Medicina Intensiva最新文献

{"title":"Quality of causality assessment among observational studies in intensive care: A methodological review","authors":"Laura Del Campo-Albendea ,&nbsp;Ana García De La Santa Viñuela ,&nbsp;Óscar Peñuelas ,&nbsp;José Ignacio Pijoan Zubizarreta ,&nbsp;Khalid Saeed Khan ,&nbsp;Alfonso Muriel ,&nbsp;Javier Zamora","doi":"10.1016/j.medin.2025.502142","DOIUrl":"10.1016/j.medin.2025.502142","url":null,"abstract":"<div><div>Intensive care units (ICUs) rely in many instances on observational research and often encounter difficulties in establishing cause-and-effect relationships. After conducting a thorough search focused on ICU observational studies, this review analysed the causal language and evaluated the quality of reporting of the methodologies employed. The causal was assessed by analysing the words linking exposure to outcomes in the title and main objective. The quality of the reporting of the key methodological aspects related to causal inference was based on STROBE and ROBINS-I tools. We identified 139 articles, with 87 (63%) and 82 (59%) studies having non-causal language in their title and main objective, respectively. Among the total, 49 (35%) articles directly addressed causality. The review found vague causal language in observational ICU research and highlighted the need for better adherence to reporting guidelines for improved causal analysis and inference.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502142"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921204","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":"Comunicación interventricular post infarto","authors":"Emilio Curiel Balsera,&nbsp;Guillermo Gómez Gallego,&nbsp;Alejandro Navarro Cruz","doi":"10.1016/j.medin.2025.502202","DOIUrl":"10.1016/j.medin.2025.502202","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502202"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921131","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":"Reverse shock index multiplied by Glasgow coma scale (rSIG) to predict mortality in traumatic brain injury: systematic review and meta-analysis","authors":"Gustavo Adolfo Vásquez-Tirado ,&nbsp;Edinson Dante Meregildo-Rodríguez ,&nbsp;Claudia Vanessa Quispe-Castañeda ,&nbsp;María Cuadra-Campos ,&nbsp;Wilson Marcial Guzmán-Aguilar ,&nbsp;Percy Hernán Abanto-Montalván ,&nbsp;Hugo Alva-Guarniz ,&nbsp;Leslie Jacqueline Liñán-Díaz ,&nbsp;Luis Ángel Rodríguez-Chávez","doi":"10.1016/j.medin.2025.502149","DOIUrl":"10.1016/j.medin.2025.502149","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether the Reverse Shock Index multiplied by the Glasgow Coma Scale (rSIG) is a predictor of in-hospital mortality in patients with traumatic brain injury (TBI).</div></div><div><h3>Design</h3><div>This is a systematic review and meta-analysis.</div></div><div><h3>Setting</h3><div>A comprehensive search was conducted in five databases for studies published up to May 22, 2024, using a PECO strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis.</div></div><div><h3>Participants</h3><div>The participants of the included primary studies.</div></div><div><h3>Interventions</h3><div>Patients with a low rSIG as a predictor of in-hospital mortality in TBI.</div></div><div><h3>Main variables of interest</h3><div>rSIG, in-hospital mortality, TBI.</div></div><div><h3>Results</h3><div>Our meta-analysis evaluated a total of eight observational studies encompassing 430,000 patients with TBI, observing 6,417 deaths (15%). After performing a sensitivity analysis, we found that patients with TBI and a low value of the reverse shock index multiplied by the Glasgow Coma Scale (rSIG) had a 24% higher risk of death (OR 1.24; 95% CI 1.12–1.38; I²: 96%). Furthermore, rSIG values were significantly higher in survivors compared to those who died (MD 7.72; 95% CI 1.86–13.58; I²: 99%).</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502149"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922221","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":"Monitoreo a través de tomografía por impedancia eléctrica en ECMO pediátrico","authors":"Gabriel Appendino,&nbsp;Fernando Paziencia,&nbsp;Carlos Lovesio","doi":"10.1016/j.medin.2025.502155","DOIUrl":"10.1016/j.medin.2025.502155","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502155"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921129","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":"Changes in the stress hormone cortisol during intensive care unit stay as a predictor of objective cognition at discharge","authors":"Guillem Navarra-Ventura ,&nbsp;Marta Godoy-González ,&nbsp;Lluís Blanch ,&nbsp;Josefina López-Aguilar ,&nbsp;Sol Fernández-Gonzalo","doi":"10.1016/j.medin.2025.502166","DOIUrl":"10.1016/j.medin.2025.502166","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502166"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749483","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":"Exploring volatile anesthetics in critical care: Facts and uncertainties","authors":"José Manuel Añón ,&nbsp;María Paz Escuela ,&nbsp;Javier Oliva-Navarro ,&nbsp;Arís Pérez-Lucendo ,&nbsp;Fernando Suarez-Sipmann","doi":"10.1016/j.medin.2025.502174","DOIUrl":"10.1016/j.medin.2025.502174","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502174"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749978","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":"Afectación multisistémica por infección comunitaria grave por Streptococcus pyogenes","authors":"Ángel Orera Pérez,&nbsp;Mónica Gordón Sauquillo,&nbsp;Paula Ramírez Galleymore","doi":"10.1016/j.medin.2025.502206","DOIUrl":"10.1016/j.medin.2025.502206","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502206"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749482","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":"Experience with ECMO therapy for acute respiratory distress syndrome treatment throughout the COVID-19 pandemic","authors":"José María Arribas-Leal ,&nbsp;José Miguel Rivera-Caravaca ,&nbsp;Claudia Vicente-Andreu ,&nbsp;Alicia Verdú-Verdú ,&nbsp;Ángel Sornichero ,&nbsp;Daniel Pérez-Martínez ,&nbsp;Juan Blanco-Morillo ,&nbsp;Francisco Gutiérrez ,&nbsp;Marina Simón-Páez ,&nbsp;Rubén Jara ,&nbsp;Sergio J. Canovas-Lopez ,&nbsp;Carlos Albacete-Moreno","doi":"10.1016/j.medin.2025.502207","DOIUrl":"10.1016/j.medin.2025.502207","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze our experience with extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory distress syndrome (ARDS) treatment during the COVID-19 pandemic.</div></div><div><h3>Design</h3><div>Retrospective, observational, single center study.</div></div><div><h3>Setting</h3><div>Third-level hospital in Spain.</div></div><div><h3>Patients</h3><div>Adult patients with COVID-19 ARDS treated with an ECMO system in our center between March 2020 and March 2023.</div></div><div><h3>Interventions</h3><div>Retrospective collection of variables during hospital admission and follow-up.</div></div><div><h3>Main Variables of Interest</h3><div>Demographic variables, clinical history, variables related to ECMO therapy, COVID-19 wave number, in-hospital mortality, adverse events, ICU and hospital length of stay, and functional status at follow-up were collected.</div></div><div><h3>Results</h3><div>Eighty-one patients were included. Of these, 61 patients (75%) died during hospitalization. Patients who died were older and had more comorbidities. During the second, third, and sixth waves, mortality was higher. In the multivariate analysis, the only independent predictor of mortality was age (OR 1.24 95% CI (1.027–1.5, <em>P</em> = 0.025). After discharge, 40% of patients had difficulties returning to normal life due to respiratory failure requiring oxygen and arthropathies.</div></div><div><h3>Conclusion</h3><div>In-hospital mortality increased during the pandemic. Older age was the only independent predictor of mortality. After discharge, no deaths were recorded during the first 18 months of follow-up, although 40% of surviving patients had respiratory and motor sequelae making it difficult for them to return to a normal life.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502207"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749976","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":"Desarrollo y validación de modelos predictivos de mortalidad en pacientes oncológicos críticos en la UCI: una necesidad urgente","authors":"Elena Cuenca Fito ,&nbsp;Inés Gómez-Acebo ,&nbsp;Alejandro González Castro","doi":"10.1016/j.medin.2025.502163","DOIUrl":"10.1016/j.medin.2025.502163","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502163"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749973","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":"¿Cambiaron durante la pandemia los procedimientos de intubación de pacientes críticos sin infección por SARS-CoV-2? Análisis secundario del estudio multicéntrico INTUPROS","authors":"José Luis García-Garmendia ,&nbsp;Josep Trenado-Álvarez ,&nbsp;Federico Gordo-Vidal ,&nbsp;Elena Gordillo-Escobar ,&nbsp;Esther Martínez-Barrios ,&nbsp;Fernando Onieva-Calero ,&nbsp;Víctor Sagredo-Meneses ,&nbsp;Emilio Rodríguez-Ruiz ,&nbsp;Rafael Ángel Bohollo-de-Austria ,&nbsp;José Moreno-Quintana ,&nbsp;María Isabel Ruiz-García ,&nbsp;José Garnacho-Montero","doi":"10.1016/j.medin.2024.502122","DOIUrl":"10.1016/j.medin.2024.502122","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the changes in intubation procedures of critically ill patients without SARS-CoV-2 infection induced during the COVID-19 pandemic.</div></div><div><h3>Design</h3><div>Secondary analysis of the INTUPROS prospective multicenter observational study on intubation in intensive care units (ICUs).</div></div><div><h3>Setting</h3><div>A numbre of 43 Spanish ICUs between April 2019 and October 2020.</div></div><div><h3>Patients</h3><div>A total of 1,515 non-COVID-19 patients intubated before and during the pandemic.</div></div><div><h3>Interventions</h3><div>None. Main variables of interest: Intubation procedures and medication, first-pass success rate, complications, and mortality.</div></div><div><h3>Results</h3><div>A total of 1,199 patients intubated before the pandemic and 316 during the pandemic were analyzed. During the pandemic, there were fewer days until intubation (OR 0.95; 95% CI: 0.92-0.98), reduced resuscitation bag (OR 0.43; 95% CI: 0.29-0.63) and non-invasive ventilation oxygenation (OR 0.51; 95% CI: 0.34-0.76), reduced use of capnography (OR 0.55; 95% CI: 0.33-0.92) and fentanyl (OR 0.47; 95% CI: 0.34-0.63). On the other hand, there was an increase in oxygenation with non-HFNC devices (OR 2.21; 95% CI: 1.23-3.96), in use of videolaryngoscopy on the first-pass (OR 2.74; 95% CI: 1.76-4.24), and greater use of midazolam (OR 1.95; 95% CI: 1.39-2.72), etomidate (OR 1.78; 95% CI: 1.28-2.47) and succinylcholine (OR 2.55; 95% CI: 1.82-3.58). The first-pass success was higher (68.5% vs. 74.7%; <em>P</em> <!-->=<!--> <!-->0.033). There were no pre-post differences in major complications (34.7% vs. 34.8%; <em>P</em> <!-->=<!--> <!-->0.970) and in-hospital mortality (42.7% vs. 38.6%; <em>P</em> <!-->=<!--> <!-->0.137).</div></div><div><h3>Conclusions</h3><div>The COVID-19 pandemic modified intubation procedures in non-COVID-19 patients, changing the oxygenation strategy, the medication and the use of videolaryngoscopy, with no impact on complications or mortality.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502122"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749974","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}