Medicine - Programa de Formación Médica Continuada Acreditado最新文献

Protocolo terapéutico de la insuficiencia respiratoria aguda 急性呼吸衰竭治疗方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.005

M. Longás, D. Romero, B. Sánchez, D. Laorden

引用次数: 0

Fisiopatología de la ventilación y del intercambio gaseoso 通风和气体交换的物理病理学

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.001

M. Arteaga, E. De Dios, C. Carpio, M. Hidalgo, R. Álvarez-Sala

{"title":"Fisiopatología de la ventilación y del intercambio gaseoso","authors":"M. Arteaga, E. De Dios, C. Carpio, M. Hidalgo, R. Álvarez-Sala","doi":"10.1016/j.med.2026.10.001","DOIUrl":"10.1016/j.med.2026.10.001","url":null,"abstract":"<div><div>Pathophysiology of ventilation and gas exchange Respiratory physiology integrates ventilatory mechanics, gas exchange, and neural control of breathing to ensure adequate tissue oxygenation and carbon dioxide elimination. Pulmonary mechanics depend on the elastic properties of the lungs and the thoracic cage as well as airway resistance, which determine respiratory effort and ventilatory efficiency. Lung volumes and capacities allow for identifying obstructive and restrictive patterns with important diagnostic and prognostic implications.</div><div>Gas exchange is primarily determined by the ventilation-perfusion ratio. An imbalance in this ratio is the most common mechanism of hypoxemia in most respiratory diseases. Alveolar-capillary diffusion has a large functional reserve under normal conditions, but can be impaired in the presence of interstitial diseases, emphysema, intense exercise, or exposure to high altitudes. Respiratory control integrates chemical and mechanical signals that modulate ventilation in chronic obstructive pulmonary disease and obstructive sleep apnea.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 63","pages":"Pages 3881-3888"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175782","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}

引用次数: 0

Protocolo de monitorización y seguimiento ambulatorio del paciente con insuficiencia respiratoria crónica. Criterios de alarma 慢性呼吸衰竭患者的门诊监测和随访方案。报警标准

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.008

S. Navarro, C. García-Quero, M.A. Gómez-Mendieta, E. Zamarrón

引用次数: 0

Insuficiencia respiratoria: concepto, etiopatogenia, clasificación y diagnóstico 呼吸衰竭：概念、病因、分类和诊断

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.003

B. Romero, D. Corchado, D. Velasco, C. Prados, A. Pérez-Figuera

{"title":"Insuficiencia respiratoria: concepto, etiopatogenia, clasificación y diagnóstico","authors":"B. Romero, D. Corchado, D. Velasco, C. Prados, A. Pérez-Figuera","doi":"10.1016/j.med.2026.10.003","DOIUrl":"10.1016/j.med.2026.10.003","url":null,"abstract":"<div><div>Respiratory failure is a clinical pathophysiological syndrome characterized by impaired gas exchange that leads to hypoxemia, hypercapnia, or both. It is defined by an arterial oxygen pressure (PaO<sub>2</sub>) below 60mm Hg and/or an arterial carbon dioxide pressure (PaCO<sub>2</sub>) above 45mm Hg under baseline conditions at sea level. Its origin is related to abnormalities in the main mechanisms of respiratory physiology, including ventilation/perfusion imbalance, intrapulmonary shunting, alveolar hypoventilation, diffusion limitation, and decreased fraction of inspired oxygen pressure. From a pathophysiological perspective, it is classified into hypoxemic and hypercapnic forms with acute, chronic, and acute-on-chronic presentations, each with specific prognostic and therapeutic implications. Arterial blood gas analysis is the gold standard for diagnosis, severity stratification, and assessment of acid-base balance. An integrated approach based on a clinical and physiological evaluation is essential for early recognition, individualized decision making regarding treatment, and optimization of clinical outcomes.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 63","pages":"Pages 3900-3907"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175785","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}

引用次数: 0

Protocolo de tratamiento de la insuficiencia respiratoria en urgencias 紧急呼吸衰竭治疗方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.007

C. Aponte, A. Iglesias, S. Alcolea, Y. Martínez-Abad, L. Esteban

引用次数: 0

Síndrome de platipnea-ortodeoxia como causa infrecuente de insuficiencia respiratoria grave en el adulto mayor, a propósito de un caso 作为老年人严重呼吸衰竭的一种罕见病因的platypine -正氧综合征，以一个病例为例

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.009

M. Martínez-Redondo, A. Pérez Figuera, D. Romera, A. Mangas

引用次数: 0

Pruebas de función respiratoria 呼吸功能测试

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.002

R. Galera, R. Casitas, F. García Río, C. Crespo, M. Bonet

引用次数: 0

Oxigenoterapia y ventilación mecánica 氧疗和机械通气

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.004

J. Selles, B. Sanz-Sanjosé, V. Arnalich, J. Fernández-Lahera, A. Santiago

{"title":"Oxigenoterapia y ventilación mecánica","authors":"J. Selles, B. Sanz-Sanjosé, V. Arnalich, J. Fernández-Lahera, A. Santiago","doi":"10.1016/j.med.2026.10.004","DOIUrl":"10.1016/j.med.2026.10.004","url":null,"abstract":"<div><div>This document reviews the essential principles of oxygen therapy and ventilatory support. Oxygen therapy is indicated to correct hypoxemia and can be administered via low- or high-flow systems, among which high-flow nasal cannula (HFNC) stands out for its ability to generate positive end-expiratory pressure (PEEP), improve CO<sub>2</sub> clearance, humidify the air, and reduce respiratory effort. It describes adjustments based on the underlying condition and highlights the importance of cannula design.</div><div>Noninvasive ventilation (NIV) includes continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), and advanced modes such as average volume-assured pressure support (AVAPS). It is particularly useful in acute exacerbations of chronic obstructive pulmonary disease (COPD) and in acute pulmonary edema. Criteria for success and failure as well as risks such as patient-self-inflicted lung injury (P-SILI) are detailed. Invasive mechanical ventilation (IMV) is reserved for severe respiratory failure. Lung-protective ventilation is emphasized and common complications such as ventilator-associated pneumonia (VAP), barotrauma, and delirium are listed.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 63","pages":"Pages 3908-3915"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175786","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}

引用次数: 0

Protocolo terapéutico de la insuficiencia respiratoria crónica 慢性呼吸衰竭治疗方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.med.2026.10.006

M. Aguilar, P. Mariscal, L. Gómez, I. Fernández

引用次数: 0

Malnutrición, disfagia, anorexia, sarcopenia y obesidad sarcopénica 营养不良、消化不良、厌食症、骨质减少症和骨质减少肥胖症

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-30 DOI: 10.1016/j.med.2026.09.003

D.F. Febres Panez, J.J. Arechederra Calderón, N. Bassy Iza, V.E. Landaeta Ribera, H.D. Villa Alvarado, P.M. Duluc Escobar

{"title":"Malnutrición, disfagia, anorexia, sarcopenia y obesidad sarcopénica","authors":"D.F. Febres Panez, J.J. Arechederra Calderón, N. Bassy Iza, V.E. Landaeta Ribera, H.D. Villa Alvarado, P.M. Duluc Escobar","doi":"10.1016/j.med.2026.09.003","DOIUrl":"10.1016/j.med.2026.09.003","url":null,"abstract":"<div><div>Malnutrition and its determinants (anorexia of aging, dysphagia, and sarcopenia, including sarcopenic obesity) are highly prevalent geriatric syndromes with significant clinical, functional, and prognostic implications for older adults. This update reviews the current evidence on the screening, diagnosis, and comprehensive management of malnutrition in older adults from a clinical and functional perspective. It also reviews the main nutritional screening tools in geriatrics and their integration with the GLIM diagnostic criteria. It analyzes anorexia of aging and dysphagia as key nutritional risk factors as well as sarcopenia and sarcopenic obesity, including their assessment using body composition techniques and their relationship to functional decline, dependency, and mortality. Finally, it summarizes the principles of management, which are based on multimodal interventions focused on personalized nutrition, multicomponent exercise, and a selective use of emerging pharmacological therapies. Systematic nutritional assessment, integrated into comprehensive geriatric assessment, is essential for the early identification and treatment of malnutrition and its determinants. A multidimensional and individualized approach improves functional status and reduces dependence and mortality in older adults.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 62","pages":"Pages 3835-3845"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072234","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}

引用次数: 0