Medicina Intensiva最新文献_第3页

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-09-26 DOI: 10.1016/j.medin.2024.07.001

Sara Alcántara Carmona, Héctor Villanueva Fernández

引用次数: 0

High flow Tracheal oxygen: assessment of diaphragmatic functionality by ultrasonography in adults during weaning from mechanical ventilation 高流量气管供氧：在成人机械通气断奶期间通过超声波评估膈肌功能

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-09-26 DOI: 10.1016/j.medin.2024.05.017

Ignacio Fernández Ceballos , Ivan Alfredo Huespe , María Sofía Venuti , Bruno Leonel Ferreyro , José María Dianti , Romina Famiglietti , Ana Montserrat Rivera , Indalecio Carboni Bisso , Marcos Jose Las Heras

引用次数: 0

Sepsis mortality prediction with Machine Learning Tecniques 利用机器学习技术预测败血症死亡率

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-09-26 DOI: 10.1016/j.medin.2024.04.010

Javier Carrillo Pérez-Tome , Tesifón Parrón-Carreño , Ana Belen Castaño-Fernández , Bruno José Nievas-Soriano , Gracia Castro-Luna

{"title":"Sepsis mortality prediction with Machine Learning Tecniques","authors":"Javier Carrillo Pérez-Tome , Tesifón Parrón-Carreño , Ana Belen Castaño-Fernández , Bruno José Nievas-Soriano , Gracia Castro-Luna","doi":"10.1016/j.medin.2024.04.010","DOIUrl":"10.1016/j.medin.2024.04.010","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a sepsis death classification model based on machine learning techniques for patients admitted to the Intensive Care Unit (ICU).</div></div><div><h3>Design</h3><div>Cross-sectional descriptive study.</div></div><div><h3>Setting</h3><div>The Intensive Care Units (ICUs) of three Hospitals from Murcia (Spain) and patients from the MIMIC III open-access database.</div></div><div><h3>Patients</h3><div>180 patients diagnosed with sepsis in the ICUs of three hospitals and a total of 4559 patients from the MIMIC III database.</div></div><div><h3>Main variables of interest</h3><div>Age, weight, heart rate, respiratory rate, temperature, lactate levels, partial oxygen saturation, systolic and diastolic blood pressure, pH, urine, and potassium levels.</div></div><div><h3>Results</h3><div>A random forest classification model was calculated using the local and MIMIC III databases. The sensitivity of the model of our database, considering all the variables classified as important by the random forest, was 95.45%, the specificity was 100%, the accuracy was 96.77%, and an AUC of 95%. . In the case of the model based on the MIMIC III database, the sensitivity was 97.55%, the specificity was 100%, and the precision was 98.28%, with an AUC of 97.3%.</div></div><div><h3>Conclusions</h3><div>According to random forest classification in both databases, lactate levels, urine output and variables related to acid.base equilibrium were the most important variable in mortality due to sepsis in the ICU. The potassium levels were more critical in the MIMIC III database than the local database.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparing lung aeration and respiratory effort using two different spontaneous breathing trial: T-piece vs pressure support ventilation 使用两种不同的自主呼吸试验比较肺通气和呼吸强度：T形通气与压力支持通气

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-08-28 DOI: 10.1016/j.medin.2023.06.015

Raquel Bosch-Compte , Francisco José Parrilla , Rosana Muñoz-Bermúdez , Irene Dot , Cristina Climent , Joan Ramon Masclans , Judith Marin-Corral , Purificación Pérez-Terán

{"title":"Comparing lung aeration and respiratory effort using two different spontaneous breathing trial: T-piece vs pressure support ventilation","authors":"Raquel Bosch-Compte , Francisco José Parrilla , Rosana Muñoz-Bermúdez , Irene Dot , Cristina Climent , Joan Ramon Masclans , Judith Marin-Corral , Purificación Pérez-Terán","doi":"10.1016/j.medin.2023.06.015","DOIUrl":"10.1016/j.medin.2023.06.015","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the changes in lung aeration and respiratory effort generated by two different spontaneous breathing trial (SBT): T-piece (T-T) vs pressure support ventilation (PSV).</p></div><div><h3>Design</h3><p>Prospective, interventionist and randomized study.</p></div><div><h3>Setting</h3><p>Intensive Care Unit (ICU) of Hospital del Mar.</p></div><div><h3>Participants</h3><p>Forty-three ventilated patients for at least 24 h and considered eligible for an SBT were included in the study between October 2017 and March 2020.</p></div><div><h3>Interventions</h3><p>30-min SBT with T-piece (T-T group, 20 patients) or 8-cmH<sub>2</sub>O PSV and 5-cmH<sub>2</sub>O positive end expiratory pressure (PSV group, 23 patients).</p></div><div><h3>Main variables of interest</h3><p>Demographics, clinical data, physiological variables, lung aeration evaluated with electrical impedance tomography (EIT) and lung ultrasound (LUS), and respiratory effort using diaphragmatic ultrasonography (DU) were collected at different timepoints: basal (BSL), end of SBT (EoSBT) and one hour after extubation (OTE).</p></div><div><h3>Results</h3><p>There were a loss of aeration measured with EIT and LUS in the different study timepoints, without statistical differences from BSL to OTE, between T-T and PSV [LUS: 3 (1, 5.5) AU vs 2 (1, 3) AU; p = 0.088; EELI: −2516.41 (−5871.88, 1090.46) AU vs −1992.4 (−3458.76, −5.07) AU; p = 0.918]. Percentage of variation between BSL and OTE, was greater when LUS was used compared to EIT (68.1% vs 4.9%, p ≤ 0.001). Diaphragmatic excursion trend to decrease coinciding with a loss of aeration during extubation.</p></div><div><h3>Conclusion</h3><p>T-T and PSV as different SBT strategies in ventilated patients do not show differences in aeration loss, nor estimated respiratory effort or tidal volume measured by EIT, LUS and DU.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087900","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

Subcutaneous emphysema everywhere! 皮下气肿无处不在！

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-08-28 DOI: 10.1016/j.medin.2024.01.007

Francisca Silva Cardoso, Rita Morais Passos

引用次数: 0

Harlequin syndrome: a picture speaks a thousand words 哈莱金综合征：一图胜千言

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-08-28 DOI: 10.1016/j.medin.2024.01.006

Jorge Martínez-Solano , Nerea Alava-Echevarría , Iago Sousa-Casasnovas

引用次数: 0

Can end-tidal CO2 measurement replace arterial partial CO2 in emergency department respiratory distress management? 在急诊科呼吸窘迫管理中，潮气末二氧化碳测量能否取代动脉部分二氧化碳测量？

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-08-28 DOI: 10.1016/j.medin.2024.03.021

Kudret Selki, Mehmet Cihat Demir, Erdinç Şengüldür, Emre Erdem, Hatice Güldal, Murat Taşdemir, Alp Kaan Furkan Kıcıroğlu, Mustafa Boğan

{"title":"Can end-tidal CO2 measurement replace arterial partial CO2 in emergency department respiratory distress management?","authors":"Kudret Selki, Mehmet Cihat Demir, Erdinç Şengüldür, Emre Erdem, Hatice Güldal, Murat Taşdemir, Alp Kaan Furkan Kıcıroğlu, Mustafa Boğan","doi":"10.1016/j.medin.2024.03.021","DOIUrl":"10.1016/j.medin.2024.03.021","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the feasibility of using end-tidal carbon dioxide (EtCO<sub>2</sub>) as a non-invasive substitute for partial pressure of arterial carbon dioxide (PaCO<sub>2</sub>) in emergency department (ED) triage and follow-up, and to explore the potential of partial pressure of venous carbon dioxide (PvCO<sub>2</sub>) as an alternative to PaCO<sub>2</sub>.</p></div><div><h3>Design</h3><p>Prospective cross-sectional study.</p></div><div><h3>Setting</h3><p>Tertiary university hospital.</p></div><div><h3>Patients or participants</h3><p>97 patients presenting with acute respiratory distress to the ED.</p></div><div><h3>Interventions</h3><p>EtCO<sub>2</sub>, arterial blood gases, and venous blood gases measured at admission (0 min), 60 min, and 120 min.</p></div><div><h3>Main variables of interest</h3><p>CO<sub>2</sub> levels.</p></div><div><h3>Results</h3><p>Among 97 patients (mean age: 70.93 ± 9.6 years; 60.8% male), EtCO<sub>2</sub> > 45 mmHg at admission showed strong positive correlations with PaCO<sub>2</sub> and PvCO<sub>2</sub> (<em>r</em> = 0.844, <em>r</em> = 0.803; <em>p</em> < 0.001, respectively). Significant positive correlation was observed between 60-min EtCO<sub>2</sub> and PaCO<sub>2</sub> (<em>r</em> = 0.729; <em>p</em> < 0.001). Strong correlation between PaCO<sub>2</sub> and PvCO<sub>2</sub> at 120 min when EtCO<sub>2</sub> > 45 mmHg (<em>r</em> = 0.870; <em>p</em> < 0.001). EtCO<sub>2</sub> was higher in hospitalized patients compared to discharged ones.</p></div><div><h3>Conclusions</h3><p>EtCO<sub>2</sub> appears promising as a substitute for PaCO<sub>2</sub> in ED patients with acute respiratory distress within the initial two hours of treatment. Venous blood gas sampling offers a less invasive alternative to arterial sampling, facilitating simultaneous blood tests.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087905","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

Intrahospital transportation of mechanically-ventilated COVID-19 patients: a cohort study 机械通气的 COVID-19 患者的院内转运：一项队列研究

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-08-28 DOI: 10.1016/j.medin.2024.05.001

Sara Ferreira Pagliarini , Pedro Henrique Rigotti Soares , Matheus Golenia dos Passos , Leonardo da Silva Marques , Wagner Nedel

引用次数: 0

Nitric oxide as the third respiratory gas. A new opportunity to revisit the use of oxygen therapy in clinical practice 一氧化氮作为第三种呼吸气体。在临床实践中重新审视氧气疗法的新机遇

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-08-28 DOI: 10.1016/j.medin.2024.06.006

José Manuel Valencia-Gallardo , Felipe Rodríguez de Castro , Jordi Solé-Violán , José Carlos Rodríguez-Gallego

引用次数: 0

High-flow nasal cannula in Spanish Pediatric Intensive Care Services: A national web survey about its use and indications 西班牙儿科重症监护服务中的高流量鼻插管：关于其使用和适应症的全国性网络调查

IF 2.7 4区医学

Medicina Intensiva Pub Date : 2024-08-28 DOI: 10.1016/j.medin.2024.03.009

Alberto García-Salido , Vicente Modesto I Alapont , Alberto Medina-Villanueva , Spanish respiratory group of the Spanish Society of Pediatric Intensive Care

{"title":"High-flow nasal cannula in Spanish Pediatric Intensive Care Services: A national web survey about its use and indications","authors":"Alberto García-Salido , Vicente Modesto I Alapont , Alberto Medina-Villanueva , Spanish respiratory group of the Spanish Society of Pediatric Intensive Care","doi":"10.1016/j.medin.2024.03.009","DOIUrl":"10.1016/j.medin.2024.03.009","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the high-flow nasal cannula (HFNC) indications in the Spanish pediatric critical care units (PICUs).</p></div><div><h3>Design</h3><p>Descriptive cross-sectional observational study.</p></div><div><h3>Setting</h3><p>Electronic survey among members of the Spanish Society of Pediatric Intensive Care (SECIP). It was sent weekly from April 10, 2023, to May 21, 2023.</p></div><div><h3>Participants</h3><p>All SECIP members.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Main variables of interest</h3><p>The questions focused on workplace, years of experience, use or non-use of HFNC, justification and expectations regarding its application, starting point within each center, clinical criteria for indication, existence of clinical guidelines, evaluation during its use, and criteria and mode of withdrawal.</p></div><div><h3>Results</h3><p>Two hundred and two participants, 176 were from Spain. Of these, 87/176 had over ten years of experience. One hundred sixty two use HFNC and 66/162 have HFNC clinical guidelines. Acute bronchiolitis (138/162) and respiratory assistance after extubation (106/56) are the two main indications. For 62/162 HFNC may reduce therapeutic escalation. Neuromuscular diseases (105/162) and anatomical airway diseases (135/162) are the two main contraindications. The reasons to do not use HFNC were the absence of evidence about it effectiveness (8/14) and its inadequate cost/effectiveness balance (8/14).</p></div><div><h3>Conclusions</h3><p>A majority of Spanish pediatric intensivists use HFNC. Its application and withdrawal appears to be primarily based on clinical experience. Besides, those who use HFNC are aware of its limitations and the lack of evidence in some cases. It is necessary to develop single-center and multicenter studies to elucidate the effectiveness of this therapy in the context of critically ill children.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087906","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