Medicina Intensiva最新文献_第2页

Actualización de la taxonomía de los modos de ventilación mecánica 更新机械通风模式分类法

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-10-01 DOI: 10.1016/j.medin.2025.502211

Aurio Fajardo-Campoverdi , Eduardo Mireles-Cabodevila , Alberto Medina , Miguel Ibarra-Estrada , José Baltazar-Torres , Robert Chatburn

{"title":"Actualización de la taxonomía de los modos de ventilación mecánica","authors":"Aurio Fajardo-Campoverdi , Eduardo Mireles-Cabodevila , Alberto Medina , Miguel Ibarra-Estrada , José Baltazar-Torres , Robert Chatburn","doi":"10.1016/j.medin.2025.502211","DOIUrl":"10.1016/j.medin.2025.502211","url":null,"abstract":"<div><div>The rapid technological development of mechanical ventilation has resulted in increasingly complex modes, advanced monitoring capabilities and the incorporation of artificial intelligence. However, manufacturers have created a multitude of trade names, which has generated a great deal of confusion in their understanding, handling and application. This problem is exacerbated in Spanish-speaking countries due to inconsistencies in translations and variability in nomenclature between regions. This manuscript aims to provide an updated review of the taxonomic classification of ventilatory modes in order to promote standardization of terminology, especially in the Spanish-speaking clinical context, and includes changes in the taxonomy and manner of labeling modes of mechanical ventilation. This review focuses on invasive mechanical ventilation of the adult critically ill patient, although the taxonomy is also applicable to all ventilation modalities, including noninvasive, high-frequency, pediatric, and even home ventilation.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502211"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189702","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

Endobronchial actinomycosis Endobronchial actinomycosis

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-10-01 DOI: 10.1016/j.medin.2025.502228

Chih-Jung Chang , Yi-Han Hsiao

引用次数: 0

La inteligencia artificial en medicina intensiva, la revolución gradual 人工智能在重症监护中的渐进式革命

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-09-01 DOI: 10.1016/j.medin.2025.502164

Alejandro González-Castro

引用次数: 0

Effectiveness of non-invasive ventilation in critical patients with acute respiratory failure and do not intubate order 无创通气在急性呼吸衰竭危重患者无插管顺序中的有效性

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-09-01 DOI: 10.1016/j.medin.2025.502169

Andres Carrillo-Alcaraz , Miguel Guia , Pilar Tornero-Yepez , Laura López-Gomez , Nuria Alonso-Fernandez , Juan Gervasio Martin Lorenzo , Juan Miguel Sanchez Nieto

{"title":"Effectiveness of non-invasive ventilation in critical patients with acute respiratory failure and do not intubate order","authors":"Andres Carrillo-Alcaraz , Miguel Guia , Pilar Tornero-Yepez , Laura López-Gomez , Nuria Alonso-Fernandez , Juan Gervasio Martin Lorenzo , Juan Miguel Sanchez Nieto","doi":"10.1016/j.medin.2025.502169","DOIUrl":"10.1016/j.medin.2025.502169","url":null,"abstract":"<div><h3>Objective</h3><div>The main purpose of this study was to analyze the prevalence of do-not-intubate (DNI) orders in patients admitted to an Intensive Care Unit (ICU) due to acute respiratory failure (ARF) and who were treated with non-invasive ventilation (NIV). The secondary objective was to correlate the presence of a DNI order with the patient’s prognosis.</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Setting</h3><div>Polyvalent ICU.</div></div><div><h3>Patients</h3><div>All consecutively admitted ICU patients for ARF between January 1<sup>st</sup>, 1997, and December 31<sup>st</sup>, 2022, who were treated with NIV.</div></div><div><h3>Main variables of interest</h3><div>Initial clinical variables, NIV failure rate, complications, in-hospital and one-year mortality.</div></div><div><h3>Results</h3><div>5972 patients were analyzed, 1275 (21.3%) presenting a DNI order. The mean age was 68.2 ± 14.9; 60.2% were male. The most frequent cause of DNI order was chronic respiratory disease (452 patients; 35.5%<em>)</em>. Patients with DNI order were older, had higher Charlson comorbidity index and higher frailty. NIV failure occurred in 536 (42.0%) patients in the DNI order group vs. 1118 (23.8%) in the non-DNI order group (p < 0.001). In-hospital mortality was higher in patients with DNI order (57.9% vs 16.4%; p < 0.001). The adjusted OR for inhospital mortality was 2.14 (95% CI 1.98 to 2.31).</div></div><div><h3>Conclusions</h3><div>DNI orders are common in patients with ARF treated with NIV and they related to worse short and long-term prognosis.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502169"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921203","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

Reformulación de los análisis aleatorios de seguridad en tiempo real durante la pandemia SARS-CoV-2 在SARS-CoV-2大流行期间重新设计实时随机安全分析

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-09-01 DOI: 10.1016/j.medin.2024.502117

Gonzalo Sirgo , Manuel A. Samper , Julen Berrueta , Joana Cañellas , Alejandro Rodríguez , María Bodí

{"title":"Reformulación de los análisis aleatorios de seguridad en tiempo real durante la pandemia SARS-CoV-2","authors":"Gonzalo Sirgo , Manuel A. Samper , Julen Berrueta , Joana Cañellas , Alejandro Rodríguez , María Bodí","doi":"10.1016/j.medin.2024.502117","DOIUrl":"10.1016/j.medin.2024.502117","url":null,"abstract":"<div><h3>Introduction</h3><div>From a safety perspective, the pandemic imposed atypical work dynamics that led to noticeable gaps in clinical safety across all levels of health care.</div></div><div><h3>Objectives</h3><div>To verify that Real-Time Random Safety Analyses (AASTRE) are feasible and useful in a high-pressure care setting.</div></div><div><h3>Design</h3><div>Prospective study (January to September 2022).</div></div><div><h3>Setting</h3><div>University hospital with 350 beds. Two mixed ICUs (12 and 14 beds).</div></div><div><h3>Interventions</h3><div>Two safety audits per week were planned to determine the feasibility and usefulness of the 32 safety measures (grouped into 8 blocks).</div></div><div><h3>Main variables of interest</h3><div>1) Feasibility: Proportion of completed audits compared to scheduled audits and time spent. 2)Utility: Changes in the care process made as a result of implementing AASTRE.</div></div><div><h3>Results</h3><div>A total of 390 patient-days were analyzed (179 were non-COVID patients and 49 were COVID patients). In the COVID patient subgroup, age, ICU stay, SAPS-3, and ICU mortality were significantly higher compared to the non-COVID patient subgroup. Regarding feasibility, 93.8% of planned rounds were carried out with an average audit time of 25±8minutes. Overall, changes in the care process were made in 11.8% of the measures analyzed.</div></div><div><h3>Conclusions</h3><div>In a high-complexity care environment, AASTRE proved to be a feasible and useful tool with only two interventions per week lasting less than 30minutes. Overall, AASTRE allowed unsafe situations to be turned safe in more than 10% of the evaluations.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502117"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921201","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

Usamos ventilación no invasiva cada día, pero ¿conocemos su eficacia real en nuestro centro? 我们每天都使用非侵入性通风，但我们知道它在我们中心的真正效果吗？

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-09-01 DOI: 10.1016/j.medin.2025.502213

Rafael Fernández Fernández

引用次数: 0

Susurros del corazón: la travesía de una disección aórtica 心脏低语：主动脉切除术之旅

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-09-01 DOI: 10.1016/j.medin.2025.502175

Pablo Carrión Montaner , Mario Sutil-Vega , Jordi Sans-Roselló

引用次数: 0

Analysis of frailty as a prognostic factor independent of age: A prospective observational study 衰弱作为独立于年龄的预后因素的分析：一项前瞻性观察研究

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-09-01 DOI: 10.1016/j.medin.2025.502144

Rosario Molina Lobo , Federico Gordo Vidal , Lola Prieto López , Inés Torrejón Pérez , Antonio Naharro Abellán , Irene Salinas Gabiña , Beatriz Lobo Valbuena

{"title":"Analysis of frailty as a prognostic factor independent of age: A prospective observational study","authors":"Rosario Molina Lobo , Federico Gordo Vidal , Lola Prieto López , Inés Torrejón Pérez , Antonio Naharro Abellán , Irene Salinas Gabiña , Beatriz Lobo Valbuena","doi":"10.1016/j.medin.2025.502144","DOIUrl":"10.1016/j.medin.2025.502144","url":null,"abstract":"<div><h3>Objective</h3><div>Analyze the effects of frailty and prefrailty in patients admitted to the ICU without age limits and to determine the factors associated with mortality.</div></div><div><h3>Design</h3><div>Prospective cohort.</div></div><div><h3>Setting</h3><div>Intensive Care Unit, Spain.</div></div><div><h3>Patients</h3><div>1462 critically ill patients without age limits.</div></div><div><h3>Intervention</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Hospital mortality and health outcomes.</div></div><div><h3>Results</h3><div>Patients’ ages ranged from 15 to 93 years, median of 66 years. Predisposing factors independently associated with frailty and prefrailty were age older than 65 years, female sex, respiratory and renal comorbidities, longer pre-ICU stays, and weekend admission. There is a greater use of noninvasive mechanical ventilation, greater colonization by multidrug-resistant bacteria, and the development of <em>delirium</em>. The risk of hospital mortality was RR 4.04 (2.11–7.74; <em>P</em>  <.001) for frail. Factors associated with in-hospital mortality in prefrail and frail were pre-ICU hospital length of stay (cutpoint 4.5 days [1.6–7.4]), greater severity on admission (SAPS3) (cutpoint 64.5 [63.6–65.4]), Glasgow Coma Scale deterioration (OR 4.14 [1.23–13.98]; <em>P</em> .022) and thrombocytopenia (OR 11.46 [2.21–59.42]; <em>P</em> .004).</div></div><div><h3>Conclusions</h3><div>Lower levels of frailty are most common in ICU patients and are associated with worse health outcomes. Our data suggest that frailty and pre frailty should be determined in all patients admitted to the ICU, regardless of their age.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502144"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921202","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

Reexplicarnos la seguridad del paciente en Medicina Intensiva: necesidad de entender y actuar 重新解释重症监护患者的安全：理解和行动的必要性

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-09-01 DOI: 10.1016/j.medin.2025.502219

María Cruz Martín Delgado , Mario Chico Fernández , Gonzalo Sirgo Rodríguez , María Bodí

引用次数: 0

El intensivista debe dirigir la implementación de la inteligencia artificial en la UCI 强化者应该领导UCI的人工智能部署

IF 3.1 4区医学

Medicina Intensiva Pub Date : 2025-09-01 DOI: 10.1016/j.medin.2025.502253

Juan-Jose Beunza

引用次数: 0