Medicina intensiva最新文献

{"title":"Association between time weighted average mechanical power normalized to compliance and prognosis of critically ill patients: A retrospective cohort study based on the MIMIC-IV database.","authors":"Yukang Dong, Guiyun Li, Jiangquan Fu, Rui Huang, Huan Yao, Jingni Wang, Ying Wang, Feng Shen","doi":"10.1016/j.medine.2025.502258","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502258","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the association of time‑weighted average mechanical power normalized to compliance (TWA-MP_CRS) with all-cause mortality to determine its value as a prognostic tool in intensive care patients.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Intensive care unit (ICU).</p><p><strong>Patients or participants: </strong>4387 first-time ICU-admitted patients in the Medical Information Mart for Intensive Care (MIMIC) IV.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main variables of interest: </strong>TWA-MP_CRS, ICU mortality and in-hospital mortality.</p><p><strong>Results: </strong>Participants' mean age was 61.4 ± 16.9 years and the median [IQR] baseline TWA-MP_CRS was 0.3 (0.2, 0.6) J/min/mL/cmH₂O. When TWA-MP_CRS was divided into quintiles (with quintile 1 representing the lowest values), after adjusting for covariates, the odds ratios [95% confidence intervals (CIs)] for ICU mortality were 1.49 (95% CI: 1.15-1.94), 1.67 (95% CI: 1.29-2.16), 1.79 (95% CI: 1.37-2.33), and 3.96 (95% CI: 3.01-5.21) for quintiles 2, 3, 4, and 5 respectively, with quintile 1 as reference. Similar results were found for hospital mortality.</p><p><strong>Conclusion: </strong>Higher TWA-MP_CRS is associated with poor clinical outcomes in critically ill patients. Higher TWA-MP_CRS can lead to a higher mortality among ICU and in-hospital patients.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502258"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700782","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}

{"title":"Persistent left superior vena cava finding during pacemaker implantation.","authors":"Eugenia Anabel Liger Borja, Jose Joaquín Cortina Gomez, Gabriela Carolina El Ashkar Palacios","doi":"10.1016/j.medine.2025.502232","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502232","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502232"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644487","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}

{"title":"The ratchet effect: Between the \"open lung\" approach and the \"stable lung\" strategy.","authors":"Alejandro González-Castro, Arturo Ávila","doi":"10.1016/j.medine.2025.502229","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502229","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502229"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621628","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}

{"title":"Introduction to the series \"Update in Pediatric Intensive Care\".","authors":"Alberto García-Salido, Yolanda López-Fernández, Alberto Medina Villanueva, María José Santiago Lozano","doi":"10.1016/j.medine.2025.502226","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502226","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502226"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602680","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}

{"title":"Intravenous beta-blockers versus amiodarone on in-hospital mortality and safety profile in adult septic patients","authors":"Guoge Huang ,&nbsp;Haizhong Li ,&nbsp;Feier Song ,&nbsp;Chunmei Zhang ,&nbsp;Mengling Jian ,&nbsp;Chunyang Huang ,&nbsp;Yingqin Zhang ,&nbsp;Bei Hu ,&nbsp;Wenqiang Jiang","doi":"10.1016/j.medine.2025.502143","DOIUrl":"10.1016/j.medine.2025.502143","url":null,"abstract":"<div><h3>Objective</h3><div>In the present study, we aimed to compare in-hospital mortality and safety of intravenous beta-blockers and amiodarone in septic patients with new-onset atrial fibrillation (NOAF). The null hypothesis is that there is no significant difference in in-hospital mortality and safety of Beta-blocker (BBs) and amiodarone in treating NOAF in patients with sepsis.</div></div><div><h3>Design</h3><div>We conducted a retrospective analysis based on the MIMIC-IV database. Septic patients with NOAF were screened.</div></div><div><h3>Setting</h3><div>Patients admitted to adult mixed ICU for septic patients with NOAF.</div></div><div><h3>Patients</h3><div>A total of 34,789 patients were screened of whom 1394 patients were included for the analysis: 286 in the amiodarone group and 1108 in the BBs group.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Cox proportional hazard model was used to examine the in-hospital mortality, ventilator-free days and duration of atrial fibrillation in patients receiving either amiodarone or intravenous BBs. Propensity score matching was applied to determine any association.</div></div><div><h3>Results</h3><div>After Propensity Score (PS) matching, a total of 244 patients were included in both the BB and amiodarone groups. In this cohort, BBs was significantly associated with lower in-hospital mortality [adjusted hazard ratio (HR) of 0.70 (95% CI 0,54–0,91; P = 0.008)]. On the other hand, patients who received amiodarone had a shorter duration of atrial fibrillation (54.17 h vs 72.81 h; <em>P</em> = 0.003). There was no significant difference in ventilator-free days between the BB group and the amiodarone group.</div></div><div><h3>Conclusion</h3><div>In septic patients with NOAF, patients receiving BBs had lower in-hospital mortality than those who received amiodarone. On the other hand, amiodarone group had a shorter duration of atrial fibrillation. There was no significant difference in ventilator-free days between the BB group and the amiodarone group.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 7","pages":"Article 502143"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019098","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}

{"title":"Intrarater and interrater reliability of the Clinical Frailty Scale-Es and FRAIL-Es in critically ill patients","authors":"Susana Arias-Rivera ,&nbsp;María Mar Sánchez-Sánchez ,&nbsp;Raquel Jareño-Collado ,&nbsp;Marta Raurell-Torredà ,&nbsp;Lorena Oteiza-López ,&nbsp;Sonia López-Cuenca ,&nbsp;Israel John Thuissard-Vasallo ,&nbsp;Fernando Frutos-Vivar","doi":"10.1016/j.medine.2025.502131","DOIUrl":"10.1016/j.medine.2025.502131","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the intrarater and interrater reliability of the Clinical Frailty Scale-Spain (CFS-España) and FRAIL-España and the internal consistency of the FRAIL-España when implemented in critically ill patients by intensive care nurses and physicians.</div></div><div><h3>Design</h3><div>Descriptive, observational and metric study.</div></div><div><h3>Setting</h3><div>intensive care unit (ICU) of Spain.</div></div><div><h3>Patients</h3><div>Patients &gt;18 years, with &gt;48 UCI hours.</div></div><div><h3>Intervention</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>On admission, frailty with CFS-España and FRAIL-España (by 3 nurses and 2 intensive care physicians), sex, age, comorbidities and severity.</div></div><div><h3>Results</h3><div>1045 assessments were performed in 206 patients. Not frail patients on admission: 53% according to the CFS-Spain and 34% according to the FRAIL-Spain.</div><div>The intraclass correlation coefficient (ICC) shows almost perfect intrarater concordance (&gt;0.80 for CFS-España and &gt;0.90 for FRAIL-España). Agreement by frailty strata (non-fragile, pre-fragile and fragile patients) was substantial or almost perfect, with no major differences in ratings between nurses and physicians.</div><div>Interprofessional concordance shows an almost perfect ICC for both scales. The lowest agreement was obtained for the FRAIL-España ratings among physicians. In the frailty strata analysis, agreement was moderate. The highest agreement for the CFS-España was considering level 4 patients as frail.</div><div>High reliability of the FRAIL-España and strong correlation of all dimensions with the global assessment were obtained, except for the comorbidities dimension, with a weak correlation.</div></div><div><h3>Conclusion</h3><div>The CFS-España and FRAIL-España scales are reliable for assessing frailty in critically ill patients by nurses and/or intensive care physicians.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 7","pages":"Article 502131"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974098","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}

{"title":"What should intensivists know about immune checkpoint inhibitors and their side effects?","authors":"Viktor Yordanov Zlatkov Aleksandrov,&nbsp;Fernando Martínez Sagasti,&nbsp;Juncal Pérez-Somarriba Moreno,&nbsp;Helena Huertas Mondéjar","doi":"10.1016/j.medine.2025.502135","DOIUrl":"10.1016/j.medine.2025.502135","url":null,"abstract":"<div><div>The pharmacological group of immune checkpoint-inhibitors (ICI) has revolutionized the field of oncology in the last ten years. The improvements in the survival of certain cancers thanks to these treatments comes at the cost of an increased morbidity and mortality due to certain immune related adverse events (irAE). This review will concentrate on the irAE that more frequently require intensive care unit (ICU) admission. The infectious burden of patients treated with ICI is also explored, shining light not only on the infections caused by the immunosuppression needed to manage the different irAE, but also on the specific infections arising from a unique immune dysregulation only seen in ICI treated patients.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 7","pages":"Article 502135"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019167","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}

{"title":"Neuroaspergillosis: Diagnostic in immunosuppressed patients illustrated by MRI imaging","authors":"Almudena Domínguez González,&nbsp;Nuria Medina Cabrera,&nbsp;Alejandro Hueso Mor","doi":"10.1016/j.medine.2025.502151","DOIUrl":"10.1016/j.medine.2025.502151","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 7","pages":"Article 502151"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506703","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}

{"title":"Congenital absence of the circumflex coronary artery","authors":"Antonio Padilla-Serrano ,&nbsp;Carmen de la Cueva Coca ,&nbsp;Antonio Cárdenas Cruz","doi":"10.1016/j.medine.2025.502152","DOIUrl":"10.1016/j.medine.2025.502152","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 7","pages":"Article 502152"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560426","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}

{"title":"Electrical impedance tomography for the detection and management optimization of pulmonary embolism","authors":"Isabel Magaña Bru,&nbsp;Alicia Delgado Arroyo,&nbsp;Fernando Suarez Sipmann","doi":"10.1016/j.medine.2025.502134","DOIUrl":"10.1016/j.medine.2025.502134","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 7","pages":"Article 502134"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019112","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}