Medicina Intensiva最新文献

Gases anestésicos en la sedación de pacientes críticos 对危重病人使用麻醉气体进行镇静

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 Epub Date: 2025-09-22 DOI: 10.1016/j.medin.2025.502301

Carlos Chamorro-Jambrina, Miguel Ángel Romera-Ortega

引用次数: 0

Central venous catheter associated bacteremia in critically ill adult patients using the sealing of unused lumens with taurolidine 中心静脉导管相关菌血症危重成人患者使用牛罗列丁封闭未使用的管腔

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 DOI: 10.1016/j.medin.2025.502252

Leonardo Lorente , Maria Lecuona , Elena Pérez , Adrián Hernández , Sergio Sánchez , Lucas González , Alejandro Ramos , Jesús Pimentel , Pablo Correa , Carmen Dolores Chinea-Rodríguez , Carolina Martín-Meana , Ana Madueño

{"title":"Central venous catheter associated bacteremia in critically ill adult patients using the sealing of unused lumens with taurolidine","authors":"Leonardo Lorente , Maria Lecuona , Elena Pérez , Adrián Hernández , Sergio Sánchez , Lucas González , Alejandro Ramos , Jesús Pimentel , Pablo Correa , Carmen Dolores Chinea-Rodríguez , Carolina Martín-Meana , Ana Madueño","doi":"10.1016/j.medin.2025.502252","DOIUrl":"10.1016/j.medin.2025.502252","url":null,"abstract":"<div><h3>Objective</h3><div>Lower risk of catheter-related bacteremia (CRB) using taurolidine (antimicrobial agent) sealing of central venous catheters (CVCs) in children has been found in a meta-analysis.</div><div>The objective of this study was to analyze whether the sealing of unused lumens of CVCs with taurolidine in critically ill adult patients reduce CRB incidence.</div></div><div><h3>Design</h3><div>Retrospective study.</div></div><div><h3>Setting</h3><div>One Spanish Intensive Care Unit.</div></div><div><h3>Patients</h3><div>Critically ill adult patients, who underwent to some CVC.</div></div><div><h3>Interventions</h3><div>The seal of unused lumens of CVCs was performed with saline serum 0.9% or taurolidine.</div></div><div><h3>Main variable of interest</h3><div>Primary Bloodstream Infection (PBSI) included catheter-related bloodstream infection (CRBSI) CRBSI and bloodstream infection of unknown origin (BSIUO).</div></div><div><h3>Results</h3><div>We diagnosed 22 PBSI in the 573 (3.8%) CVC without taurolidine and 22 PBSI in the 548 (4.0%) CVC with taurolidine (p = 0.88). Logistic regression analysis showed an association of tracheostomy with the risk of PBSI; however, we did not find the association of other variables (included taurolidine) with the risk of PBSI.</div></div><div><h3>Conclusion</h3><div>To the best of our knowledge, this is the first study reporting data about sealing of unused lumens of CVCs with taurolidine in critically ill adult patients. In our preliminary study, we have not been able to demonstrate that sealing unused lumens of CVCs with taurolidine can reduce the risk of PBSI in critically ill adult patients. However, it would be interesting to conduct randomized studies to confirm or discard our findings.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 5","pages":"Article 502252"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757087","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}

引用次数: 0

Respuesta de los autores a: Gases anestésicos en la sedación de pacientes críticos 提交人对以下问题的答复：镇静危重病人中的麻醉气体

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 Epub Date: 2025-10-29 DOI: 10.1016/j.medin.2025.502343

José Manuel Añón , María Paz Escuela , Javier Oliva-Navarro , Arís Pérez-Lucendo , Fernando Suarez-Sipmann

引用次数: 0

The value of local validation of a predictive model. A nomogram for predicting failure of non-invasive ventilation in patients with SARS-COV-2 pneumonia 预测模型的局部验证值。预测SARS-COV-2肺炎患者无创通气失败的nomogram

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 DOI: 10.1016/j.medin.2025.502148

Héctor Hernández Garcés , Alberto Belenguer Muncharaz , Francisco Bernal Julián , Irina Hermosilla Semikina , Luis Tormo Rodríguez , Estefanía Granero Gasamans , Clara Viana Marco , Rafael Zaragoza Crespo

{"title":"The value of local validation of a predictive model. A nomogram for predicting failure of non-invasive ventilation in patients with SARS-COV-2 pneumonia","authors":"Héctor Hernández Garcés , Alberto Belenguer Muncharaz , Francisco Bernal Julián , Irina Hermosilla Semikina , Luis Tormo Rodríguez , Estefanía Granero Gasamans , Clara Viana Marco , Rafael Zaragoza Crespo","doi":"10.1016/j.medin.2025.502148","DOIUrl":"10.1016/j.medin.2025.502148","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to determine predictors of non-invasive ventilation (NIV) failure and validate a nomogram to identify patients at risk of NIV failure.</div></div><div><h3>Design</h3><div>Observational, analytical study of a retrospective cohort from a single center, compared with an external cohort (March 2020 to August 2021).</div></div><div><h3>Setting</h3><div>Two intensive care units (ICUs).</div></div><div><h3>Patients</h3><div>Patients with pneumonia due to severe acute respiratory syndrome (SARS-CoV-2) and NIV > 24 h (154 and 229 in each cohort).</div></div><div><h3>Interventions</h3><div>The training cohort identified NIV failure predictors. A nomogram, created via logistic regression, underwent validation with the Hosmer-Lemeshow (HL), calibration curve and test and area under the curve (AUC). Its external validity was tested using AUC.</div></div><div><h3>Main variables of interest</h3><div>Demographics, comorbidities, severity scores, NIV settings, vital signs, blood gases, and oxygenation at the start and 24 h after NIV, NIV failure.</div></div><div><h3>Results</h3><div>NIV failure was 37.6% and 18% in the training and validation cohorts, respectively. Risk factors for NIV failure inluded age, obesity, sequential organ failure assessment (SOFA) score at admission, and heart rate (HR) and heart rate, acidosis, consciousness, oxygenation, respiratory rate (HACOR) 24 h post-NIV. The model's HL test result was 0.861, with an AUC of 0.89 (confidence interval [CI] 0.839–0.942); validation AUC was 0.547 (CI 0.449–0.645).</div></div><div><h3>Conclusions</h3><div>A predictive model using age, obesity, SOFA score, HR, and HACOR at 24 h predicts NIV failure in our COVID-19 patients but may not apply to other ICUs.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 5","pages":"Article 502148"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756981","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}

引用次数: 0

Solid consequences of enteral nutrition: Facing the therapeutic challenge of esophageal bezoars – A case report 肠内营养的坚实后果：面对食道牛黄的治疗挑战-一个病例报告

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 DOI: 10.1016/j.medin.2025.502311

Marta de Antonio-Cuscó , Lucía Picazo , Agustí Albalat-Torres , Mónica Marín-Casino , Francisco José Parrilla-Gómez , Javier Mateu-de Antonio

引用次数: 0

Macroscopic findings in Tracheobronchial Aspergillosis during Bronchoscopy 支气管镜下气管支气管曲菌病的宏观表现

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 DOI: 10.1016/j.medin.2025.502364

Leandro Tapia Barredo, Santiago Menjura Gómez, Carmen Angela Centeno Clemente

引用次数: 0

High serum malondialdehyde levels in patients with decompression sickness 减压病患者血清丙二醛水平增高

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 DOI: 10.1016/j.medin.2025.502351

Leonardo Lorente , Pedro Abreu González , Candelaria Darias Martin , Ana Matute , Gabriela Menéndez , Juan Francisco Lozano Gomariz , Alejandro Jiménez

引用次数: 0

Ecocardiografía transesofágica: valoración integral del paciente crítico 经食道超声心动图：对危重病人进行全面评估

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 Epub Date: 2026-02-16 DOI: 10.1016/j.medin.2026.502401

Virginia Fraile-Gutiérrez , David Pérez-Torres , Luis Martin-Villen , Luís Zapata , Ana Ochagavia

{"title":"Ecocardiografía transesofágica: valoración integral del paciente crítico","authors":"Virginia Fraile-Gutiérrez , David Pérez-Torres , Luis Martin-Villen , Luís Zapata , Ana Ochagavia","doi":"10.1016/j.medin.2026.502401","DOIUrl":"10.1016/j.medin.2026.502401","url":null,"abstract":"<div><div>Transesophageal echocardiography (TEE) has become an essential tool in the management of critically ill patients, particularly when transthoracic echocardiography is insufficient. Its use allows to obtain high-quality imaging to assess cardiac function, diagnose the cause of shock, monitor fluid responsiveness, and evaluate venous congestion. It is especially valuable in complex scenarios such as stroke, the postoperative period after cardiac surgery, ECMO support, and during cardiac arrest, as it provides continuous visualization without interrupting chest compressions. Although it is a semi-invasive technique, it has a very favorable safety profile when performed by trained intensivists. Adequate training, including supervision and simulation, is crucial for achieving competence. Besides, TEE allows the examination of pulmonary and abdominal structures, extending its utility beyond the heart. Its incorporation into Intensive Care Medicine has demonstrated significant clinical impact, modifying therapeutic management in a high proportion of patients.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 5","pages":"Article 502401"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757089","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}

引用次数: 0

Monitorización hemodinámica en el shock: de lo esencial a lo avanzado 休克中的血流动力学监测：从基本到高级

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 Epub Date: 2025-12-27 DOI: 10.1016/j.medin.2025.502390

Patricia Escudero-Acha, Rodrigo Albillos-Almaraz, Miguel Pajares Calvo, José Antonio Fernández-Ratero

引用次数: 0

Clinical Frailty Scale and Comorbidity-Polypharmacy Score for prediction of 30-day mortality in a mixed ICU population 临床虚弱量表和合并症-多重用药评分用于预测混合ICU人群30天死亡率

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2026-05-01 DOI: 10.1016/j.medin.2025.502292

Sarah Weihe , Lone Musaeus Poulsen , Mathias Maagaard , Anders Fournaise , Søren Kabell Nissen , Camilla Bekker Mortensen , Ole Mathiesen

{"title":"Clinical Frailty Scale and Comorbidity-Polypharmacy Score for prediction of 30-day mortality in a mixed ICU population","authors":"Sarah Weihe , Lone Musaeus Poulsen , Mathias Maagaard , Anders Fournaise , Søren Kabell Nissen , Camilla Bekker Mortensen , Ole Mathiesen","doi":"10.1016/j.medin.2025.502292","DOIUrl":"10.1016/j.medin.2025.502292","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the prediction of 30-day mortality by frailty and comorbidity in a mixed ICU population and monitor the implementation of the Clinical Frailty Scale as daily practice in the ICU.</div></div><div><h3>Design</h3><div>A prospective observational single-center cohort study.</div></div><div><h3>Setting</h3><div>Mixed ICU at Zealand University Hospital.</div></div><div><h3>Patients</h3><div>All patients >40 years of age acutely admitted to the ICU from April 1st 2021 to March 31st 2022.</div></div><div><h3>Main variables of interest</h3><div>Frailty assessed by the Clinical Frailty Scale (CFS), Comorbidity-Polypharmacy-Score (CPS), and 30-day mortality.</div></div><div><h3>Results</h3><div>A total of 319 patients were included in the study. Of these, 118 (37%) were categorized as frail, defined by a CFS ≥ 5. The CPS score was median (IQR) 13 (7–18), rated as moderate. Patients with increasing frailty demonstrated higher CPS scores. The overall 30-day mortality was 34.5%. Patients categorised as frail had a higher 30-day mortality compared to non-frail patients (47% vs 27%). The AUROC of CFS and CPS of 30-day mortality was 0.77 (95% CI 0.72 to 0.83) and 0.75 (95% CI 0.69 to 0.81), respectively. Combining CFS and CPS did not strengthen the ability to predict 30-day mortality compared to CFS alone. ICU clinicians assessed CFS in 79% of patients.</div></div><div><h3>Conclusion</h3><div>Frailty assessed by CFS had a fair prediction of 30-day mortality after ICU admission in a mixed ICU population. The discriminatory ability for predicting 30-day mortality was not improved by combining CFS and CPS compared to CFS alone.</div><div>The clinical implementation of the CFS was performed effectively.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 5","pages":"Article 502292"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757088","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}

引用次数: 0