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Prácticas seguras en los servicios de medicina intensiva. ¿Es posible el riesgo Zero?
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medin.2024.04.004
Xavier Nuvials Casals , Marta García García
{"title":"Prácticas seguras en los servicios de medicina intensiva. ¿Es posible el riesgo Zero?","authors":"Xavier Nuvials Casals ,&nbsp;Marta García García","doi":"10.1016/j.medin.2024.04.004","DOIUrl":"10.1016/j.medin.2024.04.004","url":null,"abstract":"<div><div>Incidents related to patient safety are a problem of great impact in intensive care medicine (ICM). Multiple strategies have been developed to identify them, analyze, and develop policies aim at reducing their incidence and minimizing their effects and consequences. The development of a safety culture, an adequate organizational and structural design of the ICM, which contemplates the implementation of effective safe practices, with a provision of human resources adjusted to the care activity carried out and the periodic analysis of the different events and their factors, will allow us to bring the risk of critical patient care closer to zero, as would be desirable.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 2","pages":"Pages 105-111"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143097580","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
De ecuaciones geométricas a estrategias dinámicas: avances en la personalización de la ventilación mecánica mediante la potencia mecánica
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.10.003
Alejandro González-Castro , Aurio Fajardo Campoverdi
{"title":"De ecuaciones geométricas a estrategias dinámicas: avances en la personalización de la ventilación mecánica mediante la potencia mecánica","authors":"Alejandro González-Castro ,&nbsp;Aurio Fajardo Campoverdi","doi":"10.1016/j.medin.2024.10.003","DOIUrl":"10.1016/j.medin.2024.10.003","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 59-60"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160858","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
Clinical experience on the use of liposomal amphotericin B in the ICU
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.08.006
Silvia Ramos, Isabel Solchaga-Sánchez, Alberto Calvo, Mercedes Power, Sergio García-Ramos, Patricia Piñeiro
{"title":"Clinical experience on the use of liposomal amphotericin B in the ICU","authors":"Silvia Ramos,&nbsp;Isabel Solchaga-Sánchez,&nbsp;Alberto Calvo,&nbsp;Mercedes Power,&nbsp;Sergio García-Ramos,&nbsp;Patricia Piñeiro","doi":"10.1016/j.medin.2024.08.006","DOIUrl":"10.1016/j.medin.2024.08.006","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 50-53"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128508","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
High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.07.003
Adrián Gallardo , Aldana Silvero , Santiago Saavedra
{"title":"High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table","authors":"Adrián Gallardo ,&nbsp;Aldana Silvero ,&nbsp;Santiago Saavedra","doi":"10.1016/j.medin.2024.07.003","DOIUrl":"10.1016/j.medin.2024.07.003","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 57-58"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160853","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
Edema intramiocárdico como manifestación atípica del síndrome de fuga capilar
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.05.009
Montserrat Rodríguez Gómez, María Calle Romero, Sara Domingo Marín
{"title":"Edema intramiocárdico como manifestación atípica del síndrome de fuga capilar","authors":"Montserrat Rodríguez Gómez,&nbsp;María Calle Romero,&nbsp;Sara Domingo Marín","doi":"10.1016/j.medin.2024.05.009","DOIUrl":"10.1016/j.medin.2024.05.009","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 64-65"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160862","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
Efecto del metamizol en los niveles plasmáticos de voriconazol
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.10.002
Carlos Ignacio Díaz-Calderón Horcada , Marta Mejías Trueba , Mónica Izuel Rami , Ana Belén Guisado Gil , Elena Herranz Bayo , Laura Herrera Hidalgo
{"title":"Efecto del metamizol en los niveles plasmáticos de voriconazol","authors":"Carlos Ignacio Díaz-Calderón Horcada ,&nbsp;Marta Mejías Trueba ,&nbsp;Mónica Izuel Rami ,&nbsp;Ana Belén Guisado Gil ,&nbsp;Elena Herranz Bayo ,&nbsp;Laura Herrera Hidalgo","doi":"10.1016/j.medin.2024.10.002","DOIUrl":"10.1016/j.medin.2024.10.002","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 54-56"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160852","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
Biphasic transdiaphragmatic pressure morphology identifies unilateral diaphragmatic paralysis
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.04.012
Manuel Valdivia Marchal, José Ricardo Naranjo Izurieta, José Manuel Serrano Simón
{"title":"Biphasic transdiaphragmatic pressure morphology identifies unilateral diaphragmatic paralysis","authors":"Manuel Valdivia Marchal,&nbsp;José Ricardo Naranjo Izurieta,&nbsp;José Manuel Serrano Simón","doi":"10.1016/j.medin.2024.04.012","DOIUrl":"10.1016/j.medin.2024.04.012","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 61-63"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160857","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
Neumonía grave adquirida en la comunidad por Streptococcus pyogenes
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.05.012
Johanna Marcela Abril-Victorino, Mirian Ruiz de la Cuesta-López, Sergio Gómez-Camino
{"title":"Neumonía grave adquirida en la comunidad por Streptococcus pyogenes","authors":"Johanna Marcela Abril-Victorino,&nbsp;Mirian Ruiz de la Cuesta-López,&nbsp;Sergio Gómez-Camino","doi":"10.1016/j.medin.2024.05.012","DOIUrl":"10.1016/j.medin.2024.05.012","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 66-67"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160861","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
Patient safety in the Intensive Care Department
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.07.010
María Cruz Martín-Delgado , María Bodí
{"title":"Patient safety in the Intensive Care Department","authors":"María Cruz Martín-Delgado ,&nbsp;María Bodí","doi":"10.1016/j.medin.2024.07.010","DOIUrl":"10.1016/j.medin.2024.07.010","url":null,"abstract":"<div><div>Patient safety is a priority for all healthcare systems. Despite this, too many patients still suffer harm as a consequence of healthcare. Furthermore, it has a significant impact on family members, professionals and healthcare institutions, resulting in considerable economic costs. The critically ill patient is particularly vulnerable to adverse events. Numerous safe practices have been implemented, acknowledging the influence of human factors on safety and the significance of the well-being of professionals, as well as the impact of critical episodes at hospital discharge on patients and their families. Training and engagement of professionals, patients and families are of paramount importance. Recently, artificial intelligence has demonstrated its ability to enhance clinical safety. This update on “Patient Safety” reviews all these aspects related to one of the most pivotal dimensions of healthcare quality.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 25-31"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160863","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
Fractional excretion of sodium and potassium and urinary strong ion difference in the evaluation of persistent AKI in sepsis
IF 2.7 4区 医学
Medicina Intensiva Pub Date : 2025-01-01 DOI: 10.1016/j.medin.2024.01.004
Nicolás Contrera Rolón , Joaquín Cantos , Iván Huespe , Eduardo Prado , Griselda I. Bratti , Carlos Schreck , Sergio Giannasi , Guillermo Rosa Diez , Carlos F. Varela
{"title":"Fractional excretion of sodium and potassium and urinary strong ion difference in the evaluation of persistent AKI in sepsis","authors":"Nicolás Contrera Rolón ,&nbsp;Joaquín Cantos ,&nbsp;Iván Huespe ,&nbsp;Eduardo Prado ,&nbsp;Griselda I. Bratti ,&nbsp;Carlos Schreck ,&nbsp;Sergio Giannasi ,&nbsp;Guillermo Rosa Diez ,&nbsp;Carlos F. Varela","doi":"10.1016/j.medin.2024.01.004","DOIUrl":"10.1016/j.medin.2024.01.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic performance of FENa (Fractional excretion of sodium), FEK (fractional excretion of potassium) and uSID (urinary strong ion difference) in predicting pAKI in sepsis and septic shock.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Two intensive care units in Argentina.</div></div><div><h3>Patients</h3><div>Adult patients with a confirmed diagnosis of sepsis or septic shock and AKI, and had a urinary biochemistry within 24<!--> <!-->h of the AKI diagnosis.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>We evaluated the diagnostic accuracy of FENa, FEK and uSID through a ROC (Receiver Operating Characteristic) curve analysis.</div></div><div><h3>Results</h3><div>80 patients were included. 40 patients presented pAKI. pAKI group had higher APACHE, SOFA score, and mortality rate. In the ROC curve analysis, uSID had no diagnostic utility (AUC<!--> <!-->=<!--> <!-->0.52, <em>p</em> <!-->=<!--> <!-->0.69). FENa presented moderate accuracy showing an AUC of 0.71 (95% CI 0.60−0.83; <em>p</em> <!-->=<!--> <!-->0.001), while FEK presented low accuracy with an AUC of 0.69 (95% CI 0.57−0.80; <em>p</em> <!-->=<!--> <!-->0.04). The optimal Youden point for identifying pAKI was at a FENa higher than 0.51 % with a specificity of 72.5% and a sensitivity of 65.0%. In the case of FEK, a value higher than 21.9 % presented the best relation, with a specificity of 67.5% and a sensitivity of 65.0%.</div></div><div><h3>Conclusions</h3><div>urine biochemistry interpretation in septic patients must be revised. FENa and FEK are related to the severity of AKI and could be helpful complementary tools for diagnosing pAKI.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 1","pages":"Pages 1-7"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160865","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
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