Medicina intensiva最新文献

Effect of respiratory physiotherapy in a patient with complete atelectasis of the left lung.

Medicina intensiva Pub Date : 2025-04-03 DOI: 10.1016/j.medine.2025.502204

Ramón Pérez-Gil, Gonzalo Ballesteros-Reviriego

引用次数: 0

Airway pressure release ventilation on veno-venous extracorporeal membrane oxigenation (ECMO).

Medicina intensiva Pub Date : 2025-04-03 DOI: 10.1016/j.medine.2025.502177

Ruben Martín-Latorre, Laura de Rivas-Alcover, Àngela Poquet-Poquet

引用次数: 0

Prediction of COVID-19 mortality using machine learning strategies and a large-scale panel of plasma inflammatory proteins: A cohort study.

Medicina intensiva Pub Date : 2025-04-03 DOI: 10.1016/j.medine.2025.502200

Luiz Filipe Bastos Mendes, Henrique Ritter Dal-Pizzol, Gabriele Prestes, Carolina Saibro Girardi, Lucas Santos, Daniel Pens Gelain, Glauco A Westphal, Roger Walz, Cristiane Ritter, Felipe Dal-Pizzol, Jose Claudio Fonseca Moreira

{"title":"Prediction of COVID-19 mortality using machine learning strategies and a large-scale panel of plasma inflammatory proteins: A cohort study.","authors":"Luiz Filipe Bastos Mendes, Henrique Ritter Dal-Pizzol, Gabriele Prestes, Carolina Saibro Girardi, Lucas Santos, Daniel Pens Gelain, Glauco A Westphal, Roger Walz, Cristiane Ritter, Felipe Dal-Pizzol, Jose Claudio Fonseca Moreira","doi":"10.1016/j.medine.2025.502200","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502200","url":null,"abstract":"<p><strong>Objective: </strong>To apply machine learning algorithms to generate models capable of predicting mortality in COVID-19 patients, using a large platform of plasma inflammatory mediators.</p><p><strong>Desing: </strong>Prospective, descriptive, cohort study.</p><p><strong>Setting: </strong>6 intensive care units in 2 hospitals in Southern Brazil.</p><p><strong>Patients: </strong>Patients aged > 18 years who were diagnosed with COVID-19 through reverse transcriptase reaction or rapid antigen test.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main variables of interest: </strong>Demographic and clinical variables, 65 inflammatory biomarkers, mortality.</p><p><strong>Results: </strong>Combinations of two or three proteins yield higher predictive value when compared to individual proteins or the full set of the 65 proteins. A proliferation-inducing ligand (APRIL) and cluster of differentiation 40 ligand (CD40L) consistently emerge among the highest-ranking combinations, suggesting a potential synergistic effect in predicting clinical outcomes. The network structure suggested a dysregulated immune response in non-survivors characterized by the failure of regulatory cytokines to temper an overwhelming inflammatory reaction.</p><p><strong>Conclusion: </strong>Our results highlight the value of feature selection and careful consideration of biomarker combinations to improve prediction accuracy in COVID-19 patients.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502200"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pulmonary vein thrombosis following acute type aortic dissection 急性型主动脉夹层后的肺静脉血栓形成。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.09.011

Xiaoyang Zhou , Long Zhao , Bixin Chen

引用次数: 0

Emphysematous cystitis in the postoperative period of aortic valve replacement 主动脉瓣置换术术后气肿性膀胱炎。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.07.007

Iratxe Iriondo Irigoras, M. Ángeles Rodríguez Esteban

引用次数: 0

A rare echocardiographic imaging of a giant atrial mass 罕见的巨大心房肿块超声心动图成像。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.10.004

Pingping Dong , Jianneng Pan , Xiaoyang Zhou

引用次数: 0

Early mobilisation in patients with shock and receiving vasoactive drugs in the intensive care unit: A systematic review and meta-analysis of observational studies 在重症监护室接受血管活性药物治疗的休克患者的早期康复：观察性研究的系统回顾和荟萃分析。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.09.013

Henry Mauricio Parada-Gereda , Luis F. Pardo-Cocuy , Janneth Milena Avendaño , Daniel Molano-Franco , Joan Ramón Masclans

{"title":"Early mobilisation in patients with shock and receiving vasoactive drugs in the intensive care unit: A systematic review and meta-analysis of observational studies","authors":"Henry Mauricio Parada-Gereda , Luis F. Pardo-Cocuy , Janneth Milena Avendaño , Daniel Molano-Franco , Joan Ramón Masclans","doi":"10.1016/j.medine.2024.09.013","DOIUrl":"10.1016/j.medine.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study was to assess the feasibility and safety of early mobilisation in patients with shock requiring vasoactive drugs in the intensive care unit (ICU).</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Setting</h3><div>Intensive care unit (ICU).</div></div><div><h3>Patients or participants</h3><div>Adult patients requiring vasoactive drugs who received early mobilisation in the intensive care unit.</div></div><div><h3>Interventions</h3><div>A systematic search was conducted using the databases PubMed, Cochrane Library, Scopus, Medline Ovid, Science Direct, and CINAHL, including observational studies involving adult patients requiring vasoactive drugs who received early mobilisation. A meta-analysis was performed on the proportion of safety events and the proportion of early mobilisation in patients with high, moderate, and low doses of vasoactive drugs.</div></div><div><h3>Main variables of interest</h3><div>Feasibility, safety events, and the maximum level of activity achieved during early mobilisation.</div></div><div><h3>Results</h3><div>The search yielded 1875 studies, of which 8 were included in the systematic review and 5 in the meta-analysis. The results showed that 64% (95% CI: 34%–95%, p<0.05) of patients were mobilised with low doses of vasoactive drugs, 30% (95% CI: 7%–53%, p<0.05) with moderate doses, and 7% (95% CI: 3%–16%, p 0.17) with high doses. The proportion of adverse events was low, at 2% (95% CI: 1%–4%, p<0.05).</div></div><div><h3>Conclusions</h3><div>Early mobilisation in patients with shock and the need for vasoactive drugs is feasible and generally safe. However, there is an emphasis on the need for further high-quality research to confirm these findings.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 4","pages":"Pages 193-204"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A shattered heart: Discovery of two lethal mechanical complications 一颗破碎的心脏发现两种致命的机械并发症

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.08.001

Alberto Garrido Callén, Irene Fernández Muñoz, Marta Martín Muñoz

引用次数: 0

Caring to care: Nurturing ICU healthcare professionals’ wellbeing for enhanced patient safety 关爱护理：培养重症监护室医护人员的健康，提高患者安全。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.03.008

Emilio Rodriguez-Ruiz , Martina Maria Cornelia van Mol , Joseph Maria Latour , Kristina Fuest

{"title":"Caring to care: Nurturing ICU healthcare professionals’ wellbeing for enhanced patient safety","authors":"Emilio Rodriguez-Ruiz , Martina Maria Cornelia van Mol , Joseph Maria Latour , Kristina Fuest","doi":"10.1016/j.medine.2024.03.008","DOIUrl":"10.1016/j.medine.2024.03.008","url":null,"abstract":"<div><div>Healthcare professionals working in the Intensive Care Unit<span><span><span> (ICU) care for patients suffering from a critical illness and their relatives. Working within a team of people with different personalities, competencies, and specialties, with constraints and demands might contribute to a working environment that is prone to conflicts and disagreements. This highlights that the ICU is a stressful place that can threaten healthcare professionals’ wellbeing. This article aims to address the concept of wellbeing by describing how the stressful ICU work-environment threatens the wellbeing of health professionals and discussing how this situation jeopardizes </span>patient safety. To promote wellbeing, it is imperative to explore actionable interventions such as improve communication skills, educational sessions on stress management, or </span>mindfulness. Promoting ICU healthcare professionals’ wellbeing through evidence-based strategies will not only increase their personal resilience but might contribute to a safer and more efficient patient care.</span></div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 4","pages":"Pages 216-223"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to involve the patient and family in improving safety in intensive medicine services (SMI)? 如何让患者和家属参与改善重症医学服务（SMI）的安全性？

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.06.012

Olga Rubio Sanchiz , Joan Escarrabill , Joan Fernando Peidró , Anne Sophie Gresle

{"title":"How to involve the patient and family in improving safety in intensive medicine services (SMI)?","authors":"Olga Rubio Sanchiz , Joan Escarrabill , Joan Fernando Peidró , Anne Sophie Gresle","doi":"10.1016/j.medine.2024.06.012","DOIUrl":"10.1016/j.medine.2024.06.012","url":null,"abstract":"<div><div>Patient safety is a priority for health systems and is especially relevant for critically ill patients. Despite its relevance in recent years, many patients suffer adverse events with harm and negative repercussions for professionals and institutions.</div><div>Numerous safe practices have been promoted and strategies have been developed that have been incorporated into institutional policies and thereby improving the safety culture. But there are still underdeveloped strategies, such as incorporating the participation of patients and family members in their safety.</div><div>Until recently, the patient and family have been considered as a passive part in the reception of health services, not as an active part, much less as a possible opportunity to improve safety against errors that occur during care.</div><div>The critically ill patient and/or family members must be informed and, ideally, trained to facilitate active participation in their safety. It is not about transferring responsibility, but about facilitating and promoting their participation by reinforcing their safety. And professionals must be committed to their safety and facilitate the conditions to encourage their participation.</div><div>We provide tools and reflections to help professionals implement the participation of patients and family members in safety as they pass through intensive medicine services.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 4","pages":"Pages 237-244"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0