Medicina intensiva最新文献_第2页

Electrical impedance tomography for the detection and management optimization of pulmonary embolism 电阻抗断层扫描对肺栓塞的检测和优化处理。

Medicina intensiva Pub Date : 2025-07-01 DOI: 10.1016/j.medine.2025.502134

Isabel Magaña Bru, Alicia Delgado Arroyo, Fernando Suarez Sipmann

引用次数: 0

Reply to: “Vasopressin: Why not in severe traumatic disease?” 回复：“抗利尿激素：为什么不能用于严重创伤性疾病？”

Medicina intensiva Pub Date : 2025-07-01 DOI: 10.1016/j.medine.2025.502220

Juan Carlos Ruíz-Rodríguez , Ana Ochagavia , Lluís Zapata , Ricard Ferrer

引用次数: 0

Predictive performance of ROX index and its variations for NIV failure ROX指数的预测性能及其对NIV故障的变化。

Medicina intensiva Pub Date : 2025-07-01 DOI: 10.1016/j.medine.2025.502136

Lada Lijović , Tomislav Radočaj , Nataša Kovač , Marinko Vučić , Paul Elbers

{"title":"Predictive performance of ROX index and its variations for NIV failure","authors":"Lada Lijović , Tomislav Radočaj , Nataša Kovač , Marinko Vučić , Paul Elbers","doi":"10.1016/j.medine.2025.502136","DOIUrl":"10.1016/j.medine.2025.502136","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether the ROX index and its variations can predict the risk of intubation in ICU patients receiving NIV ventilation using large public ICU databases.</div></div><div><h3>Design</h3><div>Retrospective observational cohort study.</div></div><div><h3>Setting</h3><div>Patient data was extracted from both the AmsterdamUMCdb and the MIMIC-IV ICU databases, which contained data related to 20,109 and 50,920 unique patients.</div></div><div><h3>Patients</h3><div>Non-invasively mechanically ventilated.</div></div><div><h3>Interventions</h3><div>Retrospective review of variables.</div></div><div><h3>Main variables of interest</h3><div>To assess the predictive values of models for each index, the ROX and its variations mROX, ROX-HR and mROX-HR were calculated based on mean values of SpO<sub>2</sub>, respiratory rate, FiO<sub>2</sub> and PaO<sub>2</sub> from 2-h windows within the first 12 h of NIV.</div></div><div><h3>Results</h3><div>3344 patients were eligible for analysis of which 1344 were intubated, died or returned to NIV within 24 h of ending NIV. NIV failure group had higher SOFA scores and higher CRP levels at admission. There was no difference in duration of NIV therapy or 28-day mortality, but patients who failed NIV had longer length of stay. The best performing index was ROX with an AUROC of 0.626 at 10−12 h. All other indices for all other time windows were less discriminating.</div></div><div><h3>Conclusions</h3><div>The performance of ROX index and its variations to predict NIV failure in ICU patients across large public ICU databases was moderate at best and cannot currently be recommended for clinical decision support.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 7","pages":"Article 502136"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985899","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

Diagnosis of colitis by ultrasound in an Intensive Care Unit 重症监护病房中结肠炎的超声诊断。

Medicina intensiva Pub Date : 2025-07-01 DOI: 10.1016/j.medine.2024.502115

C.M. Marín Marín , P. García Moreno , R. Vicho Pereira

引用次数: 0

Vasopressin: Why not in severe traumatic disease? 抗利尿激素：为什么不能用于严重创伤性疾病？

Medicina intensiva Pub Date : 2025-07-01 DOI: 10.1016/j.medine.2025.502173

Jesús Abelardo Barea-Mendoza , Juan Antonio Llompart-Pou , Adrian Marcos-Morales , Mario Chico-Fernández

引用次数: 0

Safety and efficacy of beta-blockers and amiodarone in the management of new-onset atrial fibrillation in critically ill patients with sepsis β受体阻滞剂和胺碘酮在脓毒症危重患者新发心房颤动治疗中的安全性和有效性。

Medicina intensiva Pub Date : 2025-07-01 DOI: 10.1016/j.medine.2025.502159

Alfonso Canabal Berlanga

引用次数: 0

Optimal hemoglobin levels in the neurocritical patient: Are we there yet? 神经危重症患者的最佳血红蛋白水平：我们达到了吗？

Medicina intensiva Pub Date : 2025-07-01 DOI: 10.1016/j.medine.2025.502162

Manuel Quintana-Diaz , Daniel Agustin Godoy

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Central venous catheter associated bacteremia in critically ill adult patients using the sealing of unused lumens with taurolidine. 中心静脉导管相关菌血症危重成人患者使用牛罗列丁封闭未使用的管腔。

Medicina intensiva Pub Date : 2025-06-28 DOI: 10.1016/j.medine.2025.502252

Leonardo Lorente, Maria Lecuona, Elena Pérez, Adrián Hernández, Sergio Sánchez, Lucas González, Alejandro Ramos, Jesús Pimentel, Pablo Correa, Carmen Dolores Chinea-Rodríguez, Carolina Martín-Meana, Ana Madueño

{"title":"Central venous catheter associated bacteremia in critically ill adult patients using the sealing of unused lumens with taurolidine.","authors":"Leonardo Lorente, Maria Lecuona, Elena Pérez, Adrián Hernández, Sergio Sánchez, Lucas González, Alejandro Ramos, Jesús Pimentel, Pablo Correa, Carmen Dolores Chinea-Rodríguez, Carolina Martín-Meana, Ana Madueño","doi":"10.1016/j.medine.2025.502252","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502252","url":null,"abstract":"<p><strong>Objective: </strong>Lower risk of catheter-related bacteremia (CRB) using taurolidine (antimicrobial agent) sealing of central venous catheters (CVCs) in children has been found in a meta-analysis. 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.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>One Spanish Intensive Care Unit.</p><p><strong>Patients: </strong>Critically ill adult patients, who underwent to some CVC.</p><p><strong>Interventions: </strong>The seal of unused lumens of CVCs was performed with saline serum 0.9% or taurolidine.</p><p><strong>Main variable of interest: </strong>Primary Bloodstream Infection (PBSI) included catheter-related bloodstream infection (CRBSI) CRBSI and bloodstream infection of unknown origin (BSIUO).</p><p><strong>Results: </strong>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 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502252"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","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}

引用次数: 0

Re-explaining patient safety in Intensive Care Medicine: In need of understanding and action. 重新解释重症监护医学中的患者安全：需要理解和行动。

Medicina intensiva Pub Date : 2025-06-27 DOI: 10.1016/j.medine.2025.502219

María Cruz Martín Delgado, Mario Chico Fernández, Gonzalo Sirgo Rodríguez, María Bodí

引用次数: 0

Clinical impact of COVID-19 respiratory infection 15 months after intensive care unit discharge. 重症监护病房出院后15个月COVID-19呼吸道感染的临床影响

Medicina intensiva Pub Date : 2025-06-20 DOI: 10.1016/j.medine.2025.502230

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

{"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}

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