Medicina Intensiva最新文献

{"title":"Control térmico en el daño cerebral agudo: revisión narrativa","authors":"Eva Esther Tejerina Álvarez ,&nbsp;José Ángel Lorente Balanza","doi":"10.1016/j.medin.2024.02.001","DOIUrl":"10.1016/j.medin.2024.02.001","url":null,"abstract":"<div><p>Temperature management has been used in patients with acute brain injury resulting from different conditions, such as post-cardiac arrest hypoxic-ischaemic insult, acute ischaemic stroke, and severe traumatic brain injury. However, current evidence offers inconsistent and often contradictory results regarding the clinical benefit of this therapeutic strategy on mortality and functional outcomes. Current guidelines have focused mainly on active prevention and treatment of fever, while therapeutic hypothermia (TH) has fallen into disuse, although doubts persist as to its effectiveness according to the method of application and appropriate patient selection. This narrative review presents the most relevant clinical evidence on the effects of TH in patients with acute neurological damage, and the pathophysiological concepts supporting its use.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279920","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":"Neumotórax espontáneo y enfisema subcutáneo masivo en paciente con neumonía necrosante por Klebsiella pneumoniae","authors":"","doi":"10.1016/j.medin.2024.02.007","DOIUrl":"10.1016/j.medin.2024.02.007","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406395","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":"POCUS abdominal. Imagen ecográfica característica de aneurisma de aorta infrarrenal trombosado","authors":"","doi":"10.1016/j.medin.2024.02.003","DOIUrl":"10.1016/j.medin.2024.02.003","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279872","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":"Correlación y concordancia de los cocientes SaO2/FiO2 y paO2/FiO2 en pacientes con neumonía por COVID-19 que recibieron soporte ventilatorio no invasivo en dos unidades de cuidados intensivos","authors":"Alberto Belenguer-Muncharaz ,&nbsp;Francisco Bernal-Julián ,&nbsp;Héctor Hernández-Garcés ,&nbsp;Irina Hermosilla-Semikina ,&nbsp;Lluís Tormo Rodriguez ,&nbsp;Clara Viana Marco","doi":"10.1016/j.medin.2024.02.005","DOIUrl":"10.1016/j.medin.2024.02.005","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273460","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":"Limitación de tratamientos de soporte vital en Unidades de Cuidados Intensivos españolas: análisis del estudio ETHICUS II","authors":"Ángel Estella ,&nbsp;Carolina Lagares ,&nbsp;María José Furones ,&nbsp;Pilar Martínez López ,&nbsp;Noelia Isabel Lázaro Martín ,&nbsp;Belén Estebánez ,&nbsp;Jose Manuel Gómez García ,&nbsp;Olga Rubio ,&nbsp;Bárbara Vidal Tejedor ,&nbsp;Laura Galarza ,&nbsp;Manuel Palomo Navarro ,&nbsp;Vicent López Camps ,&nbsp;Mari Cruz Martín ,&nbsp;Juan Carlos Montejo ,&nbsp;Alexander Avidan ,&nbsp;Charles Sprung ,&nbsp;Grupo de Trabajo de Bioética de la Sociedad Española de Medicina Intensiva y Unidades Coronarias (SEMICYUC)","doi":"10.1016/j.medin.2024.01.014","DOIUrl":"10.1016/j.medin.2024.01.014","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study is to describe the results of Spanish ICUs in ETHICUS II study.</p></div><div><h3>Design</h3><p>Planned substudy of patients from ETHICUS II study.</p></div><div><h3>Setting</h3><p>12 Spanish ICU.</p></div><div><h3>Patients or participants</h3><p>Patients admitted to Spanish ICU who died or in whom a limitation of life-sustaining treatment (LLST) was decided during a recruitment period of 6 months.</p></div><div><h3>Interventions</h3><p>Follow-up of patients was performed until discharge from the ICU and 2 months after the decision of LLST or death.</p></div><div><h3>Main variables of interest</h3><p>Demographic characteristics, clinical profile, type of decision of LLST, time and form in which it was adopted. Patients were classified into 4 categories according to the ETHICUS II study protocol: withholding or withdrawing life-sustaining therapy, active shortening of the dying process, failed cardiopulmonary resuscitation and patients with brain death.</p></div><div><h3>Results</h3><p>A total of 795 patients were analyzed; 129 patients died after CPR, 129 developed brain death. LLST was decided in 537 patients, 485 died in the ICU, 90.3%. The mean age was 66.19 years<!--> <!-->±<!--> <!-->14.36, 63.8% of male patients. In 221 (41%) it was decided to withdraw life-sustaining treatments and in 316(59%) withholding life-sustaining treatments. Nineteen patients (2.38%) had advance living directives.</p></div><div><h3>Conclusions</h3><p>The predominant clinical profile when LTSV was established was male patients over 65 years with mostly cardiovascular comorbidity.</p><p>We observed that survival was higher in LLST decisions involving withholding of treatments compared to those in which withdrawal was decided.</p><p>Spain has played a leading role in both patient and ICU recruitment participating in this worldwide multicenter study.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140087116","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":"Perforación de base de cráneo por cocaína","authors":"J. R. Romeu Prieto, María Teresa Correas López, Jhoann Miguel Guerra Cuervo","doi":"10.1016/j.medin.2024.02.004","DOIUrl":"https://doi.org/10.1016/j.medin.2024.02.004","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277238","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 de hiperinfestación por Strongyloides stercoralis: un desafío infrecuente pero mortal en las UCI","authors":"","doi":"10.1016/j.medin.2024.01.011","DOIUrl":"10.1016/j.medin.2024.01.011","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469040","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":"Massive pseudoaneurysm complicated with cardiac arrest after COVID 19 related myocardial infraction","authors":"Carlos Roca-Guerrero ,&nbsp;Andrea Arenas-Loriente ,&nbsp;Rut Andrea","doi":"10.1016/j.medin.2023.11.002","DOIUrl":"https://doi.org/10.1016/j.medin.2023.11.002","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139985394","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":"Association of obesity on the outcome of critically ill patients affected by COVID-19","authors":"Alejandro Rodríguez ,&nbsp;Ignacio Martín-Loeches ,&nbsp;Gerard Moreno ,&nbsp;Emili Díaz ,&nbsp;Cristina Ferré ,&nbsp;Melina Salgado ,&nbsp;Judith Marín-Corral ,&nbsp;Angel Estella ,&nbsp;Jordi Solé-Violán ,&nbsp;Sandra Trefler ,&nbsp;Rafael Zaragoza ,&nbsp;Lorenzo Socias ,&nbsp;Marcio Borges-Sa ,&nbsp;Marcos I Restrepo ,&nbsp;Juan J Guardiola ,&nbsp;Luis F Reyes ,&nbsp;Antonio Albaya-Moreno ,&nbsp;Alfonso Canabal Berlanga ,&nbsp;María del Valle Ortiz ,&nbsp;Juan Carlos Ballesteros ,&nbsp;María Bodí","doi":"10.1016/j.medin.2023.08.010","DOIUrl":"https://doi.org/10.1016/j.medin.2023.08.010","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the impact of obesity on ICU mortality.</p></div><div><h3>Design</h3><p>Observational, retrospective, multicentre study.</p></div><div><h3>Setting</h3><p>Intensive Care Unit (ICU).</p></div><div><h3>Patients</h3><p>Adults patients admitted with COVID-19 and respiratory failure.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Primary variables of interest</h3><p>Collected data included demographic and clinical characteristics, comorbidities, laboratory tests and ICU outcomes. Body mass index (BMI) impact on ICU mortality was studied as (1) a continuous variable, (2) a categorical variable obesity/non-obesity, and (3) as categories defined a priori: underweight, normal, overweight, obesity and Class III obesity. The impact of obesity on mortality was assessed by multiple logistic regression and Smooth Restricted cubic (SRC) splines for Cox hazard regression.</p></div><div><h3>Results</h3><p>5,206 patients were included, 20 patients (0.4%) as underweight, 887(17.0%) as normal, 2390(46%) as overweight, 1672(32.1) as obese and 237(4.5%) as class III obesity. The obesity group patients (n = 1909) were younger (61 vs. 65 years, p &lt; 0.001) and with lower severity scores APACHE II (13 [9–17] vs. 13[10−17, p &lt; 0.01) than non-obese. Overall ICU mortality was 28.5% and not different for obese (28.9%) or non-obese (28.3%, p = 0.65). Only Class III obesity (OR = 2.19, 95%CI 1.44–3.34) was associated with ICU mortality in the multivariate and SRC analysis.</p></div><div><h3>Conclusions</h3><p>COVID-19 patients with a BMI &gt; 40 are at high risk of poor outcomes in the ICU. An effective vaccination schedule and prolonged social distancing should be recommended.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139985395","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":"An uncommon echocardiographic finding in the inferior vena cava after decannulation of extracorporeal membrane oxygenation","authors":"Xiaoyang Zhou,&nbsp;Jianneng Pan,&nbsp;Bixin Chen","doi":"10.1016/j.medin.2023.10.001","DOIUrl":"https://doi.org/10.1016/j.medin.2023.10.001","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139985393","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}