Medicina intensiva最新文献

{"title":"Tranexamic acid applications in neurocritical patients: A narrative review","authors":"Eva Esther Tejerina Álvarez ,&nbsp;Irene Cavada Carranza ,&nbsp;Marcos González Bermejo ,&nbsp;Teresa Molina García ,&nbsp;José Ángel Lorente Balanza","doi":"10.1016/j.medine.2025.502139","DOIUrl":"10.1016/j.medine.2025.502139","url":null,"abstract":"<div><div>In patients with spontaneous or traumatic intracranial hemorrhage, hematoma expansion is associated with poorer neurological outcomes and increased mortality. The administration of an antifibrinolytic agent like tranexamic acid (TXA) may potentially improve clinical outcomes in patients with acute brain injury by preventing such intracranial expansion. However, studies on the impact of TXA in these patients have yielded variable results, and its efficacy, appropriate dosing and optimal timing of administration remain unclear. The present review summarizes the clinical evidence regarding the proper use of tranexamic acid in the treatment of intracranial traumatic and non-traumatic hemorrhage, and its implications for clinical practice.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502139"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076808","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":"Cytoreductive surgery for cardiac sarcoma","authors":"Bárbara Segura-Méndez ,&nbsp;Ana Revilla ,&nbsp;Yolanda Carrascal","doi":"10.1016/j.medine.2025.502132","DOIUrl":"10.1016/j.medine.2025.502132","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502132"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076804","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":"Quality and safety of ECMO transport. Practical aspects from our experience","authors":"Manuel García-Delgado ,&nbsp;Violeta Chica-Sáez ,&nbsp;Andrea Ferreiro-Marzal ,&nbsp;María Redondo-Orts ,&nbsp;María Esteban-Molina ,&nbsp;José Manuel Garrido-Jiménez ,&nbsp;on behalf of the UAMC","doi":"10.1016/j.medine.2025.502156","DOIUrl":"10.1016/j.medine.2025.502156","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502156"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257447","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":"Improvement in cerebral hypoperfusion by stellate ganglion block in refractory vasospasm","authors":"Luis Patricio Maskin,&nbsp;Federico Rodríguez Lucci","doi":"10.1016/j.medine.2025.502121","DOIUrl":"10.1016/j.medine.2025.502121","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502121"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506690","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":"Gasometry and altitude: investigation of normal ranges in Quito, Ecuador (2,850 m above sea level)","authors":"Jorge Luis Vélez-Páez ,&nbsp;Christian Castro-Bustamante ,&nbsp;Manuel Luis Avellanas-Chavala","doi":"10.1016/j.medine.2025.502140","DOIUrl":"10.1016/j.medine.2025.502140","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502140"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672186","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":"Technological innovation in critical care and limits of the life","authors":"Esteban Fernández-Hinojosa ,&nbsp;María Adriaensens Pérez ,&nbsp;José Cayetano Naranjo Jarillo","doi":"10.1016/j.medine.2025.502153","DOIUrl":"10.1016/j.medine.2025.502153","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502153"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538272","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":"Effect of a competence based medical education program on training quality in Intensive Care Medicine. COBALIDATION TRIAL","authors":"Álvaro Castellanos-Ortega ,&nbsp;María Jesús Broch Porcar ,&nbsp;Diego Palacios-Castañeda ,&nbsp;Vicente Gómez-Tello ,&nbsp;Miguel Valdivia ,&nbsp;Carlos Vicent ,&nbsp;Isabel Madrid ,&nbsp;Nuria Martinez ,&nbsp;Manuel José Párraga ,&nbsp;Elena Sancho ,&nbsp;María del Castillo Fuentes-Dura ,&nbsp;Rafael García-Ros","doi":"10.1016/j.medine.2024.502126","DOIUrl":"10.1016/j.medine.2024.502126","url":null,"abstract":"<div><h3>Objectives</h3><div>The main objective of this study was to evaluate whether the implementation of CoBaTrICE (Competency-Based Training in Intensive Care Medicine in Europe) provides higher levels of competency in comparison with the current official time-based program in Intensive Care Medicine in Spain. Secondary objectives were: 1) To determine the percentage of critical essential performance elements (CEPE) accomplished, 2) To determine compliance with workplace-based assessments (wba).</div></div><div><h3>Design</h3><div>Multicenter cluster randomized trial.</div></div><div><h3>Setting</h3><div>Thirteen Spanish ICU Departments.</div></div><div><h3>Participants</h3><div>Thirty-six residents</div></div><div><h3>Intervention</h3><div>The implementation of CoBaTrICE included: (1) Training the trainers; (2) Wba; (3) The use of an electronic portfolio. The level of competency achieved by each participant was determined by a simulation-based Objective Structured Clinical Exam (OSCE) performed at the end of the 5th year of training period.</div></div><div><h3>Main variables of interest</h3><div>Total scoring in the five scenarios, CEPE completed, level of competency (1–5) achieved.</div></div><div><h3>Results</h3><div>A total of 119 performances from 26 residents (17 from CoBaTrICE group and 9 from control group) were analyzed in the OSCE. CoBaTrICE residents´ achieved higher levels of competency [2 (1−5) vs. 2 (1−3), p = 0.07) and higher percentages of CEPE´s accomplishment than the control group (78% vs. 71%, p = 0.09).</div></div><div><h3>Conclusions</h3><div>The CoBaTrICE group showed a better performance trend in comparison to the control group, but the differences were not statistically significant. Since the number of Wba performed was low, additional research is needed to determine the potential superiority of CoBaTrICE.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502126"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928607","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":"Acute aortic syndrome and cardiogenic shock, beyond radiological diagnosis","authors":"Hala El Haddad,&nbsp;Isabel Espinosa Rueda,&nbsp;Nora Palomo-López","doi":"10.1016/j.medine.2025.502124","DOIUrl":"10.1016/j.medine.2025.502124","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502124"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451318","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":"Giant aneurysm of the left internal carotid artery with partial thrombosis","authors":"Alba Simón Paniello,&nbsp;María Candelaria Ruiz García,&nbsp;Miguel Finger Kamps","doi":"10.1016/j.medine.2024.502116","DOIUrl":"10.1016/j.medine.2024.502116","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502116"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911408","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":"Penetrating trauma in Spain: analysis of the Spanish trauma registry (RETRAUCI)","authors":"Judit Gutiérrez-Gutiérrez ,&nbsp;Jesús Abelardo Barea-Mendoza ,&nbsp;Carlos García-Fuentes ,&nbsp;Juan Antonio Llompart-Pou ,&nbsp;Begoña Guardiola-Grau ,&nbsp;Mikel Durán-Suquía ,&nbsp;María Ángeles Ballesteros-Sanz ,&nbsp;Javier González-Robledo ,&nbsp;Lluís Serviá-Goixart ,&nbsp;Cristina Méndez-Benegassi Cid ,&nbsp;Jose Maria Toboso Casado ,&nbsp;Mario Chico-Fernández ,&nbsp;on behalf of the Neurointensivism and Trauma Working Group of the SEMICYUC","doi":"10.1016/j.medine.2025.502165","DOIUrl":"10.1016/j.medine.2025.502165","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the epidemiology of penetrating trauma, mortality associated factors and its management in Spanish intensive care units.</div></div><div><h3>Design</h3><div>Multicenter, prospective registry. A comparison is established between two cohorts defined by the type of trauma (blunt and penetrating).</div></div><div><h3>Patients</h3><div>Patients with traumatic injury admitted to the participating ICUs from June 2015 to June 2022.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variable of interest</h3><div>Epidemiology, injury pattern, prehospital and hospital care, resource utilization, and clinical outcomes.</div></div><div><h3>Results</h3><div>12,806 patients were eligible, of whom 821 (6.4%) suffered penetrating trauma; 418 patients (50.9%) from stab wounds, 93 (11.3%) from gunshot wounds, and 310 (37.8%) from other objects. The most common intent was assault (47.7%). The mean ISS was 15.2 ± 10.6 in penetrating trauma and 19.8 ± 11.9 in blunt trauma (p &lt; 0.001). ICU mortality was 7.8% compared to 11.7% in blunt trauma, with deaths more frequently occurring within the first 24 hours (64% vs. 39%). Factors associated with mortality included female sex, prior use of antithrombotic agents, older age, higher NISS score, and the presence of cranial trauma or shock.</div></div><div><h3>Conclusions</h3><div>Penetrating trauma is an emergent pathology in our context with high complexity, highlighting the need for focused study and documentation, protocol development, and resource optimization to provide quality care.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 6","pages":"Article 502165"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723047","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}