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Dive into the research topics where Ramiro Manzano-Nunez is active.

Publication


Featured researches published by Ramiro Manzano-Nunez.


World Journal of Emergency Surgery | 2018

Raising concerns about the Sepsis-3 definitions

Massimo Sartelli; Yoram Kluger; Luca Ansaloni; Timothy Craig Hardcastle; Jordi Rello; Richard R. Watkins; Matteo Bassetti; Eleni Giamarellou; Federico Coccolini; Fikri M. Abu-Zidan; Abdulrashid K. Adesunkanmi; Goran Augustin; Gian Luca Baiocchi; Miklosh Bala; Oussema Baraket; Marcelo A. Beltrán; Asri Che Jusoh; Zaza Demetrashvili; Belinda De Simone; Hamilton Petry de Souza; Yunfeng Cui; R. Justin Davies; Sameer Dhingra; Jose J. Diaz; Salomone Di Saverio; Agron Dogjani; Mutasim M. Elmangory; Mushira Abdulaziz Enani; Paula Ferrada; Gustavo Pereira Fraga

The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.


European Journal of Trauma and Emergency Surgery | 2018

Expanding the field of acute care surgery: a systematic review of the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in cases of morbidly adherent placenta

Ramiro Manzano-Nunez; M. F. Escobar-Vidarte; Maria Paula Naranjo; F. Rodriguez; Paula Ferrada; J. D. Casallas; Carlos A. Ordoñez

PurposeProphylactic placement of endovascular balloon occlusion catheters has grown to be part of the surgical plans to control intraoperative hemorrhage in cases of abnormal placentation. We performed a systematic literature review to investigate the safety and effectiveness of the use of REBOA during cesarean delivery in pregnant woman with morbidly adherent placenta.MethodsA systematic review was performed. Relevant case reports and nonrandomized studies were identified by the literature search in MEDLINE. We included studies involving pregnant woman with diagnosis of abnormal placentation who underwent cesarean delivery with REBOA placed for hemorrhage control. MINORS’ criteria were used to evaluate the risk of bias of included studies. A formal meta-analysis was not performed.ResultsEight studies were included in cumulative results. These studies included a total of 392 patients. Overall, REBOA was deployed in 336 patients. Six studies reported the use of REBOA as an adjunct for prophylactic hemorrhage control in pregnant woman with diagnosis of morbidly adherent placenta undergoing elective cesarean delivery. In two studies, REBOA was deployed in patients already in established hemorrhagic shock at the moment of cesarean delivery. REBOA was deployed primarily by interventional radiologists; however, one study reported a surgeon as the REBOA provider. The results from our qualitative synthesis indicate that the use of REBOA during cesarean delivery resulted in less blood loss with a low rate complications occurrence.ConclusionREBOA is a feasible, safe, and effective means of prophylactic and remedial hemorrhage control in pregnant women with abnormal placentation undergoing cesarean delivery.


European Journal of Trauma and Emergency Surgery | 2018

Could resuscitative endovascular balloon occlusion of the aorta improve survival among severely injured patients with post-intubation hypotension?

Ramiro Manzano-Nunez; Juan P. Herrera-Escobar; Joseph DuBose; Tal M. Hörer; Samuel M. Galvagno; Claudia P. Orlas; Michael W. Parra; Federico Coccolini; Massimo Sartelli; Juan Camilo Falla-Martinez; Alberto García; Julian Chica; Maria Paula Naranjo; Alvaro I. Sanchez; Camilo Salazar; Luis Eduardo Calderón-Tapia; Valeria Lopez-Castilla; Paula Ferrada; Ernest E. Moore; Carlos A. Ordoñez

Current literature shows the association of post-intubation hypotension and increased odds of mortality in critically ill non-trauma and trauma populations. However, there is a lack of research on potential interventions that can prevent or ameliorate the consequences of endotracheal intubation and thus improve the prognosis of trauma patients with post-intubation hypotension. This review paper hypothesizes that the deployment of REBOA among trauma patients with PIH, by its physiologic effects, will reduce the odds of mortality in this population. The objective of this paper is to review the current literature on REBOA and post-intubation hypotension, and, furthermore, to provide a rational hypothesis on the potential role of REBOA in severely injured patients with post-intubation hypotension.


World Journal of Emergency Surgery | 2017

Safety and effectiveness of propranolol in severely burned patients: systematic review and meta-analysis

Ramiro Manzano-Nunez; Herney Andrés García-Perdomo; Paula Ferrada; Carlos Alberto Ordoñez Delgado; Diego Andrés Gómez; Jorge Esteban Foianini

BackgroundThe objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant outcomes in severely burned patients (TBSA >20%).MethodsRelevant articles from randomized controlled trials were identified by a literature search in MEDLINE, EMBASE, and CENTRAL. We included trials involving patients with a severe burn (>20% of total body surface area affected). Trials were eligible if they evaluated propranolol and compared to usual care or placebo. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for the final analysis. We conducted a meta-analysis using a random-effects model.ResultsWe included ten studies in our systematic review. These studies randomized a total of 1236 participants. There were no significant differences between propranolol and placebo with respect to mortality (RD −0.02 [95% CI −0.06 to 0.02]), sepsis (RD −0.03 [95% CI −0.09 to 0.04]), and the overall hospital stay (MD −0.37 [−4.52 to 3.78]). Propranolol-treated adults had a decrease in requirements of blood transfusions (MD −185.64 [95% CI −331.06 to −40.43]) and a decreased heart rate (MD −26.85 [95% CI −39.95 to −13.75]).ConclusionsOur analysis indicates that there were no differences in mortality or sepsis in severely burned patients treated with propranolol compared with those who had usual care or placebo. However, the use of propranolol in these patients resulted in lower requirements of blood transfusion and lower values of heart rate. The evidence synthesized in this systematic review is limited to conclude that propranolol reduces the length of hospital stay among severely burned patients. Future trials should assess the impact of propranolol on clinically relevant outcomes such as mortality and adverse events.


Urological Science | 2018

Interventional management of low-flow priapism: A protocol proposal

Herney Andrés García-Perdomo; Diego Gómez-Puerto; James Zapata-Copete; Ramiro Manzano-Nunez

Priapism is an involuntary prolonged erection that lasts for more than 4 h. Although several interventions have been proposed to manage the condition, these strategies are based on expert panel opinions, and little evidence exists regarding prognosis and outcomes. To synthetize information about interventions to treat priapism and to make evidence-based recommendations, we performed a literature search of Medline via Ovid, Scopus (including Embase) and Lilacs from 1980 to the current day with the following keywords: ischemic priapism, erectile function, drainage, and shunt. The length of the ischemic priapism is an important variable for the prognosis because of the pathophysiology of this condition. Here, we propose a step-by-step approach based on the time and invasiveness of the intervention. However, it is important to note that we could not find any clinical trial that supports this approach, and more research is needed for the future statements.


Colombian Journal of Anesthesiology | 2017

Current use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in trauma

Carlos A. Ordoñez; Ramiro Manzano-Nunez; Ana Milena del Valle; Fernando Rodriguez; Paola Burbano; Maria Paula Naranjo; Michael W. Parra; Paula Ferrada; Mónica Alejandra Solís-Velasco; Alberto García


Revista Colombiana de Anestesiología | 2017

Uso actual del balón de resucitación aórtico endovascular (REBOA) en trauma

Carlos A. Ordoñez; Ramiro Manzano-Nunez; Ana Milena del Valle; Fernando Rodriguez; Paola Burbano; Maria Paula Naranjo; Michael W. Parra; Paula Ferrada; Mónica Alejandra Solís-Velasco; Alberto García


Journal of Trauma-injury Infection and Critical Care | 2018

Prophylactic use of Resuscitative Endovascular Balloon Occlusion of the Aorta in women with abnormal placentation: A Systematic Review, Meta-Analysis and Case Series

Carlos A. Ordoñez; Ramiro Manzano-Nunez; Michael W. Parra; Todd E. Rasmussen; Albaro J. Nieto; Juan P. Herrera-Escobar; Paula Andrea Fernández; Maria Paula Naranjo; Alberto García; Javier Andrés Carvajal; Juan Manuel Burgos; Fernando Rodriguez; Maria F. Escobar-Vidarte


World Journal of Emergency Surgery | 2018

Casualties of peace: an analysis of casualties admitted to the intensive care unit during the negotiation of the comprehensive Colombian process of peace

Carlos A. Ordoñez; Ramiro Manzano-Nunez; Maria Paula Naranjo; Esteban Foianini; Cecibel Cevallos; Maria Alejandra Londoño; Alvaro I. Sanchez Ortiz; Alberto García; Ernest E. Moore


World Journal of Emergency Surgery | 2018

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

Nicola de’Angelis; Salomone Di Saverio; Osvaldo Chiara; Massimo Sartelli; Aleix Martínez-Pérez; Franca Patrizi; Dieter G. Weber; Luca Ansaloni; Walter L. Biffl; Offir Ben-Ishay; Miklosh Bala; Francesco Brunetti; Federica Gaiani; Solafah Abdalla; A Amiot; Hany Bahouth; Giorgio Bianchi; Daniel Casanova; Federico Coccolini; Raul Coimbra; Gian Luigi de’Angelis; Belinda De Simone; Gustavo Pereira Fraga; Pietro Genova; Rao R. Ivatury; Jeffry L. Kashuk; Andrew W. Kirkpatrick; Yann Le baleur; Fernando Machado; Gustavo M. Machain

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Michael W. Parra

Nova Southeastern University

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Paula Ferrada

Virginia Commonwealth University

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