Medicina intensiva最新文献

{"title":"Emergency ICU model: An advanced approach to the critically ill patient.","authors":"Mario Chico-Fernández, Carolina Mudarra-Reche, Jesús Abelardo Barea-Mendoza","doi":"10.1016/j.medine.2026.502431","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502431","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502431"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848184","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":"Pneumonía, \"The Young friend\" of mechanical ventilator.","authors":"Ángel Estella","doi":"10.1016/j.medine.2026.502502","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502502","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502502"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848303","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":"Accidental cannulation of the aortic arch with a central venous catheter","authors":"Antonio Padilla-Serrano , José Miguel Pérez Villares , Antonio Cárdenas Cruz","doi":"10.1016/j.medine.2025.502352","DOIUrl":"10.1016/j.medine.2025.502352","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 5","pages":"Article 502352"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846856","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":"Clinical Frailty Scale and Comorbidity-Polypharmacy Score for prediction of 30-day mortality in a mixed ICU population","authors":"Sarah Weihe ,&nbsp;Lone Musaeus Poulsen ,&nbsp;Mathias Maagaard ,&nbsp;Anders Fournaise ,&nbsp;Søren Kabell Nissen ,&nbsp;Camilla Bekker Mortensen ,&nbsp;Ole Mathiesen","doi":"10.1016/j.medine.2025.502292","DOIUrl":"10.1016/j.medine.2025.502292","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the prediction of 30-day mortality by frailty and comorbidity in a mixed ICU population and monitor the implementation of the Clinical Frailty Scale as daily practice in the ICU.</div></div><div><h3>Design</h3><div>A prospective observational single-center cohort study.</div></div><div><h3>Setting</h3><div>Mixed ICU at Zealand University Hospital.</div></div><div><h3>Patients</h3><div>All patients &gt;40 years of age acutely admitted to the ICU from April 1st 2021 to March 31st 2022.</div></div><div><h3>Main variables of interest</h3><div>Frailty assessed by the Clinical Frailty Scale (CFS), Comorbidity-Polypharmacy-Score (CPS), and 30-day mortality.</div></div><div><h3>Results</h3><div>A total of 319 patients were included in the study. Of these, 118 (37%) were categorized as frail, defined by a CFS ≥ 5. The CPS score was median (IQR) 13 (7–18), rated as moderate. Patients with increasing frailty demonstrated higher CPS scores. The overall 30-day mortality was 34.5%. Patients categorised as frail had a higher 30-day mortality compared to non-frail patients (47% vs 27%). The AUROC of CFS and CPS of 30-day mortality was 0.77 (95% CI 0.72 to 0.83) and 0.75 (95% CI 0.69 to 0.81), respectively. Combining CFS and CPS did not strengthen the ability to predict 30-day mortality compared to CFS alone. ICU clinicians assessed CFS in 79% of patients.</div></div><div><h3>Conclusion</h3><div>Frailty assessed by CFS had a fair prediction of 30-day mortality after ICU admission in a mixed ICU population. The discriminatory ability for predicting 30-day mortality was not improved by combining CFS and CPS compared to CFS alone.</div><div>The clinical implementation of the CFS was performed effectively.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 5","pages":"Article 502292"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984376","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":"Anesthetic gases in the sedation of critically ill patients","authors":"Carlos Chamorro-Jambrina,&nbsp;Miguel Ángel Romera-Ortega","doi":"10.1016/j.medine.2025.502301","DOIUrl":"10.1016/j.medine.2025.502301","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 5","pages":"Article 502301"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145447010","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":"Central venous catheter associated bacteremia in critically ill adult patients using the sealing of unused lumens with taurolidine","authors":"Leonardo Lorente ,&nbsp;Maria Lecuona ,&nbsp;Elena Pérez ,&nbsp;Adrián Hernández ,&nbsp;Sergio Sánchez ,&nbsp;Lucas González ,&nbsp;Alejandro Ramos ,&nbsp;Jesús Pimentel ,&nbsp;Pablo Correa ,&nbsp;Carmen Dolores Chinea-Rodríguez ,&nbsp;Carolina Martín-Meana ,&nbsp;Ana Madueño","doi":"10.1016/j.medine.2025.502252","DOIUrl":"10.1016/j.medine.2025.502252","url":null,"abstract":"<div><h3>Objective</h3><div>Lower risk of catheter-related bacteremia<span><span> (CRB) using taurolidine (antimicrobial agent) sealing of </span>central venous catheters (CVCs) in children has been found in a meta-analysis.</span></div><div>The objective of this study was to analyze whether the sealing of unused lumens of CVCs with taurolidine in critically ill adult patients reduce CRB incidence.</div></div><div><h3>Design</h3><div>Retrospective study.</div></div><div><h3>Setting</h3><div>One Spanish Intensive Care Unit.</div></div><div><h3>Patients</h3><div>Critically ill adult patients, who underwent to some CVC.</div></div><div><h3>Interventions</h3><div>The seal of unused lumens of CVCs was performed with saline serum 0.9% or taurolidine.</div></div><div><h3>Main variable of interest</h3><div>Primary Bloodstream Infection (PBSI) included catheter-related bloodstream infection (CRBSI) CRBSI and bloodstream infection of unknown origin (BSIUO).</div></div><div><h3>Results</h3><div>We diagnosed 22 PBSI in the 573 (3.8%) CVC without taurolidine and 22 PBSI in the 548 (4.0%) CVC with taurolidine (p = 0.88). Logistic regression analysis<span> showed an association of tracheostomy with the risk of PBSI; however, we did not find the association of other variables (included taurolidine) with the risk of PBSI.</span></div></div><div><h3>Conclusion</h3><div>To the best of our knowledge, this is the first study reporting data about sealing of unused lumens of CVCs with taurolidine in critically ill adult patients. In our preliminary study, we have not been able to demonstrate that sealing unused lumens of CVCs with taurolidine can reduce the risk of PBSI in critically ill adult patients. However, it would be interesting to conduct randomized studies to confirm or discard our findings.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 5","pages":"Article 502252"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532103","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":"Transesophageal echocardiography: A comprehensive assessment of the critically ill patient","authors":"Virginia Fraile-Gutiérrez ,&nbsp;David Pérez-Torres ,&nbsp;Luis Martin-Villen ,&nbsp;Luís Zapata ,&nbsp;Ana Ochagavia","doi":"10.1016/j.medine.2026.502401","DOIUrl":"10.1016/j.medine.2026.502401","url":null,"abstract":"<div><div>Transesophageal echocardiography (TEE) has become an essential tool in the management of critically ill patients, particularly when transthoracic echocardiography is insufficient. Its use allows to obtain high-quality imaging to assess cardiac function, diagnose the cause of shock, monitor fluid responsiveness, and evaluate venous congestion. It is especially valuable in complex scenarios such as stroke, the postoperative period after cardiac surgery, ECMO support, and during cardiac arrest, as it provides continuous visualization without interrupting chest compressions. Although it is a semi-invasive technique, it has a very favorable safety profile when performed by trained intensivists. Adequate training, including supervision and simulation, is crucial for achieving competence. Besides, TEE allows the examination of pulmonary and abdominal structures, extending its utility beyond the heart. Its incorporation into Intensive Care Medicine has demonstrated significant clinical impact, modifying therapeutic management in a high proportion of patients.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 5","pages":"Article 502401"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756917","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":"Authors’ response to: Anesthetic gases in the sedation of critically ill patients","authors":"José Manuel Añón ,&nbsp;María Paz Escuela ,&nbsp;Javier Oliva-Navarro ,&nbsp;Arís Pérez-Lucendo ,&nbsp;Fernando Suarez-Sipmann","doi":"10.1016/j.medine.2025.502343","DOIUrl":"10.1016/j.medine.2025.502343","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 5","pages":"Article 502343"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954570","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":"Triglyceride-Glucose Index as a predictor of severity in acute pancreatitis: Systematic Review and Meta-Analysis","authors":"Gustavo Adolfo Vásquez-Tirado ,&nbsp;Odett Yamile Aguirre-Varas ,&nbsp;Edinson Dante Meregildo-Rodríguez ,&nbsp;Claudia Vanessa Quispe-Castañeda ,&nbsp;Wilson Marcial Guzmán-Aguilar ,&nbsp;Leslie Jacqueline Liñán-Díaz ,&nbsp;Luis Ángel Rodríguez-Chávez","doi":"10.1016/j.medine.2025.502210","DOIUrl":"10.1016/j.medine.2025.502210","url":null,"abstract":"<div><h3>Objective</h3><div>The triglyceride-glucose (TyG) index has been proposed as a novel predictive variable of severe acute pancreatitis (SAP)</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Setting</h3><div>A comprehensive search was conducted across five databases of studies published up to March 17, 2024, using the PECO strategy. Seven studies were identified and included in our meta-analysis.</div></div><div><h3>Participants</h3><div>The participants of the included primary studies (non-severe acute pancreatitis).</div></div><div><h3>Interventions</h3><div>High triglyceride-glucose (TyG) index</div></div><div><h3>Main variables of interest</h3><div>Severe acute pancreatitis,</div></div><div><h3>Results</h3><div>Our analysis evaluated the risk of progression to severity in patients with elevated TyG index in acute pancreatitis through four non-randomized studies. The TyG index was found to be a predictor of severity in acute pancreatitis, with an overall severity risk (OR: 2.38; 95% CI: 1.50–4.08; I²: 80%). Additionally, the analysis of the standardized mean difference (SMD) across all seven studies between patients with SAP and non-SAP yielded an overall mean (OR: 0.90; 95% CI: 0.70–1.11; I²: 28%).</div></div><div><h3>Conclusion</h3><div>In patients with acute pancreatitis, a TyG index is a predictor of severity.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 5","pages":"Article 502210"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015561","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":"High serum malondialdehyde levels in patients with decompression sickness","authors":"Leonardo Lorente ,&nbsp;Pedro Abreu González ,&nbsp;Candelaria Darias Martin ,&nbsp;Ana Matute ,&nbsp;Gabriela Menéndez ,&nbsp;Juan Francisco Lozano Gomariz ,&nbsp;Alejandro Jiménez","doi":"10.1016/j.medine.2025.502351","DOIUrl":"10.1016/j.medine.2025.502351","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 5","pages":"Article 502351"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459903","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}