Medicina intensiva最新文献

{"title":"Management of severe infections by multi-resistant Gram-negative bacteria in critically ill patients.","authors":"José Garnacho-Montero, María Adriaensens-Pérez, Teresa Aldabó-Pallás, Noelia Anaya-Carrión, David Andaluz-Ojeda, Luisa Cantón-Bulnes, Gennaro De Pascale, Esperanza Fernández-Delgado, Pedro Povoa, Paula Ramírez-Gallemore, Alejandro Rodríguez-Oviedo, Cruz Soriano","doi":"10.1016/j.medine.2026.502443","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502443","url":null,"abstract":"<p><p>Infections caused by multi-resistant Gram-negative bacilli (MDR-GNB) are currently one of the main public health problems worldwide. Various mechanisms such as altered permeability, efflux pumps, or the appearance of inactivating enzymes (β-lactamases or carbapenemases, among others) cause these bacteria to develop resistance to many of the traditional therapeutic options. Since 2015, new broad-spectrum antibiotics have been incorporated, transforming the treatment of infections caused by MDR-GNB. This article, with an eminently practical focus, aims to review and update the diagnosis and treatment of infections caused by MDR-GNB in critically ill patients, attempting to position the use of new antibiotics both in targeted and empirical, without forgetting the crucial role of infection control in combating this health threat.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502443"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793285","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":"Pre-ECMO associated variables with one-year survival in ARDS patients undergoing VV ECMO therapy in the Community of Aragon.","authors":"Pablo Ruiz de Gopegui Miguelena, Luis Manuel Claraco Vega, Jessica Giménez Lecina, Andrés Carrillo López","doi":"10.1016/j.medine.2026.502441","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502441","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502441"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793280","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":"Climate change and sustainability in intensive care medicine.","authors":"María Cruz Martín Delgado, Javier Pérez-Fernández","doi":"10.1016/j.medine.2026.502497","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502497","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502497"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793277","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":"The therapeutic context as a determinant of prognosis in critically ill cancer patients.","authors":"Juan Higuera Lucas, Elena Cuenca Fito, Inés Gómez Acebo, Cándido Díaz Lagares, Marta Malingre Gajino, María Victoria Boado Varela","doi":"10.1016/j.medine.2026.502432","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502432","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502432"},"PeriodicalIF":0.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679845","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":"Online visualisation of the patient and the ultrasound image through augmented reality glasses. Does it offer any advantage in vascular cannulation?","authors":"Eduardo Villanueva Torreiro ,&nbsp;Antonio Rodríguez-Núñez ,&nbsp;Miguel A. Rodríguez-Vargas ,&nbsp;Emilio Rodriguez-Ruiz","doi":"10.1016/j.medine.2026.502393","DOIUrl":"10.1016/j.medine.2026.502393","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 4","pages":"Article 502393"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349742","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":"Pediatric trauma: Where are we and where are we heading? A narrative review of recent evidence","authors":"Luis Renter Valdovinos ,&nbsp;Ander Ceña Setien ,&nbsp;Javier Rodríguez-Fanjul ,&nbsp;Jesús Abelardo Barea-Mendoza","doi":"10.1016/j.medine.2026.502388","DOIUrl":"10.1016/j.medine.2026.502388","url":null,"abstract":"<div><div>Trauma is the leading cause of death in children and adolescents. This article reviews recent advances in the management of severe pediatric trauma, emphasizing the importance of well-organized trauma systems, effective triage, and protocols specifically adapted to pediatric physiology. Current strategies for damage-control resuscitation are discussed, including the use of blood products, vasoactive support, and novel predictive indices for shock severity. In traumatic brain injury, the role of multimodal neuromonitoring and individualized management of intracranial and cerebral perfusion pressures is reviewed. The need to move beyond adult-centered approaches and tailor care to pediatric-specific characteristics is strongly emphasized. Finally, the main research priorities in pediatric trauma are outlined, which are essential for improving survival and functional recovery in this vulnerable population.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 4","pages":"Article 502388"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517897","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":"Unexplained hyperammonemia in critically ill oncological patients: An emerging complication of gemcitabine-cisplatin therapy","authors":"Patricia Escudero-Acha,&nbsp;Marta Arroyo Diez,&nbsp;Alfredo Abajo Miranda,&nbsp;Junkal Martínez Elizalde,&nbsp;Lourdes Fisac Cuadrado,&nbsp;José Antonio Fernández Ratero","doi":"10.1016/j.medine.2025.502270","DOIUrl":"10.1016/j.medine.2025.502270","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 4","pages":"Article 502270"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180751","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":"Usefulness of vector velocity imaging in the descending thoracic aorta","authors":"Manuel Ruiz-Bailén ,&nbsp;Javier Hidalgo-Martín ,&nbsp;Julia Manetsberger ,&nbsp;Fernando Clau-Terré ,&nbsp;Javier Martínez-Gámez ,&nbsp;Johannes Dagomar Lohman ,&nbsp;María Leyre Lavilla-Lerma ,&nbsp;Diego Fernando Matallana-Zapata ,&nbsp;Marta Ballesteros-Barroso ,&nbsp;Ricardo Rivera-Fernández ,&nbsp;Pedro José Sánchez de Toro Hernández ,&nbsp;José Ángel Ramos-Cuadra","doi":"10.1016/j.medine.2025.502224","DOIUrl":"10.1016/j.medine.2025.502224","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the Speckle Tracking values in the descending thoracic aorta (DTA) of a healthy population.</div></div><div><h3>Desing</h3><div>This is an observational study.</div></div><div><h3>Setting</h3><div>Hospital Universitario de Jaén.</div></div><div><h3>Participants</h3><div>Our study included 242 healthy people (102 women) with a mean age of 42.35<!--> <!-->±<!--> <!-->16.37 years.</div></div><div><h3>Interventions</h3><div>Evaluation of Speckle Tracking in DTA.</div></div><div><h3>Main variables of interest</h3><div>Strain, velocity and displacement values in the DTA were evaluated.</div></div><div><h3>Results</h3><div>The DAT rotational velocity was 55.91<!--> <!-->±<!--> <!-->0.22º/s, the DTA radial velocity was 0.98<!--> <!-->±<!--> <!-->0.28<!--> <!-->cm/s, the circumferential strain of the DTA was −8.98<!--> <!-->±<!--> <!-->0.87%, while the circumferential strain rate was −0.96<!--> <!-->±<!--> <!-->0.15/s. The rotational displacement of the DTA was determined at 8.87<!--> <!-->±<!--> <!-->0.36º, while radial displacement was 0.82<!--> <!-->±<!--> <!-->0.11<!--> <span>mm. Logistic regression found an association between the rotational values of the aorta and the longitudinal strain of both ventricles. In thirty people, strain, rotational velocity and displacement were also evaluated in the apical 4-chamber views and in the parasternal long-axis view. Both projections showed similar values.</span></div></div><div><h3>Conclusion</h3><div>Speckle Tracking could be used to study the descending thoracic aorta, and its values could suggest or rule out the presence of cardiovascular pathology.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 4","pages":"Article 502224"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228014","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 ,&nbsp;Jesús Abelardo Barea Mendoza ,&nbsp;Marcos Valiente Fernández ,&nbsp;Carlos García Fuentes ,&nbsp;Fernando Calvo Boyero ,&nbsp;Cecilia Cueto-Felgueroso ,&nbsp;Judith Gutiérrez Gutiérrez ,&nbsp;Francisco de Paula Delgado Moya ,&nbsp;Carolina Mudarra Reche ,&nbsp;Susana Bermejo Aznárez ,&nbsp;Alfonso Lagares ,&nbsp;Mario Chico Fernández","doi":"10.1016/j.medine.2025.502227","DOIUrl":"10.1016/j.medine.2025.502227","url":null,"abstract":"<div><h3>Objective</h3><div>to compare the different evolution of conventional laboratory parameters between three severe trauma phenotypes.</div></div><div><h3>Design</h3><div>Observational study of a prospectively collected cohort of severe trauma patients, with retrospective database completion, studied between 2012 and 2022.</div></div><div><h3>Setting</h3><div>A trauma intensive care unit (ICU).</div></div><div><h3>Patients</h3><div>Severe trauma patients were defined by an Abbreviated Injury Scale<span><span> of ≥ 3 in at least one aspect. Three groups were stablished according to hemodynamic status and </span>Glasgow coma scale (GCS), and they were subsequently subdivided in prematurely deceased and survivors after &gt; 72 h (h). Laboratory parameters were followed up to 96 h, statistical analysis between groups and subgroups was performed at 0 and 24 h.</span></div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Prehospital, clinical variables on admission, prognostic variables (prospective gathering); blood count, biochemistry, coagulation, blood gas analysis (retrospectively collected).</div></div><div><h3>Results</h3><div><span>1631 patients were included, 8% prematurely deceased. Initial leukocytosis and </span>hyperglycemia<span><span> were common in all groups. Hemodynamically stable patients with a GCS &lt; 14 stood out due to a high neutrophil-to-lymphocyte ratio (NLR) and hypernatremia, both of them at 24 h, together with initial </span>coagulopathy<span> in the prematurely deceased. Hemodynamically unstable patients exhibited an initial pattern of lactic acidosis<span>, 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 &lt; 14 groups.</span></span></span></div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 4","pages":"Article 502227"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","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}

{"title":"Coma due to tension pneumocephalus in the posterior fossae","authors":"Luis Patricio Maskin,&nbsp;Florencia A. Cabañuz,&nbsp;Federico Rodriguez Lucci","doi":"10.1016/j.medine.2025.502348","DOIUrl":"10.1016/j.medine.2025.502348","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"50 4","pages":"Article 502348"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846899","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}