Acta Colombiana de Cuidado Intensivo最新文献

{"title":"Recursos para el cuidado neurocrítico en Colombia: percepción por profesionales al cuidado de los pacientes críticamente enfermos","authors":"Camilo Andrés Romero ,&nbsp;Juan Sebastián Castañeda-Medina ,&nbsp;Jorge Carrizosa ,&nbsp;Lina María Ordoñez-Velasco ,&nbsp;Sebastián Vásquez-García","doi":"10.1016/j.acci.2026.100587","DOIUrl":"10.1016/j.acci.2026.100587","url":null,"abstract":"<div><h3>Introduction/objective</h3><div>Neurocritical care (NCC) is a rapidly growing subspecialty focused on the care of critically ill neurological patients. Despite the ongoing development of this discipline, particularly in high-income countries, there is limited information in Colombia describing the resources available for NCC in critical care units. The objective of this study was to describe the perceptions of professionals responsible for the care of critically ill patients in Colombia regarding the resources available for NCC in the units where they practice.</div></div><div><h3>Methods</h3><div>A prospective, descriptive, cross-sectional observational study using a self-administered online survey with 18 categorical and perceptual questions about NCC resources in critical care units. The study included demographics, medical specialty, years of clinical practice, NCC training, perceptions of NCC in their institution, NCC resources in their institution, and general perceptions of NCC in Colombia. Two questions addressing death due to neurological criteria were included.</div></div><div><h3>Results</h3><div>A total of 122 respondents were obtained, 70% men, 67% intensivists with a mean experience of 12.5 years. Ninety-three percent reported training in NCC, and 7% had a NCC subspecialty. Two-thirds assigned a score of 7 or higher out of 10 for the technological capacity and training of their units’ human resources. Fifty-four percent reported not having a neuro-intensivist. Eighty-six percent had at least one clinical guideline for NCC. The most frequently available guidelines were subarachnoid haemorrhage, acute cerebral infarction, traumatic brain injury, and status epilepticus. Ninety-nine percent of respondents used at least one assessment method for the evaluation and monitoring of patients in NCC. The most used methods were clinical examination, neurological assessment scales, and intracranial pressure monitoring. Ninety-nine percent had at least one neuromonitoring technology in their institution for neurologically critical patients. The most frequently available neuromonitoring technologies were lumbar puncture, neuroimaging, and transcranial Doppler. Ninety-six percent of respondents believe that NCC should be developed in Colombia, and 84% consider telemedicine useful for NCC. Ninety percent determine death due to neurological criteria in their practice, and 81% report confidence in its performance.</div></div><div><h3>Conclusion</h3><div>The survey reveals variability in the availability of resources for NCC, with challenges and opportunities for its development in Colombia. Addressing gaps in education, optimizing multimodal neuromonitoring resources, expanding the number of NCC units, implementing NCC guidelines, standardizing the determination of death by neurological criteria, and expanding telemedicine are essential for improving NCC in the country.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 2","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247315","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":"Experiencia de la práctica de enfermería utilizando una herramienta de inteligencia artificial de reconocimiento de voz","authors":"Mario Andrés Narváez-Martínez ,&nbsp;Sarah Galvis-Tovar ,&nbsp;Andrea Rosas-Santana ,&nbsp;Henry Hernández-Lozano","doi":"10.1016/j.acci.2026.100593","DOIUrl":"10.1016/j.acci.2026.100593","url":null,"abstract":"<div><h3>Objective</h3><div>To describe a clinical experience in nursing practice using a voice recognition artificial intelligence tool.</div></div><div><h3>Method</h3><div>A hospital management initiative based on observation and description of a clinical nursing practice experience focused on the use of a voice recognition-based artificial intelligence tool, applied in an intensive care unit at Fundación Cardioinfantil - LaCardio. This experience contrasts 2 clinical documentation practices: one performed using Dragon Medical One software and the other through traditional transcription.</div></div><div><h3>Results</h3><div>A 15-min reduction was observed in the nurse who used the voice recognition tool for nursing documentation compared to the one who documented using traditional methods. The quality of nursing records was excellent; both groups avoided the use of acronyms or abbreviations, were timely, and adhered to the SAER technique –Situation, Background, Assessment, Recommendations, and Risks–. A distinctive factor in the voice-generated notes was that 77.78% required editing to ensure transcription accuracy.</div></div><div><h3>Conclusions</h3><div>The use of the Dragon Medical One voice recognition system reduced nursing documentation time by 50% compared to traditional typing. Dictated notes were more detailed and met the standards of the SAER model, enhancing the quality and continuity of care.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 2","pages":"Article 100593"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247247","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":"Artificial intelligence for pain monitoring in intensive care units: A scoping review of current applications and challenges","authors":"Roaa Alkahazraji","doi":"10.1016/j.acci.2026.100609","DOIUrl":"10.1016/j.acci.2026.100609","url":null,"abstract":"<div><h3>Background</h3><div>Assessing pain in critically ill patients is challenging because traditional methods often lack objectivity and consistency, which can lead to suboptimal pain management. Artificial intelligence (AI) has emerged as a potential complementary tool to assist healthcare providers in monitoring and predicting pain in intensive care units (ICUs). This scoping review aims to map and summarize current applications of AI for pain monitoring in ICU patients, identify methodological approaches, and highlight evidence gaps.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using several medical and technical databases, including PubMed, IEEE Xplore, CINAHL, and Web of Science, along with Google Scholar for supplementary searches. Studies published between 2016 and 2025 that examined AI-based methods for pain assessment in ICU patients were included. Data on study design, AI techniques, measured outcomes, and clinical context were extracted. Risk of bias was assessed descriptively. Meta-analysis was not performed due to variability between studies.</div></div><div><h3>Results</h3><div>Twenty-eight studies were included, involving real ICU patients and simulated data. AI tools ranged from facial expression analysis and physiological signal monitoring to wearable sensor systems. AI models generally improved pain detection accuracy, but there is little evidence on their impact on patient outcomes or clinical workflows. Differences in study design, pain types, and ICU settings prevented quantitative synthesis.</div></div><div><h3>Conclusions</h3><div>Artificial intelligence shows promise as a complementary tool for monitoring pain in critically ill patients. Current evidence is preliminary, and further research is needed to evaluate the clinical benefits and practical integration of AI in ICU practice.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 2","pages":"Article 100609"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247316","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":"Impacto del manejo respiratorio en el abdomen abierto en los pacientes críticos: revisión de alcance","authors":"Christian Mora-Coello ,&nbsp;Daniel Torres-Carpio","doi":"10.1016/j.acci.2026.100608","DOIUrl":"10.1016/j.acci.2026.100608","url":null,"abstract":"<div><h3>Background</h3><div>The open abdomen (OA) technique is frequently used in trauma, sepsis, and abdominal compartment syndrome (ACS). However, the respiratory impact of OA —particularly its relationship with intra-abdominal pressure (IAP), mechanical ventilation strategies, and pulmonary complications— remains insufficiently defined. This scoping review aimed to summarize current evidence on respiratory complications and ventilatory management in critically ill patients with OA.</div></div><div><h3>Methods</h3><div>A scoping review following PRISMA-ScR guidelines was conducted using PubMed, Web of Science, and Scopus (2010–2024). Studies involving adult ICU patients with OA and reporting respiratory outcomes or ventilatory strategies were included. Data were synthesized narratively, tabulated, and complemented with bibliometric mapping.</div></div><div><h3>Results</h3><div>Of 479 studies identified, 5 met inclusion criteria. The most frequent respiratory complications were acute respiratory distress syndrome (ARDS), ventilator-associated pneumonia (VAP), and reduced pulmonary compliance in the context of elevated IAP. Ventilatory strategies varied, but lung-protective ventilation and individualized PEEP titration based on IAP were consistently recommended. Evidence suggests that selected OA patients may be extubated prior to fascial closure.</div></div><div><h3>Conclusions</h3><div>This scoping review identified limited evidence suggest that OA affects respiratory mechanics, particularly pulmonary compliance and airway pressures in the context of elevated IAP. The scarcity of available evidence prevents the establishment of formal ventilatory recommendations. Important knowledge gaps are identified in: standardized ventilation targets, criteria for early extubation, and respiratory considerations in the timing of abdominal closure.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 2","pages":"Article 100608"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247274","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":"Utilización del índice biespectral (BIS®) en pacientes adultos bajo sedación profunda con ventilación mecánica en las unidades de cuidados intensivos","authors":"Álvaro Luis Ochoa Solana ,&nbsp;Juan José Molina Acosta ,&nbsp;Francisco José Molina Saldarriaga","doi":"10.1016/j.acci.2025.10.002","DOIUrl":"10.1016/j.acci.2025.10.002","url":null,"abstract":"<div><div>The prevalence of deep sedation levels varies between 35 and 68% in adult patients with mechanical ventilation, which is associated with multiple complications, increased hospital stay and increased costs, making the rational and safe use of sedation imperative. We describe how to use the BIS® monitor, its different parameters of clinical use for the appropriate use of sedation in critical care. In turn, we review the literature demonstrating with different studies its advantages: first, as a complement to the Richmond Agitation Sedation Scale (RASS), the BIS can reliably identify deep sedation; second, it is associated with a decrease in the use of medications and costs; third, it is related to a reduction of medical complications such as respiratory depression, aspiration, delirium and prolonged ICU stays derived from excessive sedation.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100576"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418702","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":"Es tiempo de actuar: Implementación de programas de movilidad temprana en Unidades de Cuidado Intensivo","authors":"Genis Castillo ,&nbsp;Bladimir Gil ,&nbsp;Jhonatan Manrique ,&nbsp;César Morales ,&nbsp;Sandra Rodríguez ,&nbsp;Albert Valencia ,&nbsp;Esther Wilches ,&nbsp;Sara Zuluaga","doi":"10.1016/j.acci.2025.08.011","DOIUrl":"10.1016/j.acci.2025.08.011","url":null,"abstract":"<div><div>In November 2024, a multidisciplinary meeting was held in Bogotá, bringing together professionals with expertise in critical care, rehabilitation, physiotherapy, nursing, and clinical management. The primary objective of this meeting was to share experiences on the implementation of early mobility programs in intensive care units (ICUs) across Colombia, review the available scientific evidence, and establish a collective call to transform clinical practice in this area.</div><div>The meeting involved representatives from leading healthcare centers in the implementation of early mobility programs, as well as researchers affiliated with universities and scientific societies. Discussions emphasized that early mobilization of critically ill patients is a safe, feasible, and evidence-based strategy. The implementation of structured protocols has consistently demonstrated significant clinical benefits, including reduced hospital and ICU length of stay, lower incidence of complications related to mechanical ventilation, improved functional recovery, and greater patient and family satisfaction. These findings underscore the importance of integrating early mobility as a core component of comprehensive critical care management.</div><div>Participants also identified logistical, cultural, and administrative barriers that hinder the implementation of these strategies, as well as practical solutions adapted to diverse institutional contexts. This document represents a call to action aimed at healthcare institutions and clinical teams to promote the adoption of early mobility as a standard of care in ICUs, with the goal of optimizing clinical outcomes and improving patients’ quality of life in the short, medium, and long term.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100570"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418703","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":"Extubación paliativa en cuidado crítico: una revisión narrativa","authors":"Camila Cruz-Capacho ,&nbsp;Camilo Molineros-Baron ,&nbsp;Luisa Fernanda Rodriguez-Campos","doi":"10.1016/j.acci.2025.10.004","DOIUrl":"10.1016/j.acci.2025.10.004","url":null,"abstract":"<div><div>Invasive mechanical ventilation is an artificial life support strategy to support respiratory system functions when the respiratory system is unable to cope with the metabolic demands of the body due to a specific pathology. Once medical interventions aimed at restoring the body's homeostasis have been exhausted, adequate control of the disease that led the patient to require mechanical ventilation has not been achieved, or there is no reasonable rehabilitative potential, mechanical ventilation is considered to have become futile, so the removal of the endotracheal tube becomes a strategy for the adequacy of therapeutic efforts.</div><div>This narrative review aims to study the methods used in the palliative extubation procedure, thus describing the order of steps to be followed to achieve an ideal management of the end-of-life situation in patients requiring ventilatory support. In addition, the use of some medications that are useful at the time of palliative extubation is described, as well as the legal and ethical considerations of this procedure, and the important role of the family. An exhaustive search of scientific databases was conducted to compile and analyze the relevant literature on palliative extubation in order to develop a comprehensive narrative review of the topic. A brief algorithm is proposed as a guide for decisions and behaviors in the context of palliative extubation, following four stages of the process: preparation, pre-extubation, extubation and post-extubation.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100578"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418705","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":"Implicaciones de ANDROMEDA-SHOCK-2 para la fisioterapia en el paciente crítico: la perfusión como señal de seguridad","authors":"Luis Alexander Peña-López ,&nbsp;Henry Mauricio Parada-Gereda ,&nbsp;María Angelica Rodríguez-Scarpetta ,&nbsp;Wilson Mauricio Lozano ,&nbsp;Manuel Garay-Fernández ,&nbsp;Esther Cecília Wilches-Luna","doi":"10.1016/j.acci.2025.100579","DOIUrl":"10.1016/j.acci.2025.100579","url":null,"abstract":"","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100579"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418815","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":"AI integration and its importance in critical care medicine: Augmented Critical Care Ecosystems (ACCEs)","authors":"Ever Leonardo Rojas-Díaz ,&nbsp;Ledys Izquierdo ,&nbsp;Andrés Rico ,&nbsp;Natali Mercado Solorzano ,&nbsp;Andrés F. Cardona ,&nbsp;Luis Pino","doi":"10.1016/j.acci.2025.08.008","DOIUrl":"10.1016/j.acci.2025.08.008","url":null,"abstract":"","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100567"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418814","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":"Ventilator-associated pneumonia (VAP): The role of the intensive care physiotherapist in ultrasound-based functional assessment","authors":"Johana Carolina Pazmiño Ordóñez ,&nbsp;María Paula Guerrero ,&nbsp;Verónica Arturo Rodríguez ,&nbsp;Ana María Pinza Ortega ,&nbsp;Diana Ávila Reyes ,&nbsp;Jorge Ignacio Martínez","doi":"10.1016/j.acci.2025.100580","DOIUrl":"10.1016/j.acci.2025.100580","url":null,"abstract":"","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"26 1","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147418813","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}