Acta Colombiana de Cuidado Intensivo最新文献

{"title":"Driving pressure como parámetro integrador en ventilación mecánica: de la fisiología al reto clínico de la personalización","authors":"Luis Alexander Peña-López ,&nbsp;Manuel Garay-Fernández ,&nbsp;Carmen Chica-Meza ,&nbsp;Oscar Humberto Ruiz Serna ,&nbsp;Wilson Mauricio Lozano Franco ,&nbsp;Ana Lucía Rangel-Colmenares ,&nbsp;Henry Mauricio Parada-Gereda","doi":"10.1016/j.acci.2025.07.004","DOIUrl":"10.1016/j.acci.2025.07.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Driving pressure (ΔP) has emerged as a key marker in mechanical ventilation, strongly associated with mortality in patients with acute respiratory distress syndrome (ARDS). Its relevance lies in integrating tidal volume and respiratory system compliance, thereby reflecting the effective mechanical stress on the functional lung. This narrative review explores the physiological foundations of ΔP, its prognostic value in various ventilated patient populations, and ongoing controversies regarding its use beyond ARDS, particularly in settings of spontaneous ventilation or extrapulmonary conditions. While evidence supports its role as an indicator of mechanical load, its interpretation must be contextualized, and it should not be used as a standalone parameter for ventilatory titration.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 681-692"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493057","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":"Desenlaces divergentes: la imprevisibilidad del síndrome de choque tóxico. Reportes de casos","authors":"Tatiana Patricia Buitrago-González ,&nbsp;Jonathan Palacios ,&nbsp;Fabio Varón-Vega","doi":"10.1016/j.acci.2025.06.003","DOIUrl":"10.1016/j.acci.2025.06.003","url":null,"abstract":"<div><div>Toxic shock syndrome is a rare but potentially fatal infectious process. It is mediated by superantigenic exotoxins, most commonly caused by <em>Streptococcus pyogenes</em>. These toxins activate T<!--> <!-->cells in an unconventional polyclonal manner, leading to cytokine storm, multiple organ failure, and death. Mortality depends on age, site of infection, comorbidities, and delayed diagnosis; hence the importance of timely recognition and treatment. We report two cases of women over 60<!--> <!-->years of age, the first with the onset of multiple organ failure with fatal outcome less than 48<!--> <!-->hours after admission to the ICU, and the second case with a less severe presentation who was discharged without complications. Both patients had the same diagnosis but different onset, symptoms, and outcomes.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 734-741"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493062","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":"Optimización hemodinámica basada en el acoplamiento ventrículo-arterial: revisión de conceptos y aplicaciones clínicas","authors":"Theno Alexandro Turrubiates Hernández ,&nbsp;Gabriela María Mora Martínez ,&nbsp;Amalia Angélica Reyes Pérez ,&nbsp;Ramon Ulises Soberano Burguete ,&nbsp;Gustavo Adrian Soto Hernández","doi":"10.1016/j.acci.2025.07.002","DOIUrl":"10.1016/j.acci.2025.07.002","url":null,"abstract":"<div><div>Acute circulatory dysfunction is a common cause of admission to the ICU and is associated with inadequate oxygen utilization at the cellular level. Hemodynamic monitoring helps guide treatment and improve outcomes. Arterial load (AL) represents the resistance that the ventricle must overcome during ejection and can be assessed through arterial impedance (Z); these characteristics can be represented by arterial elastance (Ea). Ventriculo-arterial coupling (VAC) evaluates the interaction between Ea and ventricular elastance (Ev), optimizing cardiac efficiency. VAC is altered in different types of shock (e.g., cardiogenic, septic), where the balance between Ev and Ea is lost. Measuring VAC allows for personalized treatment, improving outcomes in critically ill patients. Incorporating this parameter facilitates more precise clinical decisions, optimizes resource use, and reduces costs in managing hemodynamic instability.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 671-680"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493056","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":"Anesthetic management strategies in patients with metabolic syndrome undergoing non-cardiac surgeries: A systematic literature review","authors":"Paula Henríquez Miranda ,&nbsp;Jesica Tatiana Soto Joven ,&nbsp;María Estefany Álvarez ,&nbsp;Pablo José Puertas Peñaranda ,&nbsp;Juan Pablo Alzate Granados","doi":"10.1016/j.acci.2025.08.004","DOIUrl":"10.1016/j.acci.2025.08.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Metabolic syndrome (MS), defined by central obesity, hypertension, dyslipidemia, and insulin resistance, is associated with perioperative complications in non-cardiac surgeries. Although anesthesiology plays a significant role in modifying these risks, the lack of established protocols and inconsistency in clinical practices hinders optimal management in this population.</div></div><div><h3>Methodology</h3><div>A systematic review was conducted following PRISMA guidelines. Observational studies, previous reviews, and retrospective cohorts evaluating anesthetic strategies in adults with MS undergoing non-cardiac surgeries were included. Databases such as MEDLINE, Embase, CENTRAL, Scopus, and Web of Science were consulted.</div></div><div><h3>Results</h3><div>Four studies were included. Balanced anesthesia with remifentanil and volatile agents significantly reduced postoperative troponin elevation (OR<!--> <!-->=<!--> <!-->0.727; <em>p</em> <!-->=<!--> <!-->0.002) and the incidence of acute kidney injury (OR<!--> <!-->=<!--> <!-->0.637; <em>p</em> <!-->&lt;<!--> <!-->0.001). Spinal anesthesia was associated with a higher risk of intraoperative hypotension (14.7% vs. 1.3%) and postoperative pain (13.3% vs. 5.3%). An increase in respiratory and metabolic complications was also identified in the presence of hyperglycemia and obstructive sleep apnea.</div></div><div><h3>Discussion</h3><div>The results support the implementation of individualized anesthetic strategies, particularly balanced techniques, to reduce complications in patients with MS. However, there is a need for timely clinical guidelines to standardize anesthetic management in this vulnerable population.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 693-703"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493058","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":"Actitud del personal de enfermería ante la participación de la familia en cuidados críticos","authors":"Gissella Mariana Meza-Carreño,&nbsp;Luisa Alejandra Tenelema-Toapanta,&nbsp;Maricelys Jimenez-Barrera,&nbsp;Jorge Leodan Cabrera-Olvera","doi":"10.1016/j.acci.2025.08.001","DOIUrl":"10.1016/j.acci.2025.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Nurses collaborate with the family in care, ensuring the safety of the person.</div></div><div><h3>Objective</h3><div>To describe the nurse's perspective on the role of the family in the care of the person in critical areas.</div></div><div><h3>Materials and methods</h3><div>Qualitative, phenomenological and descriptive research. The sample consisted of12 nursing professionals due to information saturation. The semi-structured interview was applied; for the analysis, the methods were triangulated with the purpose of enriching the interpretation from different phenomenological perspectives, integrating structural depth, contextual sensitivity and interpretative rigor, which allowed a more complete understanding of the study phenomenon and broadened the richness of the findings without losing fidelity to the experience of the participants. The Consolidated Criteria for the Elaboration of Qualitative Research Reports (COREQ) were applied.</div></div><div><h3>Results</h3><div>A total of 7 categories emerged: 1) Limitations in the care and attention to the person in critical condition in the face of family participation. 2) Family integration and safety-biosafety in the care of the person in the critical care unit: practical strategies of the nursing staff. 3) Temporal and economic determinants in family participation in the care of the critically ill patient. 4) Conflicts in decision making between health personnel and the family. 5) Humanization of care in critical environments through effective collaboration between nursing staff and families. 6) Cultural differences in the interaction between health personnel, the ill person and the family in critical settings. 7) Ethical and bioethical challenges in the care of critically ill persons.</div></div><div><h3>Conclusion</h3><div>Collaboration between nurses and family members in critical areas requires empathic communication and strategies that strengthen the bond and humanized care.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 640-647"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493066","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 de decúbito prono en pacientes no intubados con neumonía por SARS-CoV-2 ingresados en Unidades de Cuidados Intensivos. Revisión sistemática y metaanálisis","authors":"Héctor Hernández Garcés ,&nbsp;Andrés Esteban Salazar Molina ,&nbsp;Alberto Belenguer Muncharaz ,&nbsp;Rafael Zaragoza Crespo","doi":"10.1016/j.acci.2025.06.002","DOIUrl":"10.1016/j.acci.2025.06.002","url":null,"abstract":"<div><h3>Purpose of the review</h3><div>Systematic review with meta-analysis to evaluate the effects of awake prone positioning in non-intubated patients (APP) with SARS-CoV-2 pneumonia admitted to the Intensive Care Unit (ICU).</div></div><div><h3>Data collection</h3><div>We conducted a systematic literature search up tp 31 December 2023, in four databases: PUBMED, EMBASE, WEB OF SCIENCE, and SCOPUS, as well as in grey literature sources such as Google Scholar, GreyNet International, and Open Grey. There were no language or geographical limits.</div></div><div><h3>Study selection</h3><div>Randomized clinical trials conducted in critically ill patients over 18 years old with SARS-CoV-2 pneumonia comparing APP with the supine position.</div></div><div><h3>Data extraction and synthesis</h3><div>Six studies including 1,813 patients were analyzed, of whom 902 (49.75%) received APP and 911 (50.25%) were in the supine position. APP reduced the need for intubation (OR 0.75; 95% CI 0.61-0.91, <em>P</em>=.003, I² 0%) but did not reduce ICU mortality <em>(P</em>=.3) or ICU length of stay <em>(P</em>=0.1). Trial sequential analysis confirmed that the optimal information size was reached and that the significance thresholds for the primary objective were crossed.</div></div><div><h3>Conclusions</h3><div>APP reduces the need for intubation in patients with SARS-CoV-2 pneumonia but does not reduce mortality or ICU length of stay compared to the supine position.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 595-604"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493026","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":"La segmentación en subgrupos clínicos mejora la predicción de las escalas generales de mortalidad en pacientes oncológicos específicos","authors":"Víctor Nieto ,&nbsp;Andrea Rojas ,&nbsp;Catalina Sanchez ,&nbsp;Adriana Carolina Aya ,&nbsp;Edwin Pulido ,&nbsp;Heidy Trujillo ,&nbsp;Natalia Sánchez P. ,&nbsp;Andrés F. Cardona","doi":"10.1016/j.acci.2025.07.007","DOIUrl":"10.1016/j.acci.2025.07.007","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate and compare the prognostic performance of the APACHE II, SAPS III, and SOFA scores in predicting mortality among critically ill oncologic patients, stratified by tumor type (solid or hematologic) and admission category (medical or surgical).</div></div><div><h3>Design</h3><div>Retrospective analytical study.</div></div><div><h3>Setting</h3><div>Oncologic intensive care unit of a high-complexity center.</div></div><div><h3>Patients</h3><div>A total of 898 critically ill cancer patients were included; 80.8% had solid tumors and 19.2% hematologic malignancies. Of these, 58.1% were admitted for medical reasons and 41.8% for surgical causes.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Measurements</h3><div>The analysis was stratified by tumor type and ICU admission category. ROC curves with 95% confidence intervals were calculated, and model calibration was assessed using logistic regression and the Hosmer-Lemeshow goodness-of-fit test.</div></div><div><h3>Results</h3><div>SAPS III showed the best overall performance, with an AUC of 0.81 in patients with solid tumors and surgical admission. SOFA had the highest performance in patients with hematologic malignancies and medical admission (AUC: 0.73). In patients with solid tumors and medical admission, all scores demonstrated limited performance (AUC &lt;<!--> <!-->0.74). The hematologic–surgical subgroup could not be evaluated due to the absence of mortality.</div></div><div><h3>Conclusion</h3><div>General severity scores have limitations in critically ill oncologic patients, but their performance improves when stratified by tumor type and admission category. SAPS III performed best in surgical patients with solid tumors, while SOFA was superior in patients with hematologic malignancies and medical admission. These findings support the use of personalized prognostic strategies in oncologic intensive care settings.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 631-639"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493030","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":"Initiation of antineoplastic treatment in the ICU: Analysis of sepsis and mortality in cancer patients based on real-world evidence (RWE)","authors":"Víctor Nieto ,&nbsp;Andrea Rojas ,&nbsp;Catalina Sanchez ,&nbsp;Daniel Molano ,&nbsp;Julián Mendoza ,&nbsp;Dinia Corzzo ,&nbsp;Álvaro Jimenez ,&nbsp;Adriana Carolina Aya ,&nbsp;Edwin Pulido ,&nbsp;Heidy Trujillo ,&nbsp;P. Natalia Sánchez ,&nbsp;Andrés F. Cardona","doi":"10.1016/j.acci.2025.08.005","DOIUrl":"10.1016/j.acci.2025.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the safety of initiating antineoplastic treatment in critically ill cancer patients admitted to an intensive care unit (ICU), analyzing its association with sepsis and mortality, and differentiating outcomes by tumor type (solid or hematologic) in a real-world evidence context.</div></div><div><h3>Design</h3><div>Retrospective observational cohort study.</div></div><div><h3>Setting</h3><div>ICU of a high-complexity oncology hospital in Bogotá, Colombia.</div></div><div><h3>Patients</h3><div>Adult patients with confirmed diagnoses of solid or hematologic cancer who began antineoplastic treatment during their ICU stay between July 2022 and December 2024.</div></div><div><h3>Interventions</h3><div>No specific interventions were performed; retrospective clinical data were analyzed.</div></div><div><h3>Measurements</h3><div>Clinical, demographic, and intensive care support variables were collected. Factors associated with sepsis and mortality were analyzed using multivariable logistic regression models, with stratified analysis by tumor type.</div></div><div><h3>Results</h3><div>Of 898 cancer patients admitted to the ICU, 57 (6.3%) initiated antineoplastic treatment during their stay. The incidence of sepsis was 28.5%, and hospital mortality was 13.9%, both higher among patients with hematologic malignancies. Independent factors associated with sepsis and mortality included medical cause of ICU admission, invasive mechanical ventilation, and presence of shock. The initiation of antineoplastic treatment was not significantly associated with increased risk of sepsis or mortality, either in the overall or stratified analysis.</div></div><div><h3>Conclusion</h3><div>The administration of antineoplastic therapy during ICU stay was not associated with increased sepsis or mortality. Treatment safety appears to depend more on the patient's baseline clinical condition than on the initiation of cancer-specific therapy itself.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 656-662"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493054","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":"Indicaciones para las terapias de remoción extracorpórea en los pacientes con intoxicaciones agudas","authors":"Fabián H. Muñoz Ramírez ,&nbsp;John Fredy Nieto Ríos ,&nbsp;Diana Lizeth Cabrera Rojas","doi":"10.1016/j.acci.2025.08.003","DOIUrl":"10.1016/j.acci.2025.08.003","url":null,"abstract":"<div><div>Acute poisonings represent one of the most challenging medical emergencies due to their potential to compromise multiple organ systems, with serious consequences that can lead to death if not treated appropriately and in a timely manner. An appropriate clinical approach, an efficient response from the toxicology laboratory, and the early implementation of effective therapeutic measures are necessary to improve clinical outcomes. Extracorporeal removal therapies become a fundamental tool to reduce organ damage and decrease mortality.</div><div>The primary purpose of this review is to provide clear and accurate information about the clinical presentation and management of patients with acute poisoning by common agents, emphasizing the indications and different modalities of extracorporeal removal therapies. The aim is to standardize procedures and ensure that healthcare professionals involved in their care can effectively recognize the signs of severe toxicity and the specific situations that warrant one of these therapies.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 4","pages":"Pages 718-728"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493060","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":"Azul de metileno como terapia complementaria en el manejo del shock séptico refractario en los pacientes con cáncer: experiencia clínica","authors":"Víctor Hugo Nieto Estrada ,&nbsp;Julián Andrés Mendoza Rodríguez ,&nbsp;Daniel Leonardo Molano Franco ,&nbsp;Anacaona Martínez del Valle ,&nbsp;María Catalina Sánchez Higuera ,&nbsp;María Margarita Dussan Trujillo ,&nbsp;Paola Andrea Rojas González ,&nbsp;Juliana Alejandra Ortiz Murcia ,&nbsp;José David Mójica Rodríguez ,&nbsp;Angie Viviana Súarez Cuadros ,&nbsp;Valeria Rocha Yaruro","doi":"10.1016/j.acci.2025.05.004","DOIUrl":"10.1016/j.acci.2025.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the clinical experience with the use of methylene blue as a complementary therapy in the management of refractory septic shock in a cohort of cancer patients.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>High-complexity oncological Intensive Care Unit.</div></div><div><h3>Participants</h3><div>Ninety-four adult patients with confirmed cancer diagnoses admitted to the ICU between October 2022 and January 2024.</div></div><div><h3>Interventions</h3><div>No specific interventions were performed; retrospective data were analyzed.</div></div><div><h3>Main outcome measures</h3><div>Total norepinephrine dose before and after methylene blue administration<strong>,</strong> Total epinephrine dose before and after methylene blue administration<strong>,</strong> ICU mortality, Multiple organ dysfunction.</div></div><div><h3>Results</h3><div>A total of 94 oncology patients with septic shock and refractory vasoplegia were included, of which 44.7% were women, with a median age of 63 years. The predominant etiology was Gram-negative bacilli (35.1%). The group treated with methylene blue showed a higher need for mechanical ventilation (97.9 vs. 66%) and greater use of norepinephrine and vasopressin, although with a significant reduction in the cumulative dose of norepinephrine (from 15.08 to 11.3<!--> <!-->mg, <em>P</em> <!-->&lt;<!--> <!-->.05) and adrenaline compared to the control group. No significant reduction in mortality was observed with methylene blue (OR: 0.66; 95% CI: 0.25-1.7). Respiratory failure was the main predictor of mortality (OR: 15.1; 95% CI: 1.63-40.7). Methylene blue was not associated with adverse events.</div></div><div><h3>Conclusions</h3><div>The use of methylene blue as an adjuvant therapy in the management of refractory septic shock in oncology patients allows for a reduction in catecholamine dosage, demonstrating a vasopressor-sparing effect without being associated with significant adverse events. Although a trend toward a protective effect on mortality and organ dysfunction is observed, these results do not reach statistical significance. Hypoxemic respiratory failure is identified as the main predictor of poor prognosis in this population. Additional studies are needed to assess its effectiveness in different stages of septic shock and in specific subgroups of oncology patients.</div></div>","PeriodicalId":100016,"journal":{"name":"Acta Colombiana de Cuidado Intensivo","volume":"25 3","pages":"Pages 495-501"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842255","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}