Acta Colombiana de Cuidado Intensivo最新文献

{"title":"Índice musculoesquelético torácico como potencial predictor de mortalidad en los pacientes críticamente enfermos con obesidad: estudio piloto","authors":"Romina del Carmen Gutiérrez-Góngora ,&nbsp;Jessica Garduño-López ,&nbsp;Marcos Antonio Amezcua-Gutiérrez ,&nbsp;Agustín Rodríguez Blas ,&nbsp;Luis Gerardo Duque Florez ,&nbsp;Manuel Armando Molina Castañeda","doi":"10.1016/j.acci.2024.11.001","DOIUrl":"10.1016/j.acci.2024.11.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Sarcopenic obesity is characterized by decreased strength and low muscle mass and has been associated with increased disability and morbidity-mortality. This study aimed to evaluate low muscle mass as a potential independent predictor of mortality in critically ill patients. Measurement of muscle mass at the T12 level using the thoracic skeletal muscle index (SMI) was proposed as a diagnostic method. The objective was to determine the association between low SMI and mortality in critically ill obese patients in the intensive care unit (ICU).</div></div><div><h3>Materials and methods</h3><div>This was a pilot study involving obese adult patients admitted to the ICU over a five-month period. A specialist in imaging performed muscle area measurements at the T12 level using thoracic computed tomography to determine SMI, utilizing Carestream PACS software. Each patient's SMI was evaluated against various outcomes, including mortality, using the chi-square test and SPSS software.</div></div><div><h3>Results</h3><div>Thirteen patients were included, with a mean BMI of 34<!--> <!-->kg/m². All patients had low muscle mass, with an average SMI of 22<!--> <!-->cm²/m². Of these, 38.4% died during their ICU stay; however, no statistically significant relationship was found between mortality and low muscle mass.</div></div><div><h3>Conclusions</h3><div>Low muscle mass was observed in all obese patients admitted to the ICU. However, low SMI was found to have no relationship with mortality, ICU length of stay, duration of mechanical ventilation, kidney injury, or the need to renal replacement therapy. The frequency of sarcopenia was significantly higher in women. Due to the uniformity in low muscle mass identified in all patients, it was not possible to make comparisons between groups.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 235-242"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efectos de la oración de intercesión en pacientes críticos y terminales: revisión sistemática de la literatura","authors":"Diana Carolina Tovar Artunduaga ,&nbsp;Ledmar Jovanny Vargas Rodríguez ,&nbsp;Airam Luna Peña Castellanos ,&nbsp;Gustavo Ramos Sepulveda","doi":"10.1016/j.acci.2025.01.005","DOIUrl":"10.1016/j.acci.2025.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Intercessory prayer is understood has been shown to help through various psychological and biological changes that are actually or potentially associated with better health.</div></div><div><h3>Objective</h3><div>The objective of the study is to identify the effects of intercessory prayer in critical and terminal patients.</div></div><div><h3>Methodology</h3><div>A systematic review of the literature was carried out. The search for articles by 2<!--> <!-->researchers belonging to the project in the main databases. It was restricted to literature on humans, over 18 years of age, published in the last 15 (fifteen) years in Spanish and English. No breed or country restrictions were made.</div></div><div><h3>Results</h3><div>The 5<!--> <!-->studies were evaluated with PEDro, where the score varied between 8 to 10 points, thus indicating a score that determined them as high-quality studies. The studies included patients over 18 years of age with critical illnesses (in the intensive care unit) and terminal illnesses (oncology in radiotherapy or chemotherapy), finding that patients who received adjuvant management with this measure had better results in mortality, prognosis, requirement of mechanical ventilation and a lower rate of multiple organ dysfunction.</div></div><div><h3>Conclusions</h3><div>Intercessory prayer has different effects that favor the recovery of patients and improve the prognosis, which is why it can be recommended as an adjuvant therapy for patients with terminal illnesses or critically ill patients.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 270-276"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donación en asistolia controlada con el uso de perfusión regional normotérmica en membrana de circulación extracorpórea: experiencia en Colombia","authors":"Liz Maristella Niño Ramírez ,&nbsp;Julián Orlando Casallas Barrera ,&nbsp;Estefanía Giraldo Bejarano ,&nbsp;Iván Martín ,&nbsp;Mario Andrés Mercado Díaz ,&nbsp;Juan Fernando Parra Correa ,&nbsp;Claudia Marcela Poveda Henao","doi":"10.1016/j.acci.2024.12.003","DOIUrl":"10.1016/j.acci.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Controlled donation after circulatory death (cDCD) is a strategy for the procurement and preservation of organs in patients with catastrophic and irreversible conditions that do not progress to brain death. Normothermic regional perfusion (NRP) using ExtraCorporeal Membrane Oxygenation (ECMO) has demonstrated improved functionality of transplanted organs, especially in the context of normothermic abdominal perfusion (NAP-ECMO) and normothermic thoracoabdominal perfusion (NTAP-ECMO), as reported in North America and Europe. However, this technique had not been previously implemented in Colombia.</div></div><div><h3>Objective</h3><div>To describe one patient managed with NAP-ECMO and another with NTAP-ECMO as part of the initial experience with the implementation of the cDCD protocol in Colombia.</div></div><div><h3>Materials and methods</h3><div>A retrospective descriptive case report of two patients meeting the criteria for death by type III circulatory arrest (asystole) according to the Maastricht classification. In both cases, the diagnosis of a catastrophic and irreversible condition justified the application of end-of-life care (EOLC), followed by the investigational implementation of cDCD using NAP-ECMO for abdominal organ perfusion and NTA-ECMO for thoracoabdominal organ perfusion.</div></div><div><h3>Results</h3><div>Two donor patients were included: a 77-year-old man for the cDCD protocol with NAP-ECMO and a 79-year-old woman for the NTAP-ECMO protocol. In both cases, the cause of death was catastrophic stroke with poor functional and vital prognosis. Total ischemia time and functional ischemia time were 66<!--> <!-->minutes and 56<!--> <!-->minutes for NAP-ECMO and 24<!--> <!-->minutes and 22<!--> <!-->minutes for NTAP-ECMO, respectively. Preservation time was 173<!--> <!-->minutes in NAP-ECMO and 60<!--> <!-->minutes in NTAP-ECMO. In both cases, laboratory tests for organ function were optimal, and intraoperative visualization during organ procurement and biopsies confirmed adequate viability of the organs.</div></div><div><h3>Conclusions</h3><div>This report of two cases confirms that implementing cDCD is both feasible and viable in Colombia. A unified multidisciplinary protocol and an integrative approach combining legal, educational, and cultural aspects are essential to ensure dignified, humane, and high-quality care for donors, recipients, and their families.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 384-394"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terapia ventilatoria guiada con catéter esofágico en una cohorte de SDRA asociado a covid en pacientes con obesidad","authors":"David Yepes Gómez,&nbsp;Ana María Acosta Murcia,&nbsp;Jaisan Jesue Granados Glenn","doi":"10.1016/j.acci.2025.03.001","DOIUrl":"10.1016/j.acci.2025.03.001","url":null,"abstract":"<div><h3>Introduction</h3><div>The management of acute respiratory distress syndrome (ARDS) has evolved with the adoption of lung-protective strategies. However, accurate PEEP titration remains a challenge, particularly in patients with obesity. Measuring transpulmonary pressure through an esophageal catheter allows for a more individualized and objective PEEP adjustment. The aim of this study was to describe the clinical and ventilatory characteristics of a cohort of obese patients with covid-19-associated ARDS managed with mechanical ventilation guided by an esophageal catheter.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational cohort study was conducted at a tertiary care ICU in Medellín (Colombia) during the SARS-CoV-2 pandemic. Patients included had a diagnosis of ARDS based on the Berlin criteria, a body mass index (BMI) greater than 30, required invasive mechanical ventilation, and received esophageal catheter placement to guide PEEP titration. Patients without confirmed ARDS or who did not require the catheter were excluded. A univariate analysis of clinical, ventilatory, and outcome variables was performed.</div></div><div><h3>Results</h3><div>Eleven patients with severe ARDS and obesity (mean BMI 34.2) were analyzed. The average PEEP was 15.5<!--> <!-->cm H₂O, with sustained positive expiratory transpulmonary pressures. Mortality was 36.4%, lower than previously reported in similar series. All patients required neuromuscular blockade and prone positioning.</div></div><div><h3>Conclusion</h3><div>This study shows that the use of an esophageal catheter in obese patients with covid-19-associated ARDS may improve PEEP titration, potentially reducing mortality. Despite the limitations due to the small cohort size, these findings suggest that the esophageal catheter is a valuable tool for optimizing mechanical ventilation in patients with pulmonary alterations. Further studies with larger sample sizes are recommended to confirm these results and to explore the impact of this technique more thoroughly in clinical practice.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 301-306"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diseño y validación de criterios específicos para la evaluación de estándares de habilitación en la prestación de servicios de fisioterapia en unidades de cuidado intensivo adulto","authors":"Angela Vanessa Rodríguez ,&nbsp;Luz Deiby Jiménez ,&nbsp;Jhon Absalón Hernández Muñoz ,&nbsp;Esther Cecilia Wilches-Luna","doi":"10.1016/j.acci.2025.02.001","DOIUrl":"10.1016/j.acci.2025.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>To design and validate specific criteria for the evaluation of qualification standards in the provision of physiotherapy services in adult intensive care units.</div></div><div><h3>Method</h3><div>A descriptive and psychometric observational study was conducted that included the design and validation of the construct and content of indicators. A literature review and discussion were conducted with a panel of experts made up of intensive care physicians, nurses, physiotherapists with experience in critically ill patients, and health auditors with experience in ICUs.</div></div><div><h3>Results</h3><div>23 criteria were designed, distributed in six of the seven Enabling Standards (human talent, equipment, infrastructure, medications, priority processes and clinical history) with an overall content validity index of 94%, and a Kappa coefficient with ranges between 86.3% and 100%.</div></div><div><h3>Conclusion</h3><div>The designed instrument is highly relevant to assess the quality of the physiotherapy service in ICU and is a practical and useful tool for physiotherapists, ICU teams and health authorities, facilitating the objective assessment of quality, the identification of areas for improvement.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 283-294"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traqueostomía percutánea en cuidado intensivo: ¿cómo mejorar la seguridad del procedimiento?","authors":"Iván Pérez ,&nbsp;Camilo Pérez ,&nbsp;María-Camila Jiménez ,&nbsp;Oscar Leonardo Torra Barajas ,&nbsp;Johana Rendón ,&nbsp;Jorge-Iván Alvarado Sánchez ,&nbsp;Bladimir Alejandro Gil Valencia","doi":"10.1016/j.acci.2024.11.005","DOIUrl":"10.1016/j.acci.2024.11.005","url":null,"abstract":"<div><div>Percutaneous tracheostomy (PT) is a common procedure in intensive care unit (ICU) patients. This method offers certain benefits compared to the traditional surgical technique, such as a lower infection rate. However, it is essential to consider its contraindications and potential complications. As with any procedure, following a learning curve is important to reduce the risk of complications.</div><div>The use of ultrasound provides greater safety during PT by allowing the identification of anatomical structures and increasing the likelihood of a safe puncture, especially when performed in a protocolized manner. However, specific training is required to achieve adequate anatomical identification. The use of bronchoscopy is not routine and its role has become increasingly limited to patients with distorted anatomies.</div><div>In summary, PT is a safe technique when performed by experienced personnel in the ICU, provided that there is adequate training and careful patient selection. Therefore, its practice should be part of the curriculum in critical care and intensive care medicine training programs.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 307-317"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transporte terrestre pediátrico: revisión de la literatura y propuesta mnemotécnica. ¿Cómo optimizar los recursos?","authors":"Sara Vallejo ,&nbsp;Nicole Builes Arbélaez ,&nbsp;Natalia Osorio Cadavid ,&nbsp;Natalia Lopera Sánchez ,&nbsp;Juan Camilo Jaramillo Bustamante","doi":"10.1016/j.acci.2024.11.006","DOIUrl":"10.1016/j.acci.2024.11.006","url":null,"abstract":"<div><div>Pediatric ground transportation is an essential component of the emergency medical care system. It requires a collaborative effort between pre-hospital care services, receptor hospitals and coordinating centers in order to maximize human and material resources and provide similar care to an emergency department or intensive care unit. In low- and middle-income countries, such as some Latin American countries, ground transportation presents a greater challenge for various reasons such as the current absence of a national coordination system, the lack of protocolized practices, and the complex topographic conditions of some locations. Identifying and addressing the specific challenges associated with this type of transportation, along with the implementation of effective strategies, can improve outcomes and ensure greater quality of care. This article will review the specific challenges that are associated with pediatric ground transportation in Colombia. This will include discussion of transport from a lower to a higher level of complexity, a complete initial evaluation, patient stabilization and safe transportation until admission to the hospital. Finally, a mnemonic proposal is made to improve the quality when doing it.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 318-324"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balón de contrapulsación como terapia de estabilización arritmogénica: a propósito de un caso","authors":"Juan Santiago Serna-Trejos ,&nbsp;Carlos Andrés Castro-Galvis ,&nbsp;Adriana Estefanía Cristancho-Goyeneche ,&nbsp;Fabian Alejandro Cadena-Noguera ,&nbsp;Paula López-Garzón","doi":"10.1016/j.acci.2024.12.002","DOIUrl":"10.1016/j.acci.2024.12.002","url":null,"abstract":"<div><div>Intra-aortic balloon counterpulsation (IABP) remains a widely used device in selected cases, despite controversy about its impact on mortality in patients with cardiogenic shock secondary to acute myocardial infarction (AMI). This case highlights its clinical relevance in addressing arrhythmic storm as a critical complication. A 78-year-old man with AMI complicated by arrhythmic storm, complete atrioventricular block and severe hemodynamic instability refractory to pharmacological management was treated with IABP, achieving hemodynamic stability, resolution of metabolic acidosis and control of arrhythmias. No major device-related complications were documented. This report highlights the role of IABP in the stabilization of critically ill patients, providing evidence of its usefulness as a therapeutic bridge in complex scenarios, and underlines the importance of its application in selected situations where other interventions are insufficient.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 378-383"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cuidados críticos obstétricos en una ciudad de mediano tamaño con recursos limitados: estudio retrospectivo","authors":"Francisco Camargo-Assis ,&nbsp;Reginaldo Medrano Díaz ,&nbsp;Jorge Racedo ,&nbsp;Valentina Medina Hernández ,&nbsp;Alina Hernández Fabra","doi":"10.1016/j.acci.2024.11.004","DOIUrl":"10.1016/j.acci.2024.11.004","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess demographic and clinicopathological features of obstetric patients admitted to the ICU in middle sized city, to discern the challenges and needs in critical obstetric care within the country.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted at Clínica Materno Infantil Casa del Niño, encompassing all pregnant women admitted to the ICU from June 2014 to August 2018. We analyzed demographics, obstetric history, admission characteristics, and outcomes from electronic medical records. Logistic regression determined associations between admission characteristics and outcomes, including maternal mortality and ICU length of stay (LOS).</div></div><div><h3>Results</h3><div>Of 59.985 pregnant women, 0.52% (309) were admitted to the ICU. Predominant admission causes were hypertensive pregnancy disorders (80.5%) and pospartum hypovolemic shock (7.0%). The average maternal age was 25.4 years, with most admissions in the late preterm period. The ICU stay averaged 4.3 days, maternal mortality rate was 1.56%. Resource utilization included emergency cesarean delivery (83.6%), vasopressor therapy (21.0%), blood product requirement (16.73%), with some patients requiring mechanical ventilation and invasive monitoring.</div></div><div><h3>Conclusions</h3><div>The study report the obstetric care spectrum within ICU settings in a resource-limited environment, underscoring the necessity for improved antenatal care and enhanced response capacity within the ICU. The findings advocate for focused management strategies in critical care, implying healthcare policy reforms and practice changes in similar settings.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 252-260"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale for the use of ventricular assist devices in myocardial infarction: A narrative review","authors":"Juan Sanjuan ,&nbsp;Kevin Gómez ,&nbsp;Pamela Pabon ,&nbsp;Gustavo Adolfo Villegas-Gomez","doi":"10.1016/j.acci.2025.01.003","DOIUrl":"10.1016/j.acci.2025.01.003","url":null,"abstract":"<div><div>Cardiogenic shock (CS) complicates 5–10% of myocardial infarction (MI) cases and remains a significant challenge despite advances in pharmacologic and revascularization techniques. Ventricular assist devices (VADs) have emerged as critical tools to improve hemodynamic stability, reduce myocardial workload, and enhance survival outcomes in these patients.</div><div>This narrative review analyzed 61 studies from 2010 to 2024, focusing on the role of VADs in MI-related CS. Data were obtained from PubMed, Medline, and Cochrane Library, emphasizing device efficacy, complications, and clinical outcomes. Inclusion criteria targeted randomized trials, observational studies, and meta-analyses evaluating intra-aortic balloon pumps, Impella, TandemHeart, and ECMO.</div><div>VADs provide varying degrees of circulatory support, with Impella and TandemHeart outperforming intra-aortic balloon pumps in reducing myocardial workload. ECMO offers comprehensive support but carries higher risks of complications such as limb ischemia and infection. Early VAD deployment improves survival, particularly in patients with INTERMACS profiles 1 and 2. However, complications such as bleeding, thrombosis, and infection remain prevalent, requiring precise patient selection and timely intervention.</div><div>VADs represent an evolving paradigm in the management of MI complicated by CS. While their benefits are evident, challenges related to complications and high costs persist. Continued innovation in device design, patient stratification protocols, and therapeutic integration is essential to optimize outcomes.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 2","pages":"Pages 336-349"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}