Medicina Intensiva最新文献

{"title":"Tratamiento médico del shock cardiogénico","authors":"Manuel García-Delgado ,&nbsp;Raquel Rodríguez-García ,&nbsp;Ana Ochagavía ,&nbsp;M. Ángeles Rodríguez-Esteban","doi":"10.1016/j.medin.2024.05.002","DOIUrl":"10.1016/j.medin.2024.05.002","url":null,"abstract":"<div><p>Cardiogenic shock is characterized by tissue hypoperfusion due to the inadequate cardiac output to maintain the tissue oxygen demand. Despite some advances in cardiogenic shock management, extremely high mortality is still associated with this clinical syndrome. Its management is based on the immediate stabilization of hemodynamic parameters through medical care and the use of mechanical circulatory supports in specialized centers. This review aims to understand the cardiogenic shock current medical treatment, consisting mainly of inotropic drugs, vasopressors and coronary revascularization. In addition, we highlight the relevance of applying measures to other organ levels based on the optimization of mechanical ventilation and the appropriate initiation of renal replacement therapy.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 8","pages":"Pages 477-486"},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141954521","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":"High rate-trauma: the new world order?","authors":"Aurio Fajardo-Campoverdi ,&nbsp;Miguel Ibarra-Estrada ,&nbsp;Alejandro González-Castro ,&nbsp;Alejandra Cortés ,&nbsp;Juan Núñez-Silveira","doi":"10.1016/j.medin.2024.03.002","DOIUrl":"10.1016/j.medin.2024.03.002","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 8","pages":"Pages 490-492"},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141954522","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":"Hacia una mejor predicción de la mortalidad en pacientes oncológicos en UCI: análisis comparativo de escalas pronósticas: revisión sistemática de la literatura","authors":"Andrea Cabrera Losada ,&nbsp;Maria Alejandra Correa Oviedo ,&nbsp;Vanessa Carolina Herrera Villazón ,&nbsp;Sebastián Gil-Tamayo ,&nbsp;Carlos Federico Molina ,&nbsp;Carola Gimenez-Esparza Vich ,&nbsp;Víctor Hugo Nieto Estrada","doi":"10.1016/j.medin.2024.06.008","DOIUrl":"10.1016/j.medin.2024.06.008","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the predictive ability of mortality prediction scales in cancer patients admitted to intensive care units.</div></div><div><h3>Design</h3><div>A systematic review of the literature was conducted using a search algorithm in October 2022. The following databases were searched: PubMed, Scopus, Virtual Health Library (BVS), and Medrxiv. The risk of bias was assessed using the QUADAS-2 scale.</div></div><div><h3>Setting</h3><div>Intensive care units admitting cancer patients.</div></div><div><h3>Participants</h3><div>Studies that included adult patients with an active cancer diagnosis who were admitted to the intensive care unit.</div></div><div><h3>Interventions</h3><div>Integrative study without interventions.</div></div><div><h3>Main variables of interest</h3><div>Mortality prediction, standardized mortality, discrimination, and calibration.</div></div><div><h3>Results</h3><div>Seven mortality risk prediction models were analyzed in cancer patients in the ICU. Most models (APACHE II, APACHE IV, SOFA, SAPS-II, SAPS-III, and MPM II) underestimated mortality, while the ICMM overestimated it. The APACHE II had the SMR (Standardized Mortality Ratio) value closest to 1, suggesting a better prognostic ability compared to the other models.</div></div><div><h3>Conclusions</h3><div>Predicting mortality in intensive care unit cancer patients remains an intricate challenge due to the lack of a definitive superior model and the inherent limitations of available prediction tools. For evidence-based informed clinical decision-making, it is crucial to consider the healthcare team's familiarity with each tool and its inherent limitations. Developing novel instruments or conducting large-scale validation studies is essential to enhance prediction accuracy and optimize patient care in this population.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 12","pages":"Pages e30-e40"},"PeriodicalIF":2.7,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840890","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":"Electrical impedance tomography: Usefulness for respiratory physiotherapy in critical illnesses","authors":"Ricardo Arriagada ,&nbsp;María Consuelo Bachmann ,&nbsp;Constanza San Martin ,&nbsp;Michela Rauseo ,&nbsp;Denise Battaglini","doi":"10.1016/j.medin.2024.02.012","DOIUrl":"https://doi.org/10.1016/j.medin.2024.02.012","url":null,"abstract":"<div><p>Respiratory physiotherapy, including the management of invasive mechanical ventilation (MV) and noninvasive mechanical ventilation (NIV), is a key supportive intervention for critically ill patients. MV has potential for inducing ventilator-induced lung injury (VILI) as well as long-term complications related to prolonged bed rest, such as post-intensive care syndrome and intensive care unit acquired weakness. Physical and respiratory therapy, developed by the critical care team, in a timely manner, has been shown to prevent these complications. In this pathway, real-time bedside monitoring of changes in pulmonary aeration and alveolar gas distribution associated with postural positioning, respiratory physiotherapy techniques and changes in MV strategies can be crucial in guiding these procedures, providing safe therapy and prevention of potential harm to the patient. Along this path, electrical impedance tomography (EIT) has emerged as a new key non-invasive bedside strategy free of radiation, to allow visualization of lung recruitment. This review article presents the main and potential applications of EIT in relation to physiotherapy techniques in the ICU setting.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 7","pages":"Pages 403-410"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141484492","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":"De fragilidad, calidad de vida y síndrome post-UCI","authors":"Arantxa Mas Serra","doi":"10.1016/j.medin.2024.04.001","DOIUrl":"10.1016/j.medin.2024.04.001","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 7","pages":"Pages 375-376"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055678","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":"Desafíos en el uso de albúmina intravenosa en pacientes críticamente enfermos: Reflexiones y perspectivas futuras","authors":"Alejandro González-Castro ,&nbsp;Raquel Ferrero-Franco ,&nbsp;Carmen Blanco Huelga","doi":"10.1016/j.medin.2024.03.016","DOIUrl":"10.1016/j.medin.2024.03.016","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 7","pages":"Pages 429-430"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057803","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":"Mediastinitis necrosante descendente en paciente sin inmunodepresión","authors":"David Roa Alonso,&nbsp;Juan Pedro Martínez García-Rodrigo,&nbsp;Fernando Fong Ruiz","doi":"10.1016/j.medin.2023.12.007","DOIUrl":"10.1016/j.medin.2023.12.007","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 7","pages":"Page 435"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966807","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":"Frailty in severe COVID-19 survivors after ICU admission. A prospective and multicenter study in Mexico","authors":"Oscar Peñuelas ,&nbsp;Manuel Lomelí ,&nbsp;Laura del Campo-Albendea ,&nbsp;Sara I. Toledo ,&nbsp;Alfredo Arellano ,&nbsp;Uriel Chavarría ,&nbsp;Maria Carmen Marín ,&nbsp;Karina Rosas ,&nbsp;María Alacíen Galván Merlos ,&nbsp;Roberto Mercado ,&nbsp;Héctor R. García-Lerma ,&nbsp;Enrique Monares ,&nbsp;Daira González ,&nbsp;Juan Pérez ,&nbsp;Andrés Esteban-Fernández ,&nbsp;Alfonso Muriel ,&nbsp;Fernando Frutos-Vivar ,&nbsp;Andrés Esteban","doi":"10.1016/j.medin.2024.02.009","DOIUrl":"https://doi.org/10.1016/j.medin.2024.02.009","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the presence of frailty in survivors of severe COVID-19 admitted in the Intensive Care Unit (ICU) and followed six months after discharge.</p></div><div><h3>Design</h3><p>An observational, prospective and multicenter, nation-wide study.</p></div><div><h3>Setting</h3><p>Eight adult ICU across eight academic acute care hospitals in Mexico.</p></div><div><h3>Patients</h3><p>All consecutive adult COVID-19 patients admitted in the ICU with acute respiratory failure between March 8, 2020 to February 28, 2021 were included. Frailty was defined according to the FRAIL scale, and was obtained at ICU admission and 6-month after hospital discharge.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Main variables of interest</h3><p>The primary endpoint was the frailty status 6-months after discharge. A regression model was used to evaluate the predictors during ICU stay associated with frailty.</p></div><div><h3>Results</h3><p>196 ICU survivors were evaluated for basal frailty at ICU admission and were included in this analysis. After 6-months from discharge, 164 patients were evaluated for frailty: 40 patients (20.4%) were classified as non-frail, 67 patients (34.2%) as pre-frail and 57 patients (29.1%) as frail. After adjustment, the need of invasive mechanical ventilation was the only factor independently associated with frailty at 6 month follow-up (Odds Ratio [OR] 3.70, 95% confidence interval 1.40–9.81, <em>P</em> = .008).</p></div><div><h3>Conclusions</h3><p>Deterioration of frailty was reported frequently among ICU survivors with severe COVID-19 at 6-months. The need of invasive mechanical ventilation in ICU survivors was the only predictor independently associated with frailty.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 7","pages":"Pages 377-385"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141481286","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":"Embolia cerebral aérea espontánea secundaria a vulnerabilidad pulmonar","authors":"Alejandra Carmen Nasarre Puyuelo ,&nbsp;Daniel Sáenz Abad ,&nbsp;José María Ferreras Amez","doi":"10.1016/j.medin.2023.12.009","DOIUrl":"10.1016/j.medin.2023.12.009","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 7","pages":"Pages 431-432"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139814481","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":"Valoración de la mortalidad traumática precoz mediante tomografía computarizada post mortem","authors":"Lidia Orejón García ,&nbsp;Laín Ibáñez Sanz ,&nbsp;Marcos Valiente Fernández ,&nbsp;Francisco de Paula Delgado Moya ,&nbsp;Elena Martinez Chamorro ,&nbsp;Mario Chico Fernández","doi":"10.1016/j.medin.2023.12.010","DOIUrl":"10.1016/j.medin.2023.12.010","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 7","pages":"Pages 424-426"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139826047","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}