Medicina Intensiva最新文献

{"title":"Antes y después de la primera reanimación cardiopulmonar extracorpórea por hipotermia accidental en España","authors":"Robert Blasco Mariño , Eduard Argudo , Iñigo Soteras Martinez","doi":"10.1016/j.medin.2024.05.021","DOIUrl":"10.1016/j.medin.2024.05.021","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 9","pages":"Pages 551-554"},"PeriodicalIF":2.7,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087902","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":"Motivos de rechazo de ingreso en UCI en población oncológica y su asociación con la mortalidad a seis meses","authors":"Elena Cuenca Fito , Alejandro González Castro , Inés Gómez Acebo","doi":"10.1016/j.medin.2024.05.005","DOIUrl":"10.1016/j.medin.2024.05.005","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 10","pages":"Pages 616-620"},"PeriodicalIF":2.7,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322258","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":"Shock Index and Physiological Stress Index for reestratifying patients with intermediate-high risk pulmonary embolism","authors":"Marcos Valiente Fernández ,&nbsp;Amanda Lesmes González de Aledo ,&nbsp;Francisco de Paula Delgado Moya ,&nbsp;Isaías Martín Badía ,&nbsp;Elena Álvaro Valiente ,&nbsp;Nerea Blanco Otaegui ,&nbsp;Pablo Risco Torres ,&nbsp;Ignacio Saéz de la Fuente ,&nbsp;Silvia Chacón Alves ,&nbsp;Lidia Orejón García ,&nbsp;María Sánchez- Bayton Griffith ,&nbsp;José Ángel Sánchez-Izquierdo Riera","doi":"10.1016/j.medin.2023.10.011","DOIUrl":"https://doi.org/10.1016/j.medin.2023.10.011","url":null,"abstract":"<div><h3>Objective</h3><p>Study and Evaluation of Two Scores: Shock Index (SI) and Physiological Stress Index (PSI) as discriminators for proactive treatment (reperfusion before decompensated shock) in a population of intermediate-high risk pulmonary embolism (PE).</p></div><div><h3>Design</h3><p>Using a database from a retrospective cohort with clinical variables and the outcome variable of “proactive treatment”, a comparison of the populations was conducted. Optimal cut-off for “proactive treatment” points were obtained according to the SI and PSI. Comparisons were carried out based on the cut-off points of both indices.</p></div><div><h3>Setting</h3><p>Patients admitted to a mixed ICU for PE.</p></div><div><h3>Participants</h3><p>Patients &gt;18 years old admitted to the ICU with intermediate-high risk PE recruited from January 2015 to October 2022.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Main variables of interest</h3><p>Population comparison and metrics regarding predictive capacity when determining proactive treatment.</p></div><div><h3>Results</h3><p>SI and PSI independently have a substandard predictive capacity for discriminating patients who may benefit from an early reperfusion therapy. However, their combined use improves detection of sicker intermediate-high risk PE patients (Sensitivity = 0.66) in whom an early reperfusion therapy may improve outcomes (Specificity = 0.9).</p></div><div><h3>Conclusions</h3><p>The use of the SI and PSI in patients with intermediate-high risk PE could be useful for selecting patients who would benefit from proactive treatment.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 6","pages":"Pages 309-316"},"PeriodicalIF":3.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163300","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":"Applicability of an unsupervised cluster model developed on first wave COVID-19 patients in second/third wave critically ill patients","authors":"Alejandro Rodríguez ,&nbsp;Josep Gómez ,&nbsp;Álvaro Franquet ,&nbsp;Sandra Trefler ,&nbsp;Emili Díaz ,&nbsp;Jordi Sole-Violán ,&nbsp;Rafael Zaragoza ,&nbsp;Elisabeth Papiol ,&nbsp;Borja Suberviola ,&nbsp;Montserrat Vallverdú ,&nbsp;María Jimenez-Herrera ,&nbsp;Antonio Albaya-Moreno ,&nbsp;Alfonso Canabal Berlanga ,&nbsp;María del Valle Ortíz ,&nbsp;Juan Carlos Ballesteros ,&nbsp;Lucía López Amor ,&nbsp;Susana Sancho Chinesta ,&nbsp;Maria de Alba-Aparicio ,&nbsp;Angel Estella ,&nbsp;Ignacio Martín-Loeches ,&nbsp;María Bodi","doi":"10.1016/j.medin.2024.02.006","DOIUrl":"https://doi.org/10.1016/j.medin.2024.02.006","url":null,"abstract":"<div><h3>Objective</h3><p>To validate the unsupervised cluster model (USCM) developed during the first pandemic wave in a cohort of critically ill patients from the second and third pandemic waves.</p></div><div><h3>Design</h3><p>Observational, retrospective, multicentre study.</p></div><div><h3>Setting</h3><p>Intensive Care Unit (ICU).</p></div><div><h3>Patients</h3><p>Adult patients admitted with COVID-19 and respiratory failure during the second and third pandemic waves.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Main variables of interest</h3><p>Collected data included demographic and clinical characteristics, comorbidities, laboratory tests and ICU outcomes. To validate our original USCM, we assigned a phenotype to each patient of the validation cohort. The performance of the classification was determined by Silhouette coefficient (SC) and general linear modelling. In a post-hoc analysis we developed and validated a USCM specific to the validation set. The model’s performance was measured using accuracy test and area under curve (AUC) ROC.</p></div><div><h3>Results</h3><p>A total of 2330 patients (mean age 63 [53–82] years, 1643 (70.5%) male, median APACHE II score (12 [9–16]) and SOFA score (4 [3–6]) were included. The ICU mortality was 27.2%. The USCM classified patients into 3 clinical phenotypes: A (n = 1206 patients, 51.8%); B (n = 618 patients, 26.5%), and C (n = 506 patients, 21.7%). The characteristics of patients within each phenotype were significantly different from the original population. The SC was −0.007 and the inclusion of phenotype classification in a regression model did not improve the model performance (0.79 and 0.78 ROC for original and validation model). The post-hoc model performed better than the validation model (SC −0.08).</p></div><div><h3>Conclusion</h3><p>Models developed using machine learning techniques during the first pandemic wave cannot be applied with adequate performance to patients admitted in subsequent waves without prior validation.</p></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 6","pages":"Pages 326-340"},"PeriodicalIF":3.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163395","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":"Complejidad moral en el proceso de donación de órganos: un acto prudencial","authors":"","doi":"10.1016/j.medin.2024.04.005","DOIUrl":"10.1016/j.medin.2024.04.005","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 9","pages":"Pages 555-556"},"PeriodicalIF":2.7,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141136832","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 de distrés respiratorio agudo en la altitud: consideraciones sobre el diagnóstico y tratamiento","authors":"","doi":"10.1016/j.medin.2024.04.006","DOIUrl":"10.1016/j.medin.2024.04.006","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 9","pages":"Pages 546-548"},"PeriodicalIF":2.7,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141133826","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":"Pósteres Orales. Infección/Sepsis/Fracaso Multiórganico. Trasplantes/Metabolismo/Nutrición. Transfusiones/Hemoderivados. Toxicología/Patología Digestiva Crítica. Monitorización Hemodinámica/Cirugía Cardiaca. Marcapasos/Arritmias II","authors":"","doi":"10.1016/S0210-5691(24)00206-7","DOIUrl":"https://doi.org/10.1016/S0210-5691(24)00206-7","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 ","pages":"Pages S253-S278"},"PeriodicalIF":3.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097518","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":"Pósteres Pantalla. Cardiovascular IV. Infección/Antibióticos VIII. Traumatismos III. Organización/Gestión/Calidad V. Respiratorio III. Trasplantes II. Sepsis/Fracaso Multiorgánico/Toxicología. Simulación/Nuevas Tecnologías/Gestión. Metabolismo/Nutrición/Ética.","authors":"","doi":"10.1016/S0210-5691(24)00207-9","DOIUrl":"https://doi.org/10.1016/S0210-5691(24)00207-9","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 ","pages":"Pages S278-S304"},"PeriodicalIF":3.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097519","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. Gestión/Respiratorio/Urgencias","authors":"","doi":"10.1016/S0210-5691(24)00201-8","DOIUrl":"https://doi.org/10.1016/S0210-5691(24)00201-8","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 ","pages":"Pages S124-S130"},"PeriodicalIF":3.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097532","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":"Pósteres Orales. SDRA/Ventilación Mecánica. Infección/Antibióticos V. Organización/Gestión/Calidad III. Traumatismos II. Síndrome Coronario Agudo I. Neurointensivismo IV. Sedación/Analgesia I","authors":"","doi":"10.1016/S0210-5691(24)00202-X","DOIUrl":"https://doi.org/10.1016/S0210-5691(24)00202-X","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"48 ","pages":"Pages S131-S184"},"PeriodicalIF":3.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097533","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}