Carola Giménez-Esparza Vich , Felipe Martínez , Daniela Olmos Kutscherauer , Daniel Molano , Maria del Carmen Gallardo , Enrique Mario Olivares-Durán , Jesús Caballero , Rosa Reina , Manuela García Sánchez , Federico C. Carini , Comité de Analgesia, Sedación y Delirium de la Federación Panamericana e Ibérica de Cuidados Críticos y Terapia Intensiva (FEPIMCTI)
{"title":"Prácticas de analgosedación y delirium en pacientes críticos de la región Panamericana e Ibérica y factores asociados a la sobresedación tras la pandemia COVID-19: resultados del estudio PANDEMIC","authors":"Carola Giménez-Esparza Vich , Felipe Martínez , Daniela Olmos Kutscherauer , Daniel Molano , Maria del Carmen Gallardo , Enrique Mario Olivares-Durán , Jesús Caballero , Rosa Reina , Manuela García Sánchez , Federico C. Carini , Comité de Analgesia, Sedación y Delirium de la Federación Panamericana e Ibérica de Cuidados Críticos y Terapia Intensiva (FEPIMCTI)","doi":"10.1016/j.medin.2024.502123","DOIUrl":"10.1016/j.medin.2024.502123","url":null,"abstract":"<div><div>Oversedation has adverse effects on critically ill patients. The Analgosedation and Delirium Committee of the FEPIMCTI (Pan-American and Iberian Federation of Critical Care Medicine and Intensive Care) conducted a cross-sectional study through a survey addressed to ICU physicians: PANDEMIC (Pan-American and Iberian Study on the Management of Analgosedation and Delirium in Critical Care [fepImCti]).</div><div>Hypothesis Worsening of these practices in the course of the pandemic and that continued afterwards, with further oversedation.</div></div><div><h3>Objectives</h3><div>Perception of analgosedation and delirium practices in Pan-American and Iberian ICUs before, during and after the COVID-19 pandemic, and factors associated with persistent oversedation after the pandemic.</div><div>Of the 1008 respondents, 25% perceived oversedation after the pandemic (95%<!--> <!-->CI: 22.4-27.8). This perception was higher in South America (35.8%; <em>P</em> <!--><<!--> <!-->.001). Main risk factor: habit acquired during the pandemic (adjusted OR [aOR]: 3.16; 95%<!--> <!-->CI: 2.24-4.45; <em>P</em> <!--><<!--> <!-->.001). Main protective factor: delirium monitoring before the pandemic (aOR: 0.70; 95%<!--> <!-->CI: 0.50-0.98; <em>P</em> <!-->=<!--> <!-->.038).</div><div>The factors identified in this study provide a basis for targeting future interventions.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 5","pages":"Article 502123"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891451","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":"¿Es hora de medir la supervivencia libre de enfermedad en población oncológica crítica?","authors":"Elena Cuenca-Fito , Eric Mayor-Vázquez","doi":"10.1016/j.medin.2025.502157","DOIUrl":"10.1016/j.medin.2025.502157","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 5","pages":"Article 502157"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891453","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 rol de la potencia elástica estática en la gravedad y en el pronóstico del síndrome de distrés respiratorio agudo","authors":"Sara Manrique , Federico Gordo","doi":"10.1016/j.medin.2025.502160","DOIUrl":"10.1016/j.medin.2025.502160","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 5","pages":"Article 502160"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891518","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}
Mauro Robertino Del Bono , Luis Felipe Damiani , Gustavo Adrián Plotnikow , Sebastián Consalvo , Emanuel Di Salvo , Gastón Murias
{"title":"Esfuerzos respiratorios inefectivos y sus potenciales consecuencias durante la ventilación mecánica","authors":"Mauro Robertino Del Bono , Luis Felipe Damiani , Gustavo Adrián Plotnikow , Sebastián Consalvo , Emanuel Di Salvo , Gastón Murias","doi":"10.1016/j.medin.2024.502133","DOIUrl":"10.1016/j.medin.2024.502133","url":null,"abstract":"<div><div>The implementation of invasive mechanical ventilation (IMV) in critically ill patients involves two crucial moments: the total control phase, affected among other things by the use of analgesics and sedatives, and the transition phase to spontaneous ventilation, which seeks to shorten IMV times and where optimizing patient-ventilator interaction is one of the main challenges. Ineffective inspiratory efforts (IEE) arise when there is no coordination between patient effort and ventilator support. IIE are common in different ventilatory modes and are associated with worse clinical outcomes: dyspnea, increased sedation requirements, increased IMV days and longer intensive care unit (ICU) and hospital stay. These are manifested graphically as an abrupt decrease in expiratory flow, being more frequent during expiration. However, and taking into consideration that it is still unknown whether this association is causal or rather a marker of disease severity, recognizing the potential physiological consequences, reviewing diagnostic methods and implementing detection and treatment strategies that can limit them, seems reasonable.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 5","pages":"Article 502133"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891473","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}
Alejandro Arturo Caballo Manuel, Carlos García Fuentes, Jesús Barea Mendoza, Susana Bermejo-Aznáres, Mario Chico-Fernández
{"title":"Recursos humanos y materiales dirigidos en un programa de atención al paciente traumático potencialmente grave en urgencias","authors":"Alejandro Arturo Caballo Manuel, Carlos García Fuentes, Jesús Barea Mendoza, Susana Bermejo-Aznáres, Mario Chico-Fernández","doi":"10.1016/j.medin.2024.09.004","DOIUrl":"10.1016/j.medin.2024.09.004","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 4","pages":"Pages 245-247"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739138","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}