Medicina Intensiva最新文献

{"title":"Ultrasound artifacts “shred sign” and “pseudo-B lines” in the liver: What is the culprit?","authors":"Xiaoyang Zhou, Yuyi Sha, Bixin Chen","doi":"10.1016/j.medin.2024.03.013","DOIUrl":"10.1016/j.medin.2024.03.013","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 12","pages":"Pages 740-741"},"PeriodicalIF":2.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721583","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":"Stress relaxation, another cause of “Pseudo auto-PEEP”?","authors":"Manuel Valdivia Marchal , María Carmen Bermúdez Ruiz , José Ricardo Naranjo Izurieta , Ashlen Rodríguez Carmona , Juan Francisco Martínez Carmona , José Manuel Serrano Simón","doi":"10.1016/j.medin.2024.06.009","DOIUrl":"10.1016/j.medin.2024.06.009","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 12","pages":"Pages 731-734"},"PeriodicalIF":2.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721580","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":"Selective decontamination of the digestive tract in a burns unit reduces the incidence of hospital-acquired infections: A retrospective before-and-after cohort study","authors":"David Pérez-Torres ,&nbsp;Ana Isabel Martín-Luengo ,&nbsp;Cristina Cuenca-Rubio ,&nbsp;José Ángel Berezo-García ,&nbsp;Cristina Díaz-Rodríguez ,&nbsp;Isabel Canas-Pérez ,&nbsp;María Lorena Fernández-Rodríguez ,&nbsp;Cristina Colmenero-Calleja ,&nbsp;Jesús Sánchez-Ballesteros ,&nbsp;Pablo Blanco-Schweizer ,&nbsp;Thalia Gloria Ticona-Espinoza ,&nbsp;José María Piqueras-Pérez","doi":"10.1016/j.medin.2024.05.006","DOIUrl":"10.1016/j.medin.2024.05.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of selective decontamination of the digestive tract (SDD) on hospital-acquired infections (HAIs) in patients with acute burn injury requiring admission to a Burns Unit (BU).</div></div><div><h3>Design</h3><div>Retrospective before-and-after cohort study, between January 2017 and June 2023. SDD was implemented in March 2019, dividing patients into two groups.</div></div><div><h3>Setting</h3><div>Four-bed BU, in a referral University Hospital in Spain.</div></div><div><h3>Patients</h3><div>All the patients admitted during the study period were eligible for analysis. Patients who died or were discharged within 48<!--> <!-->hours of admission, and patients with an estimated survival less than 10% not considered for full escalation of therapy were excluded.</div></div><div><h3>Intervention</h3><div>SDD comprised the administration of a 4-day course of an intravenous antibiotic, and an oral suspension and oral topical paste of non-absorbable antibiotics during the stay in the BU.</div></div><div><h3>Main variable of interest</h3><div>Incidence of HAIs during the stay in the BU. Secondary outcomes: incidence of specific types of infections by site (bacteremia, pneumonia, skin and soft tissue infection) and microorganism (Gram-positive, Gram-negative, fungi), and safety endpoints.</div></div><div><h3>Results</h3><div>We analyzed 72 patients: 27 did not receive SDD, and 45 received SDD. The number of patients who developed HAIs were 21 (77.8%) and 21 (46.7%) in the non-SDD and the SDD groups, respectively (p<!--> <!-->=<!--> <!-->0.009). The number of hospital-acquired infectious episodes were 2.52 (1.21–3.82) and 1.13 (0.54–1.73), respectively (p<!--> <!-->=<!--> <!-->0.029).</div></div><div><h3>Conclusions</h3><div>SDD was associated with a reduced incidence of bacterial HAIs and a decrease in the number of infectious episodes per patient.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 12","pages":"Pages 677-685"},"PeriodicalIF":2.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721573","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":"Nutrithorax: an uncommon differential diagnosis of the plankton sign","authors":"Isabel Canas-Pérez,&nbsp;David Pérez-Torres,&nbsp;Cristina Cuenca-Rubio","doi":"10.1016/j.medin.2024.04.009","DOIUrl":"10.1016/j.medin.2024.04.009","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 12","pages":"Pages e43-e45"},"PeriodicalIF":2.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720110","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":"Giant lung abscess complicating pneumonia managed with veno venous extracorporeal membrane oxygenation","authors":"Marina López Olivencia,&nbsp;Luis Jaramillo Valarezo,&nbsp;Aaron Blandino Ortiz","doi":"10.1016/j.medin.2024.04.008","DOIUrl":"10.1016/j.medin.2024.04.008","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 11","pages":"Pages e21-e22"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592538","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":"Asociación de fracción de espacio muerto con la mortalidad en pacientes con síndrome de dificultad respiratoria aguda por COVID-19: Un estudio observacional de una cohorte histórica","authors":"Carlos Carvajal ,&nbsp;Nelson Darío Giraldo Ramirez ,&nbsp;Andrés David de la Hoz Castro ,&nbsp;Carlos Guillermo Vidal Vargas ,&nbsp;Hemel Antonio Pacheco ,&nbsp;David Fernández Sánchez ,&nbsp;Laura Vannesa González Salazar ,&nbsp;Silvia Stella Romero Otta ,&nbsp;Silvia Vergara Jaimes ,&nbsp;Juan Fernando Bolívar Ospina ,&nbsp;Juliana Correa Céspedes ,&nbsp;Alejandro Narváez Orozco ,&nbsp;Jorge Hernando Donado ,&nbsp;Carlos Alberto Cadavid ,&nbsp;Gisela de la Rosa","doi":"10.1016/j.medin.2024.05.007","DOIUrl":"10.1016/j.medin.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between dead space fraction (VD/VT) measured through time capnography, corrected minute volume (CMV), and ventilation ratio (VR) with clinical outcomes in COVID-19 patients requiring invasive mechanical ventilation.</div></div><div><h3>Design</h3><div>Observational study of a historical cohort in an university hospital in Medellin, Colombia.</div></div><div><h3>Participants</h3><div>Patients aged 15 and above with confirmed COVID-19 diagnosis admitted to the ICU requiring mechanical ventilation; interventions: measurement of VD/VT, CMV, and VR in COVID-19 patients.</div></div><div><h3>Main variables of interest</h3><div>VD/VT, CMV, VR, demographic data, oxygenation index, and ventilatory parameters.</div></div><div><h3>Results</h3><div>During the study period, 1,047 COVID-19 patients on mechanical ventilation were analyzed, of whom 446 (42%) died. Deceased patients exhibited a higher prevalence of advanced age and obesity, elevated Charlson index, higher APACHE II and SOFA scores, as well as an increase in VD/VT ratio (0.27 in survivors and 0.31 in deceased) and minute ventilation volume on the first day of mechanical ventilation. Multivariate analysis revealed independent associations with in-hospital mortality, higher VD/VT (HR: 1.24; 95% CI: 1.003-1.525; <em>P</em> <!-->=<!--> <!-->0.046), age (HR: 1.024; 95% CI: 1.014-1.034; <em>P</em>&lt;<!--> <!-->0.001), and SOFA score at onset (HR: 1.036; 95% CI: 1.001-1.07; <em>P</em> <!-->=<!--> <!-->0.017).</div></div><div><h3>Conclusions</h3><div>VD/VT demonstrated an association with mortality in COVID-19 ARDS patients on mechanical ventilation. These findings suggest that VD/VT measurement may serve as a severity marker for the disease.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 11","pages":"Pages 639-645"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592597","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":"Análisis de los errores de medicación en Cuidados Intensivos Neonatales: una revisión sistemática","authors":"Francisco Miguel Escandell-Rico ,&nbsp;Lucia Pérez-Fernández","doi":"10.1016/j.medin.2024.06.012","DOIUrl":"10.1016/j.medin.2024.06.012","url":null,"abstract":"<div><div>Medication errors, potentially causing harm and causing harm, increase significantly in newborns cared for in intensive care settings. In this sense, this work carries out a systematic review to analyze the most current evidence in relation to medication errors in neonatal intensive care, discussing the topics that refer to health technology from smart pumps, cost-effectiveness of medications, the practice of nursing professionals on the medication administration process and quality improvement models. In this way, it could be considered a useful tool to promote quality and safety in neonatal intensive care.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 11","pages":"Pages 654-662"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839311","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":"Mortality prediction model from combined serial lactate, procalcitonin and calprotectin levels in critically ill patients with sepsis: A retrospective study according to Sepsis-3 definition","authors":"Luis García de Guadiana-Romualdo ,&nbsp;Lourdes Albert Botella ,&nbsp;Carlos Rodríguez Rojas ,&nbsp;Angela Puche Candel ,&nbsp;Roberto Jimenez Sánchez ,&nbsp;Pablo Conesa Zamora ,&nbsp;María Dolores Albaladejo-Otón ,&nbsp;José Manuel Allegue-Gallego","doi":"10.1016/j.medin.2024.05.004","DOIUrl":"10.1016/j.medin.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>1) To evaluate the ability of baseline and on 24 h serum calprotectin, in comparison to canonical biomarkers (lactate and procalcitonin), for prognosis of 28-day mortality in critically ill septic patients; and 2) To develop a predictive model combining the three biomarkers.</div></div><div><h3>Design</h3><div>A single-center, retrospective study.</div></div><div><h3>Setting</h3><div>Intensive Care Unit of a university hospital.</div></div><div><h3>Patients or participants</h3><div>One hundred and seventy three septic pacientes were included.</div></div><div><h3>Interventions</h3><div>Measurement of baseline lactate, procalcitonin and calprotectin level and procalcitonin and calprotectin levels on 24 h.</div></div><div><h3>Main variables of interest</h3><div>Demographics and comorbidities, SOFA score on ICU admission, baseline lactate, procalcitonin and calprotectin on admission and on 24 h and 28-day mortality.</div></div><div><h3>Results</h3><div>1) On ICU admission, lactate was the only biomarker achieving a significant accuracy (AUC: 0.698); 2) On 24 h, no differences were found on procalcitonin and calprotectin levels. Procalcitonin and calprotectin clearances were significantly lower in non-survivors and both achieved a moderate performance (AUCs: 0.668 and 0.664, respectively); 3) A biomarker based-model achieved a significant accuracy (AUC: 0.766), trending to increase (AUC: 0.829) to SOFA score alone; y 4) Baseline lactate levels and procalcitonin and calprotectin clearance were independent predictors for the outcome.</div></div><div><h3>Conclusions</h3><div>1) Baseline and on 24 h calprotectina and procalcitonin levels lacked ability in predicting 28-day mortality; 2) Accuracy of clearance of both biomarkers was moderate; and 3) Combination of SOFA score and the predictive biomarker based-model showed a high prognostic accuracy.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 11","pages":"Pages 629-638"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592596","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":"Aneurisma de aorta abdominal complicado con fístula aortocava","authors":"","doi":"10.1016/j.medin.2024.02.011","DOIUrl":"10.1016/j.medin.2024.02.011","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 11","pages":"Pages 672-673"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790204","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":"Seguridad del paciente, ¿qué aportan la simulación clínica y la innovación docente?","authors":"Antonio Dueñas-Ruiz ,&nbsp;Luis M. Tamayo Lomas ,&nbsp;Miguel A. Castro Villamor ,&nbsp;Francisco Martín-Rodríguez","doi":"10.1016/j.medin.2024.06.016","DOIUrl":"10.1016/j.medin.2024.06.016","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 11","pages":"Pages 669-670"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839078","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}