Acta Colombiana de Cuidado Intensivo最新文献

{"title":"Estado hiperglucémico hiperosmolar: Enfoque práctico para el diagnóstico y tratamiento basado en guías","authors":"José Correa-Guerrero,&nbsp;Elguis Rodríguez Garizabalo,&nbsp;Jesús Bello Simanca,&nbsp;Hugo Corrales Santander,&nbsp;Francisco Camargo Assis,&nbsp;Luis Rodríguez Arrieta,&nbsp;Alejandro Castellano Pinedo,&nbsp;Carmelo Dueñas Castell","doi":"10.1016/j.acci.2026.100611","DOIUrl":"10.1016/j.acci.2026.100611","url":null,"abstract":"<div><div>Hyperosmolar hyperglycemic state is a severe metabolic complication characterized by marked hyperglycemia, dehydration, and elevated plasma osmolality, with high mortality, especially among older adults and patients with comorbidities. Optimal management includes carefully monitored fluid replacement, titrated insulin therapy, close electrolyte monitoring, and prevention of treatment-related complications. This review focuses on the evolution of diagnostic criteria and current therapeutic strategies based on international guidelines and consensus statements. A manual search was conducted on the official websites of the American Diabetes Association, the American Association of Clinical Endocrinologists, and the Joint British Diabetes Societies, complemented by databases such as PubMed/MEDLINE, Scopus, and ScienceDirect for related primary literature. Given the narrative nature of this review, no structured tool was used to formally assess the methodological quality of the included guidelines; instead, a qualitative appraisal was performed based on the consistency of the recommendations and their clinical applicability. This approach prioritized practical usefulness and conceptual comparison among consensus statements over an exhaustive methodological evaluation.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 3","pages":"Article 100611"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746254","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":"Capillary refill time as a predictor of mortality in cancer patients with sepsis-associated circulatory dysfunction: A prospective cohort study","authors":"María Fernanda García-Aguilera,&nbsp;Glenn Hernández,&nbsp;Matias Pozo,&nbsp;Emerita Basantes,&nbsp;Luis Unigarro,&nbsp;Pablo Llerena,&nbsp;Carlos Montenegro,&nbsp;Daina Brito,&nbsp;Jorge Jiménez,&nbsp;Gloria Aldean,&nbsp;Harold Alexander-León,&nbsp;Yunqi Yu Liu,&nbsp;Carlos Manterola,&nbsp;Victor Figueroa,&nbsp;Nayely García-Méndez,&nbsp;Tamara Otzen","doi":"10.1016/j.acci.2026.100618","DOIUrl":"10.1016/j.acci.2026.100618","url":null,"abstract":"<div><h3>Introduction</h3><div>Capillary refill time (CRT) is a simple clinical marker of peripheral perfusion that has been associated with adverse outcomes in critically ill patients. However, its prognostic value in cancer patients with sepsis-associated circulatory dysfunction has not been widely studied.</div></div><div><h3>Objective</h3><div>To evaluate capillary refill time as a predictor of mortality in cancer patients cancer patients with sepsis-associated circulatory dysfunction.</div></div><div><h3>Methods</h3><div>A prospective multicenter cohort study was conducted with 187 cancer patients with circulatory dysfunction admitted to two intensive care units in Quito, Ecuador, between June 2023 and June 2024. Capillary refill time and other perfusion parameters were measured at baseline and at 2, 6, and 24<!--> <!-->h after resuscitation. Survival analysis and receiver operating characteristic curves were used to assess the discriminative ability of perfusion variables.</div></div><div><h3>Results</h3><div>Capillary refill time was significantly higher in non-survivors across all measurements (<em>p</em> <!-->&lt;<!--> <!-->0.001). The capillary refill time measured at 6<!--> <!-->h presented the highest discriminative capacity, with an area under the curve of 0.750 (95% CI: 0.676–0.825). In multivariable Cox regression, capillary refill time ≥3.0<!--> <!-->s at 6<!--> <!-->h was independently associated with mortality (HR<!--> <!-->=<!--> <!-->2.15; 95% CI: 1.02–4.52; <em>p</em> <!-->=<!--> <!-->0.044).</div></div><div><h3>Conclusions</h3><div>Capillary refill time, particularly at 6<!--> <!-->h, is a useful predictor of mortality in cancer patients with sepsis-associated circulatory dysfunction. Its simplicity and low cost position it as a promising tool for clinical management in the intensive care unit.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 3","pages":"Article 100618"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746853","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":"SDRA severo inducido por vapeo, con requerimiento de ECMO VV. Un enfoque fisiopatológico. Reporte de Caso","authors":"Tatiana Patricia Buitrago-González,&nbsp;Luis Miguel Álvarez Silva,&nbsp;Juan Felipe Castaño Orozco","doi":"10.1016/j.acci.2026.100634","DOIUrl":"10.1016/j.acci.2026.100634","url":null,"abstract":"<div><div>Electronic vaping-associated lung injury (EVALI) is a clinical entity with nonspecific but potentially fatal manifestations. Electronic devices contain various irritating and toxic components that alter respiratory physiology. As a diagnosis of exclusion, it requires compatible pulmonary imaging and the absence of alternative etiologies. We report the case of a 31-year-old man with a history of e-cigarette use during the past year, who was admitted with dyspnea and fever. His condition progressed to severe ARDS, requiring short-term venovenous ECMO (VV-ECMO) support, with subsequent hospital discharge without complications. This case is analyzed to explore the pathophysiology, which is not yet fully understood, of ARDS secondary to these types</div><div>of devices.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 3","pages":"Article 100634"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746858","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":"Actualización en terapia médica nutricional del paciente críticamente enfermo: avances, desafíos y evidencia reciente","authors":"Nestor David Caicedo-Buitrago,&nbsp;Mateo Londoño-Pereira,&nbsp;Claudia Milena Ardila Melendez,&nbsp;Ricardo Merchán,&nbsp;Fernando Pereira-Paternina,&nbsp;Cristian Pinilla,&nbsp;Sonia Gamboa,&nbsp;Alejandra Cabral,&nbsp;Janeth Barbosa Barbosa,&nbsp;Maria del Pilar Morales,&nbsp;Bladimir Gil","doi":"10.1016/j.acci.2026.100612","DOIUrl":"10.1016/j.acci.2026.100612","url":null,"abstract":"<div><div>Medical nutrition therapy (MNT) in critically ill patients has evolved from a prescriptive approach based on population averages toward a progressive and individualized strategy grounded in the pathophysiology of metabolic stress, preservation of muscle mass, and functional outcomes. The aim of this review is to critically synthesize the most relevant and recent evidence on MNT in the ICU, focusing on five key topics: international clinical practice guidelines recommendations for nutrition in critically ill patients, protein dosing, refeeding syndrome, micronutrients, and precision nutrition. A review of clinical practice guidelines, randomized controlled trials, systematic reviews, and international consensus statements was conducted, prioritizing methodological quality and clinical applicability. Current evidence supports the early and progressive initiation of enteral nutrition, avoiding overfeeding during the acute phase and reserving parenteral nutrition for selected situations. Contemporary trials have not demonstrated consistent clinical benefits with high protein doses, questioning their universal use. Refeeding syndrome remains a frequent and preventable complication that requires early identification and conservative management strategies. Micronutrient deficiencies are common, although routine empirical supplementation is not supported by the evidence, favoring targeted replacement instead. Finally, precision nutrition, supported by biomarkers, metabolic monitoring, and artificial intelligence, emerges as a promising strategy to personalize MNT. Overall, current evidence supports early, cautious, and individualized MNT aimed at metabolic safety and patient-centered outcomes in critically ill patients.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 3","pages":"Article 100612"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746857","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":"Ecografía pulmonar y diafragmática en el destete ventilatorio: fundamentos fisiológicos, evidencia clínica y aplicaciones en cuidados intensivos","authors":"Luis Alexander Peña-López,&nbsp;Henry Mauricio Parada-Gereda,&nbsp;María Angelica Rodríguez-Scarpetta,&nbsp;Jorge Enrique Daza-Arana,&nbsp;Leonardo Arzayus-Patiño,&nbsp;Wilson Mauricio Lozano-Franco,&nbsp;Oscar Humberto Ruiz-Serna,&nbsp;Esther Cecília Wilches-Luna,&nbsp;Nicolas Arancibia-Ramirez","doi":"10.1016/j.acci.2026.100632","DOIUrl":"10.1016/j.acci.2026.100632","url":null,"abstract":"<div><div>Ventilator weaning represents a critical phase in the care of critically ill adult patients, and its failure is associated with higher reintubation rates, prolonged intensive care unit (ICU) stay, and increased mortality. In this context, respiratory ultrasound has emerged as a non-invasive and reproducible tool that provides functional information complementary to traditional weaning predictors.</div><div>This manuscript presents a narrative review integrating physiological foundations, diagnostic accuracy evidence, and clinically relevant studies on the use of diaphragmatic and lung ultrasound during the ventilator weaning process. The synthesised evidence suggests that parameters such as diaphragmatic excursion and thickening fraction are associated with clinically useful diagnostic performance in anticipating weaning and extubation success, particularly when interpreted according to the ventilatory context and timing of measurement. Complementarily, lung ultrasound and the Lung Ultrasound Score (LUS <em>score</em>) allow quantification of aeration loss and identification of dynamic deterioration during spontaneous breathing trials, facilitating the recognition of patients at higher risk of post-extubation failure.</div><div>Overall, the combined ultrasound assessment of the respiratory pump and lung aeration supports a physiologically guided approach to weaning, focused on risk stratification and individualisation of respiratory support. Finally, a conceptual integrative framework is presented to support clinical decision-making, while acknowledging current limitations and the need for future standardisation.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 3","pages":"Article 100632"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746257","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":"Balance hídrico acumulado en pacientes pediátricos hospitalizados con dengue","authors":"Juan Diego Galindo Dávila,&nbsp;Daniela Fernanda Salamanca Muñoz,&nbsp;Iván José Ardila Gómez,&nbsp;Doris Martha Salgado García","doi":"10.1016/j.acci.2026.100619","DOIUrl":"10.1016/j.acci.2026.100619","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Dengue infection presents a wide clinical spectrum, and fluid management plays a key role in preventing progression to shock. However, fluid overload may lead to adverse clinical outcomes. The aim of this study was to analyze the association between cumulative fluid balance within the first 48<!--> <!-->hours and clinical outcomes in pediatric patients hospitalized with dengue.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted in two tertiary care institutions in southern Colombia between April and December 2023. Patients aged 1 month to 18 years with confirmed dengue were included. Cumulative fluid balance was classified into three categories: &lt;<!--> <!-->5%, 5–7%, and<!--> <!-->&gt;7%. Clinical outcomes evaluated included hospital length of stay, intensive care unit (ICU) stay, and presence of shock.</div></div><div><h3>Results</h3><div>A total of 104 patients were included. A longer hospital stay was observed in patients with a fluid balance of 5–7% (median 6 days, IQR 5–8) compared to those with &lt;<!--> <!-->5% (median 4 days, IQR 3–5) (p<!--> <!-->=<!--> <!-->0.004). The presence of shock was more frequent in patients with fluid balance<!--> <!-->&gt;5% (100% vs 76%, p<!--> <!-->=<!--> <!-->0.013). No significant differences were found in ICU length of stay or other complications.</div></div><div><h3>Conclusions</h3><div>A cumulative fluid balance greater than 5% is associated with longer hospital stay and higher frequency of shock in pediatric patients with dengue, highlighting the importance of careful fluid management in this population.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 3","pages":"Article 100619"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746854","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":"Ecografía versus palpación: eficacia y complicaciones en accesos vasculares en unidades de cuidados intensivos","authors":"Jose Daniel Hurtado Sevillano,&nbsp;Jessica Tatiana Grajales Bedoya,&nbsp;Wilmar Chavez Hurtado,&nbsp;Alcira Escobar,&nbsp;Gabriela Arturo","doi":"10.1016/j.acci.2026.100635","DOIUrl":"10.1016/j.acci.2026.100635","url":null,"abstract":"<div><h3>Introduction</h3><div>Vascular cannulation is a fundamental procedure in nursing practice, especially in the context of Intensive Care Units (ICUs). However, when performed using conventional techniques, it can be associated with clinically relevant complications. In this context, ultrasound (US) emerges as a tool that strengthens the safety, effectiveness, and quality of care in critically ill patients.</div></div><div><h3>Objective</h3><div>To analyze the effectiveness and complications of US-guided vascular cannulation compared to the palpation technique, performed by nursing professionals in adult patients hospitalized in ICUs.</div></div><div><h3>Materials and methods</h3><div>An integrative review was conducted following the PRISMA guidelines and Ganong's methodology. The search included studies published between 2019 and 2025 in PubMed, Scopus, ScienceDirect, LILACS, and ProQuest; in English, Spanish, and Portuguese. The PICOT strategy was applied, and methodological quality was assessed using the Joanna Briggs Institute (JBI) checklists.</div></div><div><h3>Results</h3><div>Based on the applied selection criteria, seven studies involving nursing professionals were included. The studies showed that ultrasound-guided cannulation had higher first-attempt success rates, fewer failed attempts, and a lower frequency of complications such as phlebitis, hematomas, and infections, especially in patients with difficult venous access (DVA).</div></div><div><h3>Conclusions</h3><div>Ultrasound-guided vascular cannulation, led by nurses in the ICU, is an effective and safe intervention that optimizes clinical outcomes, strengthens the professional role for advanced clinical competence, improves the experience of critically ill patients, and contributes to the optimization of resources with a positive environmental impact.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 3","pages":"Article 100635"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746258","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":"Eficacia y seguridad del uso de esteroides en pacientes críticamente enfermos con intubación orotraqueal mayor a 48 horas y prueba de fuga fallida como método objetivo de evaluación, revisión sistemática y metaanálisis","authors":"Diana Lizeth Cabrera Rojas ,&nbsp;Oscar Julio Osorio Becerra ,&nbsp;Marco Antonio González Agudelo ,&nbsp;Jorge Hernando Donado Gómez","doi":"10.1016/j.acci.2025.100584","DOIUrl":"10.1016/j.acci.2025.100584","url":null,"abstract":"<div><h3>Introduction</h3><div>Orotracheal intubation for more than 48<!--> <!-->hours increases the risk of stridor and reintubation; therefore, objective risk assessment and the use of corticosteroids may help reduce these complications.</div></div><div><h3>Objective</h3><div>To determine the efficacy and safety of corticosteroids versus placebo or no corticosteroids in critically ill patients intubated for more than 48<!--> <!-->hours and identified as high risk through a failed cuff leak test.</div></div><div><h3>Methods</h3><div>We included only randomized controlled trials that met the specified criteria, with no restrictions on publication date or language. Search was conducted in PubMed, Embase, Cochrane, and Google Scholar. Study selection was based on a thorough evaluation of inclusion and exclusion criteria. Data extraction was performed using a standardized form, and risk of bias was assessed using the Cochrane RoB tool. Dichotomous outcomes were analyzed using odds ratios. Primary analysis was conducted using a random-effects model, and secondary analysis using a fixed-effects model. Certainty of evidence was assessed using the GRADE approach.</div></div><div><h3>Results</h3><div>Five studies including a total of 412 patients were analyzed. Corticosteroid use reduced the risk of stridor (OR 0.25; 95% CI: 0.15–0.43; p &lt;<!--> <!-->0.00001) and post-extubation reintubation (OR 0.27; 95% CI: 0.13–0.58; p &lt;<!--> <!-->0.0007) by 75% and 73%, respectively. No objective data was available regarding safety outcomes.</div></div><div><h3>Conclusion</h3><div>The use of corticosteroids is effective in reducing post-extubation stridor and reintubation in critically ill patients intubated for more than 48<!--> <!-->hours and at high risk of these complications.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 2","pages":"Article 100584"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247312","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":"The first critical care Datathon in Colombia: A collaborative learning and innovation experience","authors":"Edith Elianna Rodríguez ,&nbsp;Javier Camacho ,&nbsp;María del Pilar Arias ,&nbsp;Juan Sebastián Osorio Valencia ,&nbsp;Ledys Izquierdo ,&nbsp;Leonardo Andrés Gómez Cortés ,&nbsp;Mónica Rojas ,&nbsp;David René Rodríguez Lima ,&nbsp;Melisa Pérez ,&nbsp;Juan Morales ,&nbsp;Johana Hurtado ,&nbsp;Amanda Quintairos ,&nbsp;Cesar Enciso ,&nbsp;Ever Leonardo Rojas-Díaz","doi":"10.1016/j.acci.2026.100594","DOIUrl":"10.1016/j.acci.2026.100594","url":null,"abstract":"<div><h3>Introduction</h3><div>Datathons are collaborative learning events that promote interdisciplinary engagement with data. In healthcare, they provide a unique opportunity for clinicians and data scientists to jointly address complex clinical problems using real-world datasets. In Colombia, while Datathons have been organized in areas such as public health and other healthcare domains, this was, to our knowledge, the first Datathon focused specifically on critical care.</div></div><div><h3>Methods</h3><div>We conducted an observational, semi-quantitative study involving all participants of the first Critical Care Datathon in Colombia, held during the national intensive care congress. Participants evaluated the Datathon experience using a validated Likert-scale survey assessing learning domains such as teamwork, data management, and machine learning application. Descriptive and comparative statistics were conducted using R software.</div></div><div><h3>Results</h3><div>The Datathon brought together 26 participants from more than 10 institutions across Colombia. Twenty-three participants completed the survey, representing a range of disciplines including medicine, therapy, pharmacy, engineering, and data science. Most participants worked in clinical settings, though only 4% reported full-time data roles. Participants tackled predictive challenges using anonymized ICU datasets, with many employing machine learning techniques. Likert scores indicated high perceived knowledge acquisition in interdisciplinary teamwork, data analysis, and research methods. Prior data experience correlated with significantly higher self-perceived knowledge in communication of ideas, medical data analysis, research methods and data security (<em>p</em> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Conclusions</h3><div>The first critical care Datathon in Colombia demonstrated the feasibility and educational value of interdisciplinary collaboration in health data science. Participants reported significant perceived gains in analytical skills and teamwork competencies. Datathons offer a scalable model for improving data literacy among health professionals and fostering innovation in clinical care.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 2","pages":"Article 100594"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247248","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":"Insulinas de acción rápida como sustituto de la insulina cristalina. ¿Realmente es una alternativa en críticos? Revisión de la literatura","authors":"Tatiana Patricia Buitrago-González ,&nbsp;Daniel Martin Arsanios ,&nbsp;Jhon Jairo Peralta Franco","doi":"10.1016/j.acci.2026.100592","DOIUrl":"10.1016/j.acci.2026.100592","url":null,"abstract":"<div><div>Colombia is currently facing a shortage of essential medicines, including crystalline insulin, a cornerstone of treatment for critically ill patients. In response to this crisis, strategies based on the use of rapid-acting analogs administered intravenously have emerged; however, these recommendations are largely based on expert opinion and lack robust evidence. This literature review aims to evaluate whether the use of rapid-acting analogs represents a safe and effective alternative to addressing the shortage of regular insulin in critically ill patients.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 2","pages":"Article 100592"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247505","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}