute until ED was avoided. Results. Twenty-eight patients (16 female; mean age 73 years) were referred for assessment of ambulatory O2 requirements. Twenty-three (82%) had ED during baseline 6MWT. Twenty-two patients performed the 6MWT with two liters/minute of O2, ten performed a third 6MWT with four liters/minute of O2, and seven with six liters/minute of O2. The six participants who performed all four 6MWTs significantly increased their walking distance by 56.33 meters (SD 36.45) compared to the baseline (p = 0.001). Four of the seven patients (57.14%) who performed the last 6MWT had ED despite O2 supplementation. Conclusion. The prevalence of ED during baseline 6MWT was high. Some participants even experienced ED with six liters/minute of supplemental O2. Despite this, walking distance increased more than the learning effect. © 2025. María Cano University Foundation.
Exertional Desaturation and Ambulatory Oxygen Therapy Requirements in People with Idiopathic Pulmonary Fibrosis. A Retrospective Study
(Fundacion Universitaria Maria Cano, 0025) Soler, Tamara; Cabrera, Osvaldo; Gutierrez-Arias, Ruvistay; Lara, Francisca; Benavides, María Guacolda
Introduction. Exertional desaturation (ED) is common in advanced idiopathic pulmonary fibrosis (IPF) stages. Ambulatory O2 therapy could increase physical activity by preventing ED in people with IPF. Objective. This study aimed to assess ED and ambulatory O2 requirements in people with IPF using a protocol that involved up to four 6-minute walking tests (6MWT). Method. An observational study of a dynamic retrospective cohort from a high-complexity hospital was conducted. The ambulatory O2 requirement assessment protocol involves performing up to four 6MWT depending on ED. All participants performed the baseline test (no additional O2). If ED (SpO2 < 90%) was observed, up to three additional 6MWTs were performed with two, four, and six O2 liters/minute until ED was avoided. Results. Twenty-eight patients (16 female; mean age 73 years) were referred for assessment of ambulatory O2 requirements. Twenty-three (82%) had ED during baseline 6MWT. Twenty-two patients performed the 6MWT with two liters/minute of O2, ten performed a third 6MWT with four liters/minute of O2, and seven with six liters/minute of O2. The six participants who performed all four 6MWTs significantly increased their walking distance by 56.33 meters (SD 36.45) compared to the baseline (p = 0.001). Four of the seven patients (57.14%) who performed the last 6MWT had ED despite O2 supplementation. Conclusion. The prevalence of ED during baseline 6MWT was high. Some participants even experienced ED with six liters/minute of supplemental O2. Despite this, walking distance increased more than the learning effect. © 2025. María Cano University Foundation.
Myokine Secretion Dynamics and Their Role in Critically Ill Patients: A Scoping Review
(Multidisciplinary Digital Publishing Institute (MDPI), 0025) Jalil, Yorschua; Damiani, L. Felipe; García-Valdés, Patricio; Basoalto, Roque; Gallastegui, Julen; Gutierrez-Arias, Ruvistay
Background/Objectives: Myokines can modulate organ function and metabolism, offering a protective profile against ICU complications beyond preventing local muscle wasting. This scoping review aims to explore and summarize the evidence regarding the secretion of myokines and their potential local or systemic effects in critically ill patients. Methods: A scoping review following Joana Briggs Institute recommendations was conducted. A systematic search of MEDLINE (Ovid), Embase (Ovid), CENTRAL, CINAHL (EBSCOhost), WoS, and Scopus was conducted from inception to February 2023. We included primary studies evaluating myokine secretion/concentration in critically ill adults undergoing physical rehabilitation interventions. Two independent reviewers performed study selection and data extraction. Results: Seventeen studies published between 2012 and 2023 were included. Most were randomized clinical trials (47%). Physical rehabilitation interventions included electrical muscle stimulation, as well as passive and active mobilization, delivered alone or combined, in single or daily sessions lasting 20–60 min. Twelve studies (70%) evaluated interleukin-6, while interleukin-10, tumour necrosis factor-α, Interleukin-8, and myostatin were also commonly studied. Thirteen studies (76%) reported changes in myokine secretion or gene expression, although no clear concentration change pattern emerged. Myokines involved in muscle protein synthesis and breakdown may protect against muscle waste and weakness. Conclusions: The study of myokine dynamics in critically ill patients highlights the systemic impact of physical rehabilitation. This emerging field has grown in interest over the past decade, offering significant research potential. However, challenges such as study design, small sample sizes, and variability in physical therapy protocols hinder a comprehensive understanding of myokine responses. © 2025 by the authors.
Strategies used to manage overlap of primary study data by exercise-related overviews: protocol for a systematic methodological review
(BMJ Publishing Group, 2023-04) Gutierrez-Arias, Ruvistay; Pieper, Dawid; Lunny, Carole; Torres-Castro, Rodrigo; Aguilera-Eguía, Raúl; Seron, Pamela
Introduction One of the most conflicting methodological issues when conducting an overview is the overlap of primary studies across systematic reviews (SRs). Overlap in the pooled effect estimates across SRs may lead to overly precise effect estimates in the overview. SRs that focus on exercise-related interventions are often included in overviews aimed at grouping and determining the effectiveness of various interventions for managing specific health conditions. The aim of this systematic methodological review is to describe the strategies used by authors of overviews focusing on exercise-related interventions to manage the overlap of primary studies. Methods and analysis A comprehensive search strategy has been developed for different databases and their platforms. The databases to be consulted will be MEDLINE (Ovid), Embase (Ovid), The Cochrane Database of Systematic Reviews (Cochrane Library) and Epistemonikos. Two reviewers will independently screen the records identified through the search strategy and extract the information from the included overviews. The frequency and the type of overlap management strategies of the primary studies included in the SRs will be considered as the main outcome. In addition, the recognition of the lack of use of any overlap management strategy and the congruence between planning and conducting the overview focusing on overlap management strategies will be assessed. A subgroup analysis will be carried out according to the journal impact factor, year of publication and compliance with the Preferred Reporting Items for Overviews of Reviews statement. Ethics and dissemination This study will not involve human subjects and therefore does not require ethics committee approval. However, the conduct and reporting of the findings of this review will be conducted in a rigorous, systematic and transparent manner, which relates to research ethics. The findings of this review will be presented at scientific conferences and published as one or more studies in peer-review scientific journals related to rehabilitation or research methods. © 2023 Author(s). Published by BMJ.

Examinando por Autor "Gutierrez-Arias, Ruvistay"

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