Medicina intensiva最新文献

{"title":"Clinical impact of COVID-19 respiratory infection 15 months after intensive care unit discharge.","authors":"María-Lidón Mateu-Campos, Susana Altaba-Tena, Beatriz Boscá-Martínez, Jesús Camáñez-Fortanet, Clara Viana-Marco, Ana-Belén González-Núñez, Anna-Rosa Villanova-Landete, Fernando Sánchez-Morán, Raquel Navarro-Alcaraz","doi":"10.1016/j.medine.2025.502230","DOIUrl":"10.1016/j.medine.2025.502230","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of persistent COVID-19 symptoms in SARS-CoV-2 patients 15 months after ICU discharge,their impact on physical, psychological, and neurocognitive domains, and the burden on primary caregivers.</p><p><strong>Design: </strong>Descriptive, ambispective observational study.</p><p><strong>Setting: </strong>Intensive Care Unit from a tertiary-level hospital.</p><p><strong>Patients: </strong>SARS-CoV-2 patients discharged from ICU.</p><p><strong>Main variables of interest: </strong>demographics and hospitalization data. Questionnaires assesing persistent COVID symptoms, functional tests (6-Minute Walk Test), anxiety (Beck Anxiety Inventory), PTSD and Zarit Caregiver Burden scales. Statistical analysis was performed using Stata for Mac, version 14.2.</p><p><strong>Results: </strong>85 patients were evaluated, with a median age of 60.3 years (IQR 54.0-68.9), 70.6% males. A high percentage of patients reported musculoskeletal disorders such as arthralgia (44.7%) and myalgia (38.2%), cognitive impairments (52.9%), sleep disturbances (34.1%), asthenia (44.5%) and anxiety (34.5%). The overall BAI score was 2 (0-9), with paraesthesia being the most common symptom. Additionally, 29.4% of patients reported \"fear of the worst\", 35% had unpleasant or recurrent memories of their ICU stay, and 16.4% were unable to relax (moderate/severe degree). Interviews with primary caregivers revealed that 22.2% reported caregiving as a significant burden.</p><p><strong>Conclusions: </strong>persistent COVID affects three primary functional domains: physical, cognitive and psychological, as well as on primary caregivers concerns and burdens.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502230"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340718","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":"Left ventricular systolic function and mechanical ventilation weaning failure: An updated systematic review and meta-analysis with trial sequential analysis.","authors":"Cristina Santonocito, Simone Messina, Mateusz Zawadka, Pruszczyk Andrzej, Elena Bignami, Andrea Morelli, Sabino Scolletta, Alberto Noto, Filippo Sanfilippo","doi":"10.1016/j.medine.2025.502231","DOIUrl":"10.1016/j.medine.2025.502231","url":null,"abstract":"<p><strong>Objective: </strong>The impact of left ventricular (LV) systolic dysfunction on weaning failure is unclear.</p><p><strong>Design: </strong>Updated meta-analysis assessing the association between LV ejection fraction (LVEF) and weaning failure.</p><p><strong>Setting: </strong>A systematic search of MEDLINE and EMBASE for prospective studies reporting weaning according to echocardiographic data measured before starting a spontaneous breathing trial (SBT).</p><p><strong>Patients or participants: </strong>Studies included in the meta-analysis that reported on weaning and echocardiographic data.</p><p><strong>Main variables of interest: </strong>LVEF, E/e' ratio, E velocity, deceleration time of the E wave, and e' velocity.</p><p><strong>Results: </strong>Three studies were added in this update (n = 14, sample 20-30% larger). Lower LVEF (n = 12) was associated with weaning failure: MD: -4.71 95%CI [-9.18, -0.23]; p = 0.04, I² = 90%, low certainty of evidence), without subgroups difference according to SBT type or LVEF mean values. Trial sequential analysis showed that results were not robust (information size n = 745/1378). E/e' ratio (MD: 1.90, 95%CI [0.48,3.32]; p = 0.009, I² = 84%), E velocity (MD: 8.32, 95%CI [2.59,14.05]; p = 0.004, I² = 54%) and shorter deceleration time of the E wave (MD: -12.01, 95%CI [-21.13, -2.89]; p = 0.01, I² = 0%) were associated with weaning failure, whilst e' velocity was not (MD: -0.59, 95%CI [-1.51,0.32]; p = 0.20, I² = 64%).</p><p><strong>Conclusions: </strong>An association of weaning failure with poorer LV systolic function (LVEF), not detected by the previous meta-analysis, was found. However, such association is highly fragile and with a mean difference below 5%, which seems not clinically relevant. Higher E/e' ratio and other diastolic parameters confirmed their association with weaning failure, whilst e' did not.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502231"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340729","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":"Reply to: \"Vasopressin: Why not in severe traumatic disease?\"","authors":"Juan Carlos Ruíz-Rodríguez, Ana Ochagavia, Lluís Zapata, Ricard Ferrer","doi":"10.1016/j.medine.2025.502220","DOIUrl":"10.1016/j.medine.2025.502220","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502220"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334703","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":"Respiratory rate remains the forgotten vital sign.","authors":"Enrique Chicote-Álvarez, Adolfo Calvo-Martínez, María Macías-Pascual","doi":"10.1016/j.medine.2025.502225","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502225","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502225"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328246","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":"Neutrophil CD64 as a prognostic biomarker for mortality in sepsis: A systematic review and meta-analysis.","authors":"Seo Hee Yoon, Sohyun Eun","doi":"10.1016/j.medine.2025.502251","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502251","url":null,"abstract":"<p><strong>Objective: </strong>Sepsis remains a major cause of mortality worldwide. While neutrophil CD64 (nCD64) has demonstrated superior performance in detecting sepsis compared to conventional biomarkers, its prognostic value remains unclear. This meta-analysis evaluates the performance of nCD64 in predicting mortality in patients with sepsis.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Settings: </strong>A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted up to January 28, 2025, to identify relevant studies.</p><p><strong>Patients: </strong>Patients aged 16 years or older diagnosed with sepsis based on Sepsis-1, Sepsis-2, or Sepsis-3 criteria.</p><p><strong>Interventions: </strong>Studies assessing the predictive accuracy of nCD64 for mortality and providing sufficient data for contingency table construction were included.</p><p><strong>Main variables of interest: </strong>Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated with 95% confidence intervals (CIs). Overall predictive accuracy was assessed using the area under the summary receiver operating characteristic curve.</p><p><strong>Results: </strong>Eight studies involving 756 patients were included. The pooled sensitivity, specificity, and DOR of nCD64 for predicting mortality were 0.79 (95% CI: 0.68-0.87), 0.67 (95% CI: 0.56-0.77), and 7.71 (95% CI: 4.38-13.57), respectively. The predictive accuracy was 0.80.</p><p><strong>Conclusions: </strong>Our findings suggest that nCD64 may serve as a valuable auxiliary biomarker for identifying patients with sepsis at higher risk of mortality.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502251"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304142","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":"Serum phosphate abnormalities in critically ill children.","authors":"Nuria Del Amo Carramiñana, Paula Lasarte Merino, Celia Pascual Alonso, Jesús López-Herce, Rafael González Cortés","doi":"10.1016/j.medine.2025.502217","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502217","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502217"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277097","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":"Cardiogenic shock due to a large apical pseudoaneurysm of the left ventricle: A rare complication.","authors":"Jaime Andrés Romero León, Elena Morente García, Eva Peregrina Caño","doi":"10.1016/j.medine.2025.502212","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502212","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502212"},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251664","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":"Update of the taxonomy of mechanical ventilation modes.","authors":"Aurio Fajardo-Campoverdi, Eduardo Mireles-Cabodevila, Alberto Medina, Miguel Ibarra-Estrada, José Baltazar-Torres, Robert Chatburn","doi":"10.1016/j.medine.2025.502211","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502211","url":null,"abstract":"<p><p>The rapid technological development of mechanical ventilation has resulted in increasingly complex modes, advanced monitoring capabilities and the incorporation of artificial intelligence. However, manufacturers have created a multitude of trade names, which has generated a great deal of confusion in their understanding, handling and application. This problem is exacerbated in Spanish-speaking countries due to inconsistencies in translations and variability in nomenclature between regions. This manuscript aims to provide an updated review of the taxonomic classification of ventilatory modes in order to promote standardization of terminology, especially in the Spanish-speaking clinical context, and includes changes in the taxonomy and manner of labeling modes of mechanical ventilation. This review focuses on invasive mechanical ventilation of the adult critically ill patient, although the taxonomy is also applicable to all ventilation modalities, including noninvasive, high-frequency, pediatric, and even home ventilation.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502211"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251665","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":"Cardiac hydatid disease.","authors":"Emilio Curiel Balsera, Javier Muñoz Bono, Hugo Molina Diaz","doi":"10.1016/j.medine.2025.502218","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502218","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502218"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236344","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":"Key laboratory changes in severe trauma, a different pattern for each clinical phenotype.","authors":"Adrián Marcos-Morales, Jesús Abelardo Barea Mendoza, Marcos Valiente Fernández, Carlos García Fuentes, Fernando Calvo Boyero, Cecilia Cueto-Felgueroso, Judith Gutiérrez Gutiérrez, Francisco de Paula Delgado Moya, Carolina Mudarra Reche, Susana Bermejo Aznárez, Alfonso Lagares, Mario Chico Fernández","doi":"10.1016/j.medine.2025.502227","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502227","url":null,"abstract":"<p><strong>Objective: </strong>to compare the different evolution of conventional laboratory parameters between three severe trauma phenotypes.</p><p><strong>Design: </strong>Observational study of a prospectively collected cohort of severe trauma patients, with retrospective database completion, studied between 2012 and 2022.</p><p><strong>Setting: </strong>A trauma intensive care unit (ICU).</p><p><strong>Patients: </strong>Severe trauma patients were defined by an Abbreviated Injury Scale of ≥ 3 in at least one aspect. Three groups were stablished according to hemodynamic status and Glasgow coma scale (GCS), and they were subsequently subdivided in prematurely deceased and survivors after > 72 h (h). Laboratory parameters were followed up to 96 h, statistical analysis between groups and subgroups was performed at 0 and 24 h.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main variables of interest: </strong>Prehospital, clinical variables on admission, prognostic variables (prospective gathering); blood count, biochemistry, coagulation, blood gas analysis (retrospectively collected).</p><p><strong>Results: </strong>1631 patients were included, 8% prematurely deceased. Initial leukocytosis and hyperglycemia were common in all groups. Hemodynamically stable patients with a GCS < 14 stood out due to a high neutrophil-to-lymphocyte ratio (NLR) and hypernatremia, both of them at 24 h, together with initial coagulopathy in the prematurely deceased. Hemodynamically unstable patients exhibited an initial pattern of lactic acidosis, coagulopathy, and decreased platelet-to-lymphocyte ratio, hemoglobin, albumin and calcium, all these changes being most prominent in the prematurely deceased. A 24 h peak in NLR was found in both the hemodynamically unstable and GCS < 14 groups.</p><p><strong>Conclusion: </strong>Evolution of laboratory parameters differ according to the patient's phenotype. They complete the initial severity evaluation and in hemodynamically stable patients they act as a warning for potential neurological damage.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502227"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228013","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}