Medicina Intensiva最新文献

{"title":"Intravenous beta-blockers versus amiodarone on in-hospital mortality and safety profile in adult septic patients","authors":"Guoge Huang ,&nbsp;Haizhong Li ,&nbsp;Feier Song ,&nbsp;Chunmei Zhang ,&nbsp;Mengling Jian ,&nbsp;Chunyang Huang ,&nbsp;Yingqin Zhang ,&nbsp;Bei Hu ,&nbsp;Wenqiang Jiang","doi":"10.1016/j.medin.2025.502143","DOIUrl":"10.1016/j.medin.2025.502143","url":null,"abstract":"<div><h3>Objective</h3><div>In the present study, we aimed to compare in-hospital mortality and safety of intravenous beta-blockers and amiodarone in septic patients with new-onset atrial fibrillation (NOAF). The null hypothesis is that there is no significant difference in in-hospital mortality and safety of Beta-blocker (BBs) and amiodarone in treating NOAF in patients with sepsis.</div></div><div><h3>Design</h3><div>We conducted a retrospective analysis based on the MIMIC-IV database. Septic patients with NOAF were screened.</div></div><div><h3>Setting</h3><div>Patients admitted to adult mixed ICU for septic patients with NOAF.</div></div><div><h3>Patients</h3><div>A total of 34,789 patients were screened of whom 1394 patients were included for the analysis: 286 in the amiodarone group and 1108 in the BBs group.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Cox proportional hazard model was used to examine the in-hospital mortality, ventilator-free days and duration of atrial fibrillation in patients receiving either amiodarone or intravenous BBs. Propensity score matching was applied to determine any association.</div></div><div><h3>Results</h3><div>After Propensity Score (PS) matching, a total of 244 patients were included in both the BB and amiodarone groups. In this cohort, BBs was significantly associated with lower in-hospital mortality [adjusted hazard ratio (HR) of 0.70 (95% CI 0,54–0,91; P = 0.008)]. On the other hand, patients who received amiodarone had a shorter duration of atrial fibrillation (54.17 h vs 72.81 h; <em>P</em> = 0.003). There was no significant difference in ventilator-free days between the BB group and the amiodarone group.</div></div><div><h3>Conclusion</h3><div>In septic patients with NOAF, patients receiving BBs had lower in-hospital mortality than those who received amiodarone. On the other hand, amiodarone group had a shorter duration of atrial fibrillation. There was no significant difference in ventilator-free days between the BB group and the amiodarone group.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502143"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522352","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":"What should intensivists know about immune checkpoint inhibitors and their side effects?","authors":"Viktor Yordanov Zlatkov Aleksandrov,&nbsp;Fernando Martínez Sagasti,&nbsp;Juncal Pérez-Somarriba Moreno,&nbsp;Helena Huertas Mondéjar","doi":"10.1016/j.medin.2024.502135","DOIUrl":"10.1016/j.medin.2024.502135","url":null,"abstract":"<div><div>The pharmacological group of immune checkpoint-inhibitors (ICI) has revolutionized the field of oncology in the last ten years. The improvements in the survival of certain cancers thanks to these treatments comes at the cost of an increased morbidity and mortality due to certain immune related adverse events (irAE). This review will concentrate on the irAE that more frequently require intensive care unit (ICU) admission. The infectious burden of patients treated with ICI is also explored, shining light not only on the infections caused by the immunosuppression needed to manage the different irAE, but also on the specific infections arising from a unique immune dysregulation only seen in ICI treated patients.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502135"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522353","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":"Niveles óptimos de hemoglobina en el paciente neurocrítico: ¿hemos llegado ya?","authors":"Manuel Quintana-Diaz ,&nbsp;Daniel Agustin Godoy","doi":"10.1016/j.medin.2025.502162","DOIUrl":"10.1016/j.medin.2025.502162","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502162"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522517","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":"Seguridad y eficacia de betabloqueantes y amiodarona en el manejo de la fibrilación auricular de nueva aparición en el paciente crítico con sepsis","authors":"Alfonso Canabal Berlanga","doi":"10.1016/j.medin.2025.502159","DOIUrl":"10.1016/j.medin.2025.502159","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502159"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522451","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":"Respuesta a: «Vasopresina: ¿por qué no en la enfermedad traumática grave?»","authors":"Juan Carlos Ruíz-Rodríguez ,&nbsp;Ana Ochagavia ,&nbsp;Lluís Zapata ,&nbsp;Ricard Ferrer","doi":"10.1016/j.medin.2025.502220","DOIUrl":"10.1016/j.medin.2025.502220","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502220"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522514","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":"Electrical impedance tomography for the detection and management optimization of pulmonary embolism","authors":"Isabel Magaña Bru,&nbsp;Alicia Delgado Arroyo,&nbsp;Fernando Suarez Sipmann","doi":"10.1016/j.medin.2024.502134","DOIUrl":"10.1016/j.medin.2024.502134","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502134"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522516","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":"Ausencia congénita de la arteria coronaria circunfleja","authors":"Antonio Padilla-Serrano ,&nbsp;Carmen de la Cueva Coca ,&nbsp;Antonio Cárdenas Cruz","doi":"10.1016/j.medin.2025.502152","DOIUrl":"10.1016/j.medin.2025.502152","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502152"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522513","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":"Fiabilidad intraobservador e interobservador de las escalas de fragilidad Clinical Frailty Scale-España y FRAIL-España en pacientes críticos","authors":"Susana Arias-Rivera ,&nbsp;María Mar Sánchez-Sánchez ,&nbsp;Raquel Jareño-Collado ,&nbsp;Marta Raurell-Torredà ,&nbsp;Lorena Oteiza-López ,&nbsp;Sonia López-Cuenca ,&nbsp;Israel John Thuissard-Vasallo ,&nbsp;Fernando Frutos-Vivar","doi":"10.1016/j.medin.2024.502131","DOIUrl":"10.1016/j.medin.2024.502131","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the intrarater and interrater reliability of the Clinical Frailty Scale-Spain (CFS-España) and FRAIL-España and the internal consistency of the FRAIL-España when implemented in critically ill patients by intensive care nurses and physicians.</div></div><div><h3>Design</h3><div>Descriptive, observational and metric study.</div></div><div><h3>Setting</h3><div>Intensive care unit (ICU) of Spain.</div></div><div><h3>Patients</h3><div>Patients<!--> <!-->&gt;<!--> <!-->18 years, with &gt;<!--> <!-->48 UCI hours.</div></div><div><h3>Intervention</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>On admission, frailty with CFS-España and FRAIL-España (by 3 nurses and 2 intensive care physicians), sex, age, comorbidities and severity.</div></div><div><h3>Results</h3><div>1,045 assessments were performed in 206 patients. Not frail patients on admission: 53% according to the CFS-Spain and 34% according to the FRAIL-Spain.</div><div>The intraclass correlation coefficient (ICC) shows almost perfect intrarater concordance (&gt;<!--> <!-->0.80 for CFS-España and &gt;<!--> <!-->0.90 for FRAIL-España). Agreement by frailty strata (non-fragile, pre-fragile and fragile patients) was substantial or almost perfect, with no major differences in ratings between nurses and physicians.</div><div>Interprofessional concordance shows an almost perfect ICC for both scales. The lowest agreement was obtained for the FRAIL-España ratings among physicians. In the frailty strata analysis, agreement was moderate. The highest agreement for the CFS-España was considering level 4 patients as frail.</div><div>High reliability of the FRAIL-España and strong correlation of all dimensions with the global assessment were obtained, except for the comorbidities dimension, with a weak correlation.</div></div><div><h3>Conclusion</h3><div>The CFS-España and FRAIL-España scales are reliable for assessing frailty in critically ill patients by nurses and/or intensive care physicians.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502131"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522452","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":"Neuroaspergilosis: un desafío diagnóstico en los pacientes inmunosuprimidos ilustrado en una imagen de resonancia magnética","authors":"Almudena Domínguez González,&nbsp;Nuria Medina Cabrera,&nbsp;Alejandro Hueso Mor","doi":"10.1016/j.medin.2025.502151","DOIUrl":"10.1016/j.medin.2025.502151","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502151"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522354","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":"Vasopresina: ¿por qué no en la enfermedad traumática grave?","authors":"Jesús Abelardo Barea-Mendoza ,&nbsp;Juan Antonio Llompart-Pou ,&nbsp;Adrian Marcos-Morales ,&nbsp;Mario Chico-Fernández","doi":"10.1016/j.medin.2025.502173","DOIUrl":"10.1016/j.medin.2025.502173","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 7","pages":"Article 502173"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522507","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}