The work has been published in the journal Critical Care due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position 4/35, thus managing to position itself as a Q1 (Primer Cuartil), in the category Critical Care Medicine. Notably, the journal is positioned above the 90th percentile.

This publication has been distinguished as a “Highly Cited Paper” by the agencies WoS (ESI, Clarivate) and ESI (Clarivate), meaning that it ranks within the top 1% of the most cited articles in its thematic field during the year of its publication. In terms of the observed impact of the contribution, this work is considered one of the most influential worldwide, as it is recognized as highly cited. (source consulted: ESI Nov 14, 2024)

And this is evidenced by the extremely high normalized impacts through some of the main indicators of this type, which, although dynamic over time and dependent on the set of average global citations at the time of calculation, already indicate that they are well above the average in different agencies:

• Normalization of citations relative to the expected citation rate (ESI) by the Clarivate agency: 6.93 (source consulted: ESI Nov 14, 2024)
• Field Citation Ratio (FCR) from Dimensions: 64.5 (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-24, the following number of citations:

• WoS: 109
• Europe PMC: 83
• Open Alex: 179

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-24:

• The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 274.
• The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 274 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

• The Total Score from Altmetric: 100.45.
• The number of mentions on the social network Facebook: 1 (Altmetric).
• The number of mentions on the social network X (formerly Twitter): 130 (Altmetric).
• The number of mentions in news outlets: 2 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

• The work has been submitted to a journal whose editorial policy allows open Open Access publication.

This work has been carried out with international collaboration, specifically with researchers from: Canada; France.