Medicina Intensiva最新文献

{"title":"Innovación tecnológica en cuidados intensivos y los límites de la vida","authors":"Esteban Fernández-Hinojosa , María Adriaensens Pérez , José Cayetano Naranjo Jarillo","doi":"10.1016/j.medin.2025.502153","DOIUrl":"10.1016/j.medin.2025.502153","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502153"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185277","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":"The impact of mechanical insufflation-exsufflation on the weaning success rate of tracheostomized patients on prolonged mechanical ventilation: a pilot and feasibility study of a randomized controlled trial","authors":"Cristiane Bastos Netto ,&nbsp;Maycon Moura Reboredo ,&nbsp;Rodrigo Souza Vieira ,&nbsp;Lídia Maria Carneiro da Fonseca ,&nbsp;Elivaldo Cyrillo Júnior ,&nbsp;André Luís Dias de Souza ,&nbsp;Erich Vidal Carvalho ,&nbsp;Bruno Valle Pinheiro","doi":"10.1016/j.medin.2024.502125","DOIUrl":"10.1016/j.medin.2024.502125","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility of adding mechanical insufflation-exsufflation (MI-E) to a weaning protocol for tracheostomized patients undergoing prolonged mechanical ventilation (MV).</div></div><div><h3>Design</h3><div>Single-center, open-label, randomized, controlled pilot and feasibility study.</div></div><div><h3>Setting</h3><div>Intensive care unit in Brazil.</div></div><div><h3>Patients</h3><div>Tracheostomized adults who were invasively ventilated for more than 14 days and who were weaned from MV.</div></div><div><h3>Interventions</h3><div>Patients were randomized into two groups: intervention group (IG) or a control group (CG). During weaning with a tracheostomy collar, the IG received two daily sessions of MI-E, each with 5 cycles (insufflation and exsufflation pressures of 45 cm H₂O). The CG received conventional chest physiotherapy.</div></div><div><h3>Main variables of interest</h3><div>The primary outcomes were the feasibility of adding MI-E to the weaning protocol and the rate of successful weaning.</div></div><div><h3>Results</h3><div>A total of 47 patients were randomized, with 25 in the IG and 22 in the CG. All patients randomized to the MI-E group received the proposed protocol, completing all the scheduled MI-E sessions. Adverse events occurred in 14% of the MI-E sessions, but they did not lead to treatment interruption. Weaning success was observed in 76% of IG patients and 73% of CG patients (relative risk, 1.05; 95% CI, 0.75–1.46). No significant differences were observed between the IG and CG regarding ICU mortality (16% and 18%, respectively, p = 0.99) or hospital mortality (40% and 41%, respectively, p = 0.99).</div></div><div><h3>Conclusions</h3><div>The addition of MI-E to the standard weaning protocol is feasible, but not result in a greater rate of successful weaning in tracheostomized patients.</div></div><div><h3>Clinical trial registration number</h3><div>U1111-1302-9035.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502125"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185280","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":"Defensa pósteres pantalla - LESIÓN AGUDA PULMONAR/SDRA/VENTILACIÓN, INFECCIÓN/ANTIBIÓTICOS 6, INFECCIÓN/ANTIBIÓTICOS/SEPSIS/FMO 1, INFECCIÓN/ANTIBIÓTICOS 7, CARDIOVASCULAR 4, CARDIOVASCULAR 5, CARDIOVASCULAR 6, SEDACIÓN/ANALGESIA 3, METABOLISMO Y NUTRICIÓN, ORGANIZACIÓN/GESTIÓN/CALIDAD 4, TOXICOLOGÍA/NUEVAS TECNOLOGÍAS","authors":"","doi":"10.1016/S0210-5691(25)00182-2","DOIUrl":"10.1016/S0210-5691(25)00182-2","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 ","pages":"Pages S169-S194"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108933","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":"Comunicaciones orales - MISCELÁNEA 2","authors":"","doi":"10.1016/S0210-5691(25)00178-0","DOIUrl":"10.1016/S0210-5691(25)00178-0","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 ","pages":"Pages S80-S85"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108926","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":"Gasometría y altitud: investigación de los rangos de normalidad en Quito, Ecuador (2.850 m sobre el nivel del mar)","authors":"Jorge Luis Vélez-Páez ,&nbsp;Christian Castro-Bustamante ,&nbsp;Manuel Luis Avellanas-Chavala","doi":"10.1016/j.medin.2025.502140","DOIUrl":"10.1016/j.medin.2025.502140","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502140"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185278","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":"Traumatismo penetrante en España: análisis del registro español de trauma en la UCI (RETRAUCI)","authors":"Judit Gutiérrez-Gutiérrez ,&nbsp;Jesús Abelardo Barea-Mendoza ,&nbsp;Carlos García-Fuentes ,&nbsp;Juan Antonio Llompart-Pou ,&nbsp;Begoña Guardiola-Grau ,&nbsp;Mikel Durán-Suquía ,&nbsp;María Ángeles Ballesteros-Sanz ,&nbsp;Javier González-Robledo ,&nbsp;Lluís Serviá-Goixart ,&nbsp;Cristina Méndez-Benegassi Cid ,&nbsp;Jose Maria Toboso Casado ,&nbsp;Mario Chico-Fernández ,&nbsp;En representación del grupo de trabajo de Neurointensivismo y Trauma de la SEMICYUC","doi":"10.1016/j.medin.2025.502165","DOIUrl":"10.1016/j.medin.2025.502165","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the epidemiology of penetrating trauma, mortality associated factors and its management in Spanish intensive care units.</div></div><div><h3>Design</h3><div>Multicenter, prospective registry. A comparison is established between two cohorts defined by the type of trauma (blunt and penetrating).</div></div><div><h3>Patients</h3><div>Patients with traumatic injury admitted to the participating ICUs from June 2015 to June 2022.</div></div><div><h3>Interventions</h3><div>None.</div><div>Main variable of interest Epidemiology, injury pattern, prehospital and hospital care, resource utilization, and clinical outcomes.</div></div><div><h3>Results</h3><div>Twelve thousand eight hundred six patients were eligible, of whom 821 (6.4%) suffered penetrating trauma; 418 patients (50.9%) from stab wounds, 93 (11.3%) from gunshot wounds, and 310 (37.8%) from other objects. The most common intent was assault (47.7%). The mean ISS was 15.2<!--> <!-->±<!--> <!-->10.6 in penetrating trauma and 19.8<!--> <!-->±<!--> <!-->11.9 in blunt trauma (<em>P</em>&lt;.001). ICU mortality was 7.8% compared to 11.7% in blunt trauma, with deaths more frequently occurring within the first 24<!--> <!-->hours (64 vs. 39%). Factors associated with mortality included female sex, prior use of antithrombotic agents, older age, higher NISS score, and the presence of cranial trauma or shock.</div></div><div><h3>Conclusions</h3><div>Penetrating trauma is an emergent pathology in our context with high complexity, highlighting the need for focused study and documentation, protocol development, and resource optimization to provide quality care.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502165"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185281","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":"Comunicaciones orales - NUEVAS TECNOLOGÍAS/NEFROLOGÍA","authors":"","doi":"10.1016/S0210-5691(25)00186-X","DOIUrl":"10.1016/S0210-5691(25)00186-X","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 ","pages":"Pages S246-S250"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104179","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":"Síndrome aórtico agudo y shock cardiogénico, más allá del diagnóstico radiológico","authors":"Hala El Haddad,&nbsp;Isabel Espinosa Rueda,&nbsp;Nora Palomo-López","doi":"10.1016/j.medin.2024.502124","DOIUrl":"10.1016/j.medin.2024.502124","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 6","pages":"Article 502124"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185479","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":"Defensa pósteres pantalla - NEUROINTENSIVISMO/TRAUMATISMOS, HEMATOLOGÍA/ONCOLOGÍA CRÍTICA 3, INFECCIÓN/ANTIBIÓTICOS 10, INFECCIÓN/ANTIBIÓTICOS/SEPSIS/FMO 2, ÉTICA/DONACIÓN/TRASPLANTES, MARCAPASOS/ARRITMIAS/CIRUGÍA CARDÍACA, ORGANIZACIÓN/GESTIÓN/CALIDAD 6, ORGANIZACIÓN/GESTIÓN/CALIDAD 7, RESPIRATORIO 3, TRAUMATISMOS 2","authors":"","doi":"10.1016/S0210-5691(25)00185-8","DOIUrl":"10.1016/S0210-5691(25)00185-8","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 ","pages":"Pages S222-S245"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104178","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":"Índice de autores","authors":"","doi":"10.1016/S0210-5691(25)00188-3","DOIUrl":"10.1016/S0210-5691(25)00188-3","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 ","pages":"Pages S275-S285"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108229","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}