Medicina intensiva最新文献_第2页

Giant lung abscess complicating pneumonia managed with veno venous extracorporeal membrane oxygenation 用静脉体外膜肺氧合治疗肺炎并发的巨大肺脓肿。

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.05.003

引用次数: 0

Analysis of medication errors in Neonatal Intensive Care: A systematic review 新生儿重症监护中的用药错误分析：系统回顾。

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.08.002

Francisco Miguel Escandell-Rico , Lucia Pérez-Fernández

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Patient safety, what does clinical simulation and teaching innovation contribute? 患者安全，临床模拟和教学创新有何贡献？

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.07.008

Antonio Dueñas-Ruiz , Luis M. Tamayo Lomas , Miguel A. Castro Villamor , Francisco Martín-Rodríguez

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The effect of different definitions of hepatic injury on incidence and mortality rates in the ICU patient population with secondary hepatic injury 不同的肝损伤定义对重症监护病房继发性肝损伤患者发病率和死亡率的影响。

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.06.002

{"title":"The effect of different definitions of hepatic injury on incidence and mortality rates in the ICU patient population with secondary hepatic injury","authors":"","doi":"10.1016/j.medine.2024.06.002","DOIUrl":"10.1016/j.medine.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>The aim was to investigate how different hepatic injury (HI) definitions used in the same study population change incidence and mortality rates and which would best diagnose secondary HI.</div></div><div><h3>Design</h3><div>Single-centre retrospective observational cohort study.</div></div><div><h3>Setting</h3><div>Tertiary hospital ICU, ANKARA, Turkey.</div></div><div><h3>Patients</h3><div>Four hundred seventy-eight adult patients were included in the study.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Three definitions of HI were compared. Taking the SOFA hepatic criteria (SOFA: Total bilirubin<span> (TBL) > 1.2 mg/dl) as the gold standard, sensitivity, specificity, positive and negative predictive values, and accuracy of the modified 2017 definition by the American College of Gastroenterology (ACG) and the 2019 European Association for the Study of the Liver (EASL) were calculated.</span></div></div><div><h3>Results</h3><div>Incidence rates ranged from 10% to 45% according to the definition (p < 0.005), while mortality rates ranged from 38% to 57%. When the SOFA1.2 (TBL > 1.2 definition was taken as the gold standard, the diagnostic value of the ACG definition was high, and HI was found to be an independent risk factor that increased mortality four times.</div></div><div><h3>Conclusions</h3><div>According to this study’s results, the incidence and mortality rates of secondary HI vary greatly depending on the definition used. A definition that includes minimal increases in ALT, AST, and TBL predicts mortality with reasonable incidence rates.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 11","pages":"Pages 646-653"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433675","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

Analysis of energy load values in mechanical ventilation in obese patients with hypoxemic respiratory failure secondary to SARS-CoV-2 继发于 SARS-CoV-2 的低氧呼吸衰竭肥胖患者机械通气的能量负荷值分析。

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.06.018

Alejandro González-Castro , Elena Cuenca Fito , Carmen Huertas Martín , Yhivian Peñasco , Aurio Fajardo Campoverdi

引用次数: 0

Abdominal aortic aneurysm complicated with aortocaval fistula 腹主动脉瘤并发主动脉腔瘘。

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.04.001

引用次数: 0

Reply to “Patient safety, what does clinical simulation and teaching innovation contribute?” 对 "患者安全，临床模拟和教学创新有何贡献？"的答复

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.07.013

María Jesús Broch Porcar, Álvaro Castellanos-Ortega

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Mortality prediction model from combined serial lactate, procalcitonin and calprotectin levels in critically ill patients with sepsis: A retrospective study according to Sepsis-3 definition 根据脓毒症重症患者的乳酸、降钙素原和钙黏蛋白联合序列水平建立死亡率预测模型：根据败血症-3定义的回顾性研究。

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.05.015

{"title":"Mortality prediction model from combined serial lactate, procalcitonin and calprotectin levels in critically ill patients with sepsis: A retrospective study according to Sepsis-3 definition","authors":"","doi":"10.1016/j.medine.2024.05.015","DOIUrl":"10.1016/j.medine.2024.05.015","url":null,"abstract":"<div><h3>Objective</h3><div>1) To evaluate the ability of baseline and on 24 h serum calprotectin, in comparison to canonical biomarkers (lactate and procalcitonin), for prognosis of 28-day mortality in critically ill septic patients; and 2) To develop a predictive model combining the three biomarkers.</div></div><div><h3>Design</h3><div>A single-center, retrospective study.</div></div><div><h3>Setting</h3><div>Intensive Care Unit of a university hospital.</div></div><div><h3>Patients or participants</h3><div>One hundred and seventy three septic pacientes were included.</div></div><div><h3>Interventions</h3><div><span>Measurement of baseline lactate, procalcitonin and </span>calprotectin<span> level and procalcitonin and calprotectin levels on 24 h.</span></div></div><div><h3>Main variables of interest</h3><div>Demographics and comorbidities, SOFA score on ICU admission, baseline lactate, procalcitonin and calprotectin on admission and on 24 h and 28-day mortality.</div></div><div><h3>Results</h3><div>1) On ICU admission, lactate was the only biomarker achieving a significant accuracy (AUC: 0.698); 2) On 24 h, no differences were found on procalcitonin and calprotectin levels. Procalcitonin and calprotectin clearances were significantly lower in non-survivors and both achieved a moderate performance (AUCs: 0.668 and 0.664, respectively); 3) A biomarker based-model achieved a significant accuracy (AUC: 0.766), trending to increase (AUC: 0.829) to SOFA score alone; y 4) Baseline lactate levels and procalcitonin and calprotectin clearance were independent predictors for the outcome.</div></div><div><h3>Conclusions</h3><div>1) Baseline and on 24 h calprotectina and procalcitonin levels lacked ability in predicting 28-day mortality; 2) Accuracy of clearance of both biomarkers was moderate; and 3) Combination of SOFA score and the predictive biomarker based-model showed a high prognostic accuracy.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 11","pages":"Pages 629-638"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332785","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

Association of dead space fraction to mortality in patients with COVID-19-related ARDS: A historical cohort observational study COVID-19相关ARDS患者的死亡空间分数与死亡率的关系：一项历史队列观察研究。

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.06.009

{"title":"Association of dead space fraction to mortality in patients with COVID-19-related ARDS: A historical cohort observational study","authors":"","doi":"10.1016/j.medine.2024.06.009","DOIUrl":"10.1016/j.medine.2024.06.009","url":null,"abstract":"<div><h3>Objective</h3><div><span>To assess the correlation of dead space fraction (VD/VT) measured through time capnography, corrected minute volume (CMV) and ventilation ratio (VR) with clinical outcomes in COVID-19 patients requiring invasive </span>mechanical ventilation.</div></div><div><h3>Design</h3><div>Observational study of a historical cohort.</div></div><div><h3>Setting</h3><div>University hospital in Medellin, Colombia.</div></div><div><h3>Participants</h3><div>Patients aged 15 and above with a confirmed COVID-19 diagnosis admitted to the ICU and requiring mechanical ventilation.</div></div><div><h3>Interventions</h3><div>Measurement of VD/VT, CMV, and VR in COVID-19 patients.</div></div><div><h3>Main variables of interest</h3><div>VD/VT, CMV, VR, demographic data, oxygenation indices and ventilatory parameters.</div></div><div><h3>Results</h3><div><span>During the study period, 1047 COVID-19 patients on mechanical ventilation were analyzed, of whom 446 (42%) died. Deceased patients exhibited a higher prevalence of advanced age and obesity, elevated Charlson index, higher APACHE II and SOFA scores, as well as an increase in VD/VT ratio (0.27 in survivors and 0.31 in deceased) and minute ventilation volume on the first day of mechanical ventilation. The </span>multivariate analysis revealed independent associations to in-hospital mortality, higher VD/VT (HR 1.24; 95%CI 1.003–1.525; p = 0.046), age (HR 1.024; 95%CI 1.014–1.034; p < 0.001), and SOFA score at onset (HR: 1.036; 95%CI: 1.001–1.07; p = 0.017).</div></div><div><h3>Conclusions</h3><div>VD/VT demonstrated an association with mortality in COVID-19 patients with ARDS on mechanical ventilation. These findings suggest that VD/VT measurement may serve as a severity marker for the disease.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 11","pages":"Pages 639-645"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437971","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

Frailty, prevalence in our intensive care units and differential characteristics of these patients 虚弱、重症监护病房的发病率以及这些病人的不同特点。

Medicina intensiva Pub Date : 2024-11-01 DOI: 10.1016/j.medine.2024.06.015

引用次数: 0