Medicina Intensiva最新文献

{"title":"Aneurisma gigante de arteria carótida interna izquierda con trombosis parcial","authors":"Alba Simón Paniello, Maria Candelaria Ruiz Garcia, Miguel Finger Kamps","doi":"10.1016/j.medin.2024.502116","DOIUrl":"10.1016/j.medin.2024.502116","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502116"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovación tecnológica en cuidados intensivos y los límites de la vida","authors":"Esteban Fernández-Hinojosa , María Adriaensens Pérez , José Cayetano Naranjo Jarillo","doi":"10.1016/j.medin.2025.502153","DOIUrl":"10.1016/j.medin.2025.502153","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502153"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of mechanical insufflation-exsufflation on the weaning success rate of tracheostomized patients on prolonged mechanical ventilation: a pilot and feasibility study of a randomized controlled trial","authors":"Cristiane Bastos Netto ,&nbsp;Maycon Moura Reboredo ,&nbsp;Rodrigo Souza Vieira ,&nbsp;Lídia Maria Carneiro da Fonseca ,&nbsp;Elivaldo Cyrillo Júnior ,&nbsp;André Luís Dias de Souza ,&nbsp;Erich Vidal Carvalho ,&nbsp;Bruno Valle Pinheiro","doi":"10.1016/j.medin.2024.502125","DOIUrl":"10.1016/j.medin.2024.502125","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility of adding mechanical insufflation-exsufflation (MI-E) to a weaning protocol for tracheostomized patients undergoing prolonged mechanical ventilation (MV).</div></div><div><h3>Design</h3><div>Single-center, open-label, randomized, controlled pilot and feasibility study.</div></div><div><h3>Setting</h3><div>Intensive care unit in Brazil.</div></div><div><h3>Patients</h3><div>Tracheostomized adults who were invasively ventilated for more than 14 days and who were weaned from MV.</div></div><div><h3>Interventions</h3><div>Patients were randomized into two groups: intervention group (IG) or a control group (CG). During weaning with a tracheostomy collar, the IG received two daily sessions of MI-E, each with 5 cycles (insufflation and exsufflation pressures of 45 cm H₂O). The CG received conventional chest physiotherapy.</div></div><div><h3>Main variables of interest</h3><div>The primary outcomes were the feasibility of adding MI-E to the weaning protocol and the rate of successful weaning.</div></div><div><h3>Results</h3><div>A total of 47 patients were randomized, with 25 in the IG and 22 in the CG. All patients randomized to the MI-E group received the proposed protocol, completing all the scheduled MI-E sessions. Adverse events occurred in 14% of the MI-E sessions, but they did not lead to treatment interruption. Weaning success was observed in 76% of IG patients and 73% of CG patients (relative risk, 1.05; 95% CI, 0.75–1.46). No significant differences were observed between the IG and CG regarding ICU mortality (16% and 18%, respectively, p = 0.99) or hospital mortality (40% and 41%, respectively, p = 0.99).</div></div><div><h3>Conclusions</h3><div>The addition of MI-E to the standard weaning protocol is feasible, but not result in a greater rate of successful weaning in tracheostomized patients.</div></div><div><h3>Clinical trial registration number</h3><div>U1111-1302-9035.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502125"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gasometría y altitud: investigación de los rangos de normalidad en Quito, Ecuador (2.850 m sobre el nivel del mar)","authors":"Jorge Luis Vélez-Páez ,&nbsp;Christian Castro-Bustamante ,&nbsp;Manuel Luis Avellanas-Chavala","doi":"10.1016/j.medin.2025.502140","DOIUrl":"10.1016/j.medin.2025.502140","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502140"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatismo penetrante en España: análisis del registro español de trauma en la UCI (RETRAUCI)","authors":"Judit Gutiérrez-Gutiérrez ,&nbsp;Jesús Abelardo Barea-Mendoza ,&nbsp;Carlos García-Fuentes ,&nbsp;Juan Antonio Llompart-Pou ,&nbsp;Begoña Guardiola-Grau ,&nbsp;Mikel Durán-Suquía ,&nbsp;María Ángeles Ballesteros-Sanz ,&nbsp;Javier González-Robledo ,&nbsp;Lluís Serviá-Goixart ,&nbsp;Cristina Méndez-Benegassi Cid ,&nbsp;Jose Maria Toboso Casado ,&nbsp;Mario Chico-Fernández ,&nbsp;En representación del grupo de trabajo de Neurointensivismo y Trauma de la SEMICYUC","doi":"10.1016/j.medin.2025.502165","DOIUrl":"10.1016/j.medin.2025.502165","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the epidemiology of penetrating trauma, mortality associated factors and its management in Spanish intensive care units.</div></div><div><h3>Design</h3><div>Multicenter, prospective registry. A comparison is established between two cohorts defined by the type of trauma (blunt and penetrating).</div></div><div><h3>Patients</h3><div>Patients with traumatic injury admitted to the participating ICUs from June 2015 to June 2022.</div></div><div><h3>Interventions</h3><div>None.</div><div>Main variable of interest Epidemiology, injury pattern, prehospital and hospital care, resource utilization, and clinical outcomes.</div></div><div><h3>Results</h3><div>Twelve thousand eight hundred six patients were eligible, of whom 821 (6.4%) suffered penetrating trauma; 418 patients (50.9%) from stab wounds, 93 (11.3%) from gunshot wounds, and 310 (37.8%) from other objects. The most common intent was assault (47.7%). The mean ISS was 15.2<!--> <!-->±<!--> <!-->10.6 in penetrating trauma and 19.8<!--> <!-->±<!--> <!-->11.9 in blunt trauma (<em>P</em>&lt;.001). ICU mortality was 7.8% compared to 11.7% in blunt trauma, with deaths more frequently occurring within the first 24<!--> <!-->hours (64 vs. 39%). Factors associated with mortality included female sex, prior use of antithrombotic agents, older age, higher NISS score, and the presence of cranial trauma or shock.</div></div><div><h3>Conclusions</h3><div>Penetrating trauma is an emergent pathology in our context with high complexity, highlighting the need for focused study and documentation, protocol development, and resource optimization to provide quality care.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502165"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síndrome aórtico agudo y shock cardiogénico, más allá del diagnóstico radiológico","authors":"Hala El Haddad,&nbsp;Isabel Espinosa Rueda,&nbsp;Nora Palomo-López","doi":"10.1016/j.medin.2024.502124","DOIUrl":"10.1016/j.medin.2024.502124","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502124"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cirugía citorreductora en el sarcoma cardiaco","authors":"Bárbara Segura-Méndez ,&nbsp;Ana Revilla ,&nbsp;Yolanda Carrascal","doi":"10.1016/j.medin.2024.502132","DOIUrl":"10.1016/j.medin.2024.502132","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502132"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mejoría de la hipoperfusión cerebral mediante bloqueo del ganglio estrellado en el vasoespasmo refractario","authors":"Luis Patricio Maskin,&nbsp;Federico Rodríguez Lucci","doi":"10.1016/j.medin.2024.502121","DOIUrl":"10.1016/j.medin.2024.502121","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502121"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a competence based medical education program on training quality in Intensive Care Medicine. COBALIDATION TRIAL","authors":"Álvaro Castellanos-Ortega ,&nbsp;María Jesús Broch Porcar ,&nbsp;Diego Palacios-Castañeda ,&nbsp;Vicente Gómez-Tello ,&nbsp;Miguel Valdivia ,&nbsp;Carlos Vicent ,&nbsp;Isabel Madrid ,&nbsp;Nuria Martinez ,&nbsp;Manuel José Párraga ,&nbsp;Elena Sancho ,&nbsp;María del Castillo Fuentes-Dura ,&nbsp;Rafael García-Ros","doi":"10.1016/j.medin.2024.502126","DOIUrl":"10.1016/j.medin.2024.502126","url":null,"abstract":"<div><h3>Objectives</h3><div>The main objective of this study was to evaluate whether the implementation of CoBaTrICE (Competency-Based Training in Intensive Care Medicine in Europe) provides higher levels of competency in comparison with the current official time-based program in Intensive Care Medicine in Spain. Secondary objectives were: 1) To determine the percentage of critical essential performance elements (CEPE) accomplished, 2) To determine compliance with workplace-based assessments (wba).</div></div><div><h3>Design</h3><div>Multicenter cluster randomized trial.</div></div><div><h3>Setting</h3><div>Thirteen Spanish ICU Departments.</div></div><div><h3>Participants</h3><div>Thirty-six residents</div></div><div><h3>Intervention</h3><div>The implementation of CoBaTrICE included: (1) Training the trainers; (2) Wba; (3) The use of an electronic portfolio. The level of competency achieved by each participant was determined by a simulation-based Objective Structured Clinical Exam (OSCE) performed at the end of the 5th year of training period.</div></div><div><h3>Main variables of interest</h3><div>Total scoring in the five scenarios, CEPE completed, level of competency (1–5) achieved.</div></div><div><h3>Results</h3><div>A total of 119 performances from 26 residents (17 from CoBaTrICE group and 9 from control group) were analyzed in the OSCE. CoBaTrICE residents´ achieved higher levels of competency [2 (1−5) vs. 2 (1−3), p = 0.07) and higher percentages of CEPE´s accomplishment than the control group (78% vs. 71%, p = 0.09).</div></div><div><h3>Conclusions</h3><div>The CoBaTrICE group showed a better performance trend in comparison to the control group, but the differences were not statistically significant. Since the number of Wba performed was low, additional research is needed to determine the potential superiority of CoBaTrICE.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502126"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calidad y seguridad del transporte en ECMO. Aspectos prácticos derivados de nuestra experiencia","authors":"Manuel García-Delgado ,&nbsp;Violeta Chica-Sáez ,&nbsp;Andrea Ferreiro-Marzal ,&nbsp;María Redondo-Orts ,&nbsp;María Esteban-Molina ,&nbsp;José Manuel Garrido-Jiménez ,&nbsp;en representación de la UAMC","doi":"10.1016/j.medin.2025.502156","DOIUrl":"10.1016/j.medin.2025.502156","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502156"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}