Medicina intensiva最新文献

Dynamic air bronchogram in pneumococcal community acquired pneumonia 肺炎球菌社区获得性肺炎的动态空气支气管造影。

Medicina intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medine.2024.06.004

Abdo Taché Sala, Sara Foradada Ubach, Meritxell Lladó Vilar

引用次数: 0

Global definition of acute respiratory distress syndrome: An epidemiology perspective 急性呼吸窘迫综合征的全球定义：流行病学视角。

Medicina intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medine.2024.10.001

Pablo Cardinal-Fernández , Guillermo Ortiz , Luis Blanch

引用次数: 0

Clinical utility of rapid shallow breathing index in predicting successful weaning: secondary analysis of the COBRE-US trial 快速浅呼吸指数在预测成功断奶方面的临床实用性：COBRE-US 试验的二次分析。

Medicina intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medine.2024.06.007

Fabio Varón-Vega , Eduardo Tuta-Quintero , Henry Robayo-Amortegui , Adriana Rincón , Luis F. Giraldo-Cadavid , Jonathan Palacios , Stephanie Crevoisier , Diana C. Duarte , Marcela Poveda , Laura Cucunubo , Pablo Monedero

{"title":"Clinical utility of rapid shallow breathing index in predicting successful weaning: secondary analysis of the COBRE-US trial","authors":"Fabio Varón-Vega , Eduardo Tuta-Quintero , Henry Robayo-Amortegui , Adriana Rincón , Luis F. Giraldo-Cadavid , Jonathan Palacios , Stephanie Crevoisier , Diana C. Duarte , Marcela Poveda , Laura Cucunubo , Pablo Monedero","doi":"10.1016/j.medine.2024.06.007","DOIUrl":"10.1016/j.medine.2024.06.007","url":null,"abstract":"<div><h3>Objective</h3><div><span><span>To assess the predictive capacity of the Rapid Shallow Breathing Index (RSBI) for success in </span>spontaneous breathing trials (SBT) and </span>extubation<span> in critically ill patients. We evaluated the association between RSBI, duration of mechanical ventilation, and ventilator-free time at 28 days.</span></div></div><div><h3>Design</h3><div>Prospective multicenter observational study. Secondary analysis of the COBRE-US study.</div></div><div><h3>Setting</h3><div>Intensive care unit (ICU).</div></div><div><h3>Patients or participants</h3><div>367 patients in the ICU receiving invasive mechanical ventilation.</div></div><div><h3>Interventions</h3><div>Assessment of RSBI at the end of SBT.</div></div><div><h3>Main variables of interest</h3><div>RSBI, SBT, duration of mechanical ventilation, and ventilator-free time at 28 days were evaluated.</div></div><div><h3>Results</h3><div>367 patients in the ICU under invasive mechanical ventilation were evaluated, of whom 59.7% were male with a median age of 61 years (IQR: 49–72). A total of 456 SBT were conducted with a success rate of 76.5%. RSBI had a ROC-curve of 0.53 for SBT success and a ROC-curve of 0.48 for extubation. The Spearman correlation coefficient between RSBI and duration of ventilation was 0.117 (p = 0.026), while for ventilator-free time at 28 days, it was −0.116 (p = 0.028).</div></div><div><h3>Conclusions</h3><div>RSBI was not associated with success in SBT or extubation, regardless of the cutoff point used. Correlation analyses showed weak associations between RSBI and both the duration of ventilation and ventilator-free time at 28 days.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 2","pages":"Pages 72-77"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433674","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

Organ donation process: more than just guidelines and protocols 器官捐献程序：不仅仅是指导方针和协议。

Medicina intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medine.2024.10.003

Lorena Oteiza López , Óscar Elía Mañú

引用次数: 0

Anti-Xa activity below range is related to thrombosis in patients with severe COVID-19 抗 Xa 活性低于范围与严重 COVID-19 患者的血栓形成有关。

Medicina intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medine.2024.07.003

Pilar Marcos-Neira , Cristian Morales-Indiano , Mariana Fernández-Caballero , Teresa Tomasa-Irriguible , Luisa Bordejé-Laguna , Víctor Ruíz-Artola

{"title":"Anti-Xa activity below range is related to thrombosis in patients with severe COVID-19","authors":"Pilar Marcos-Neira , Cristian Morales-Indiano , Mariana Fernández-Caballero , Teresa Tomasa-Irriguible , Luisa Bordejé-Laguna , Víctor Ruíz-Artola","doi":"10.1016/j.medine.2024.07.003","DOIUrl":"10.1016/j.medine.2024.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to anlayse the relationship between anti-Xa activity below range and thomboembolic events.</div></div><div><h3>Design</h3><div>Single center prospective observational longitudinal cohort study (February–November 2021).</div></div><div><h3>Setting</h3><div>Patients admitted to the ICU of a University Hospital.</div></div><div><h3>Participants</h3><div>Patients with severe COVID-19 pneumoniae.</div></div><div><h3>Interventions</h3><div>Enoxaparin was used for prophylactic and therapeutic anticoagulation. Enoxaparin dosing and dose adjustment were based on anti-Xa activity according to the hospital protocol.</div></div><div><h3>Main variables of interest</h3><div>Target: thomboembolic events.</div><div>Predictors: demographics, pharmacotherapy, anti-Xa measurements, clinical data, and laboratory results.</div><div>Logistic regression was used to identify independent risk factors for thomboembolic events.</div></div><div><h3>Results</h3><div>Data were available for 896 serum anti-Xa measurements from 228 subjects. Overall, 71.9% were male, with a median age of 62. Most patients needed invasive mechanical ventilation (87.7%) and mortality was 24.1%. A total of 28.9% new thomboembolic events were diagnosed. There were 27.1% anti-Xa measesurements below range. When multivariable logistic regression analysis was performed anti-Xa activity below range (RR, 4.2; p = 0.000), C-reactive protein (25 mg/L increase) (RR, 1.14; p = 0.005) and D-dimer (1000 ng/L increase) (RR, 1.06; p = 0.002) were the independent factors related to new thomboembolic events in patients with severe COVID-19.</div></div><div><h3>Conclusions</h3><div>Anti-Xa activity below range, C-reactive protein and D-dimer were the independent factors related to thomboembolic events in patients with severe COVID-19. Purposely designed clinical trials should be carried out to confirm the benefit of an anti-Xa monitoring.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 2","pages":"Pages 78-87"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763660","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

Venous pulmonary embolism - A rare clinical case 静脉肺栓塞--一个罕见的临床病例。

Medicina intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medine.2024.06.008

Sérgio Pina , Pedro Alves , Andriy Krystopchuc

引用次数: 0

Moral complexity in the organ donation process: The satisfaction of a job well done 器官捐献过程中的道德复杂性：完成工作的满足感。

Medicina intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medine.2024.07.014

José Miguel Pérez-Villares , Ramón Lara-Rosales , Alberto Fernández-Carmona , Alberto Iglesias-Santiago

引用次数: 0

The human factor and ergonomics in Patient Safety 病人安全中的人为因素和人体工程学。

Medicina intensiva Pub Date : 2025-02-01 DOI: 10.1016/j.medine.2024.03.014

Miguel Valdivia de la Fuente, Diego José Palacios Castañeda, Nuria Martínez Sanz