Medicina Intensiva最新文献

{"title":"High flow Tracheal oxygen: assessment of diaphragmatic functionality by ultrasonography in adults during weaning from mechanical ventilation","authors":"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","doi":"10.1016/j.medin.2024.05.017","DOIUrl":"10.1016/j.medin.2024.05.017","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 10","pages":"Pages 614-616"},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322257","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":"Diez aspectos clave sobre el uso de la vasopresina en el paciente crítico","authors":"Ricard Ferrer ,&nbsp;Pedro Castro ,&nbsp;Carol Lorencio ,&nbsp;Josman Monclou ,&nbsp;Pilar Marcos-Neira ,&nbsp;Ana Ochagavía ,&nbsp;Juan Carlos Ruíz-Rodríguez ,&nbsp;Josep Trenado ,&nbsp;Christian Villavicencio ,&nbsp;Juan Carlos Yébenes ,&nbsp;Lluís Zapata ,&nbsp;en nombre del Grupo de trabajo de sepsis de la SOCMIC","doi":"10.1016/j.medin.2024.07.008","DOIUrl":"10.1016/j.medin.2024.07.008","url":null,"abstract":"<div><div>The most used vasopressors in critically ill patients are exogenous catecholamines, mainly norepinephrine. Their use can be associated with serious adverse events and even increased mortality, especially if administered at high doses. In recent years, the addition of vasopressin has been proposed to counteract the deleterious effects of high doses of catecholamines (decatecholaminization) with the intention of improving the prognosis of these patients. Currently, vasopressin has two main indications: septic shock and vasoplegic shock in the postoperative period of cardiac surgery. In septic shock, current evidence favors its early initiation before reaching high doses of norepinephrine. In the postoperative period of cardiac surgery, the different benefits of the use of vasopressin have been studied, especially in patients with atrial fibrillation and pulmonary hypertension. When used properly, vasopressin is a safe an effective drug for the indications described above.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 12","pages":"Pages 704-713"},"PeriodicalIF":2.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721577","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":"El futuro de la enfermería en la unidad de cuidados intensivos: la especialización y la práctica clínica avanzada ¿rivalidad o sinergia?","authors":"Mónica Vázquez-Calatayud","doi":"10.1016/j.medin.2024.08.004","DOIUrl":"10.1016/j.medin.2024.08.004","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 12","pages":"Pages 728-730"},"PeriodicalIF":2.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721579","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":"Incorporar la perspectiva del paciente crítico… ¿Cuestión de moda o de necesidad?","authors":"Olga Rubio Sanchiz ,&nbsp;Joan Escarrabill","doi":"10.1016/j.medin.2024.06.010","DOIUrl":"10.1016/j.medin.2024.06.010","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 12","pages":"Pages 737-739"},"PeriodicalIF":2.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721582","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":"Comparing lung aeration and respiratory effort using two different spontaneous breathing trial: T-piece vs pressure support ventilation","authors":"Raquel Bosch-Compte ,&nbsp;Francisco José Parrilla ,&nbsp;Rosana Muñoz-Bermúdez ,&nbsp;Irene Dot ,&nbsp;Cristina Climent ,&nbsp;Joan Ramon Masclans ,&nbsp;Judith Marin-Corral ,&nbsp;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-cmH₂O PSV and 5-cmH₂O 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":"48 9","pages":"Pages 501-510"},"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}

{"title":"Subcutaneous emphysema everywhere!","authors":"Francisca Silva Cardoso,&nbsp;Rita Morais Passos","doi":"10.1016/j.medin.2024.01.007","DOIUrl":"10.1016/j.medin.2024.01.007","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 9","pages":"Pages 557-558"},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087903","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":"Harlequin syndrome: a picture speaks a thousand words","authors":"Jorge Martínez-Solano ,&nbsp;Nerea Alava-Echevarría ,&nbsp;Iago Sousa-Casasnovas","doi":"10.1016/j.medin.2024.01.006","DOIUrl":"10.1016/j.medin.2024.01.006","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 9","pages":"Pages 561-562"},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087904","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":"Can end-tidal CO2 measurement replace arterial partial CO2 in emergency department respiratory distress management?","authors":"Kudret Selki,&nbsp;Mehmet Cihat Demir,&nbsp;Erdinç Şengüldür,&nbsp;Emre Erdem,&nbsp;Hatice Güldal,&nbsp;Murat Taşdemir,&nbsp;Alp Kaan Furkan Kıcıroğlu,&nbsp;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 (EtCO₂) as a non-invasive substitute for partial pressure of arterial carbon dioxide (PaCO₂) in emergency department (ED) triage and follow-up, and to explore the potential of partial pressure of venous carbon dioxide (PvCO₂) as an alternative to PaCO₂.</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>EtCO₂, 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>CO₂ levels.</p></div><div><h3>Results</h3><p>Among 97 patients (mean age: 70.93 ± 9.6 years; 60.8% male), EtCO₂ &gt; 45 mmHg at admission showed strong positive correlations with PaCO₂ and PvCO₂ (<em>r</em> = 0.844, <em>r</em> = 0.803; <em>p</em> &lt; 0.001, respectively). Significant positive correlation was observed between 60-min EtCO₂ and PaCO₂ (<em>r</em> = 0.729; <em>p</em> &lt; 0.001). Strong correlation between PaCO₂ and PvCO₂ at 120 min when EtCO₂ &gt; 45 mmHg (<em>r</em> = 0.870; <em>p</em> &lt; 0.001). EtCO₂ was higher in hospitalized patients compared to discharged ones.</p></div><div><h3>Conclusions</h3><p>EtCO₂ appears promising as a substitute for PaCO₂ 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":"48 9","pages":"Pages 511-519"},"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}

{"title":"Intrahospital transportation of mechanically-ventilated COVID-19 patients: a cohort study","authors":"Sara Ferreira Pagliarini ,&nbsp;Pedro Henrique Rigotti Soares ,&nbsp;Matheus Golenia dos Passos ,&nbsp;Leonardo da Silva Marques ,&nbsp;Wagner Nedel","doi":"10.1016/j.medin.2024.05.001","DOIUrl":"10.1016/j.medin.2024.05.001","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 9","pages":"Pages 549-551"},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087901","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":"Nitric oxide as the third respiratory gas. A new opportunity to revisit the use of oxygen therapy in clinical practice","authors":"José Manuel Valencia-Gallardo ,&nbsp;Felipe Rodríguez de Castro ,&nbsp;Jordi Solé-Violán ,&nbsp;José Carlos Rodríguez-Gallego","doi":"10.1016/j.medin.2024.06.006","DOIUrl":"10.1016/j.medin.2024.06.006","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 9","pages":"Pages 543-545"},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087908","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}