Medicina intensiva最新文献

{"title":"Noninvasive bedside neuromonitoring in acute brain injury. A narrative review.","authors":"Daniel Agustín Godoy, Jon Pérez-Bárcena, Francisco de Paula Delgado-Moya, Jesús Abelardo Barea-Mendoza, Juan Antonio Llompart-Pou","doi":"10.1016/j.medine.2025.502305","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502305","url":null,"abstract":"<p><p>Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502305"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133218","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":"Scalenus anterior thickening: A novel predictor for mechanical ventilation weaning. A prospective observational study.","authors":"Lydia Magdy Milad, Mina Adolf Helmy, Ahmed I Ezz-Eldin, Waleed I Hamimmy, Amr Hussein Sayed","doi":"10.1016/j.medine.2025.502306","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502306","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility and reproducibility of the scalenus anterior thickening fraction and its diagnostic accuracy to predict weaning outcomes.</p><p><strong>Design: </strong>Prospective observational study conducted as 2 sub-studies: sub-study A, which included healthy volunteers, and sub-study B, which included critically ill patients undergoing mechanical ventilation weaning.</p><p><strong>Setting: </strong>Single-center study conducted at a tertiary center over 6 months.</p><p><strong>Participants: </strong>Twenty-one healthy volunteers were included in sub-study A, whereas sub-study B included 66 critically ill patients undergoing weaning from mechanical ventilation.</p><p><strong>Interventions: </strong>A high-frequency linear transducer was placed horizontally at the level of the cricoid cartilage with the neck rotated to the opposite side; at this point, the scalenus anterior muscle can be visualized clearly. The M mode was then switched on in the middle of the muscle with the sweep speed adjusted to a minimum to allow multiple breaths to be obtained on the same screen. Inspiratory and expiratory thickness was measured as an average of 3 breaths; subsequently, the thickening fraction was calculated as (inspiratory thickness - expiratory thickness)/expiratory thickness and expressed as a percentage.</p><p><strong>Main variables of interest: </strong>Accuracy of the scalenus anterior thickening fraction to predict failed weaning.</p><p><strong>Results: </strong>Scalenus anterior thickening has good intra- and inter-observer reliability with interclass correlation coefficients of 0.79 and 0.8 for inspiratory and expiratory muscles, respectively. It also showed good accuracy in predicting failed spontaneous breathing trials with an area under the curve (95% confidence interval) of 0.92 (0.82-1) and 0.94 (0.84-0.98) for the right and left sides, respectively. Additionally, scalenus anterior thickening fraction could predict reintubation with an area under the curve of 1.00 (0.93-1.00) and 0.99 (0.91-1.00).</p><p><strong>Conclusion: </strong>Scalenus anterior examination is a feasible tool with good interobserver reliability. The scalenus anterior thickening fraction could accurately predict weaning outcomes.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502306"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133138","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":"Cardiac arrest in a previously healthy infant caused by secondary pseudohypoaldosteronism: Case report and literature review.","authors":"Mónica Calviño-Costas, Sofía Bassy Navarro, Inés Leoz Gordillo, Carmen De Lucas Collantes, María Suarez Bustamante, Alberto García-Salido","doi":"10.1016/j.medine.2025.502303","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502303","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502303"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103062","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":"Validity of the FRAIL-España scale for critically ill patients.","authors":"Susana Arias-Rivera, Fernando Frutos-Vivar, María Nieves Moro-Tejedor, María Mar Sánchez-Sánchez, Emilia Romero-de San Pío, Yeray Gabriel Santana-Padilla, Gemma Via-Clavero, María Del Rosario Villar-Redondo, María Jesús Frade-Mera, Mónica Juncos-Gozalo, Elisabet Gallart-Vivé, Marta Raurell-Torredà","doi":"10.1016/j.medine.2025.502259","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502259","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the validity and sensitivity to change of the FRAIL-España scale in critically ill adult patients admitted to intensive care units (ICUs) in Spain.</p><p><strong>Design: </strong>Descriptive, observational, prospective, multicenter, metric in nature.</p><p><strong>Setting: </strong>ICUs in Spain.</p><p><strong>Patients: </strong>Patients >18 years old with ICU stay >48 h.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main variables of interest: </strong>Frailty (FRAIL-España), sociodemographic characteristics, dependency, ICU stay clinical variables, stay, mortality, destination at discharge.</p><p><strong>Results: </strong>The prevalence of frailty at ICU admission, among the 493 patients in the cohort, was 23.9%. Multivariate risk factors for frailty were age and hospital admissions in the year prior to the current admission. Being independent, having a stable partner, and good physical quality of life are protective factors for frailty. Frailty is associated with greater resource utilization, increased mortality, and a higher likelihood of discharge to a long-stay facility. The effect size of the observed change was moderate-large (d = 0.850).</p><p><strong>Conclusions: </strong>The FRAIL-España model shows good convergent validity with age, dependency, marital status, comorbidities, perceived physical quality of life, and hospitalization in an acute care facility in the previous year. It has good predictive validity for ICU-acquired weakness, alterations in glycemic control and resource use, hospital discharge, and mortality. It is sensitive for detecting changes in frailty.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502259"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103147","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":"Electrical impedance tomography implementation in pleuropulmonary pathology in adult patients.","authors":"Gabriel Appendino, Celeste Gomez, Carlos Lovesio","doi":"10.1016/j.medine.2025.502262","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502262","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502262"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103120","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":"Reply to \"Enhancing methodological rigor in mechanical insufflation-exsufflation weaning studies: Commentary on patient selection, long-term outcomes, and psychological assessment\".","authors":"Cristiane Bastos Netto, Maycon Moura Reboredo, Erich Vidal Carvalho, Bruno Valle Pinheiro","doi":"10.1016/j.medine.2025.502302","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502302","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502302"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093302","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":"Cytokine release syndrome and hemophagocytic syndrome associated with immunotherapy: A narrative review.","authors":"Eric Mayor-Vázquez, Elena Cuenca Fito, Pilar Marcos-Neira, Cándido Díaz-Lagares, Carme Gomila-Sintes, Noelia Albalá, Alejandra García-Roche, Pedro Castro","doi":"10.1016/j.medine.2025.502254","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502254","url":null,"abstract":"<p><p>In recent years, there has been an increase in the number of patients affected by oncohematologic diseases in developed countries due to the improved survival rates and quality of life. This increase has generated a greater need for care in intensive care units (ICU), mainly due to complications related to immunosuppression, treatment toxicity or complications derived from cancer itself. Immunotherapy has transformed cancer treatment, but it can cause serious side effects such as cytokine release syndrome and hemophagocytic syndrome, which often require ICU admission. This review seeks to expand knowledge and management strategies for these complications in the ICU.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502254"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058784","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":"Reverse shock index multiplied by Glasgow coma scale (rSIG) to predict mortality in traumatic brain injury: systematic review and meta-analysis","authors":"Gustavo Adolfo Vásquez-Tirado ,&nbsp;Edinson Dante Meregildo-Rodríguez ,&nbsp;Claudia Vanessa Quispe-Castañeda ,&nbsp;María Cuadra-Campos ,&nbsp;Wilson Marcial Guzmán-Aguilar ,&nbsp;Percy Hernán Abanto-Montalván ,&nbsp;Hugo Alva-Guarniz ,&nbsp;Leslie Jacqueline Liñán-Díaz ,&nbsp;Luis Ángel Rodríguez-Chávez","doi":"10.1016/j.medine.2025.502149","DOIUrl":"10.1016/j.medine.2025.502149","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether the Reverse Shock Index<span><span> multiplied by the Glasgow Coma Scale (rSIG) is a predictor of in-hospital mortality in patients with </span>traumatic brain injury (TBI).</span></div></div><div><h3>Design</h3><div>This is a systematic review and meta-analysis.</div></div><div><h3>Setting</h3><div>A comprehensive search was conducted in five databases for studies published up to May 22, 2024, using a PECO strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis.</div></div><div><h3>Participants</h3><div>The participants of the included primary studies.</div></div><div><h3>Interventions</h3><div>Patients with a low rSIG as a predictor of in-hospital mortality in TBI.</div></div><div><h3>Main variables of interest</h3><div>rSIG, in-hospital mortality, TBI.</div></div><div><h3>Results</h3><div>Our meta-analysis evaluated a total of eight observational studies encompassing 430,000 patients with TBI, observing 6,417 deaths (15%). After performing a sensitivity analysis, we found that patients with TBI and a low value of the reverse shock index multiplied by the Glasgow Coma Scale (rSIG) had a 24% higher risk of death (OR 1.24; 95% CI 1.12–1.38; I²: 96%). Furthermore, rSIG values were significantly higher in survivors compared to those who died (MD 7.72; 95% CI 1.86–13.58; I²: 99%).</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 9","pages":"Article 502149"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019117","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":"Post-myocardial infarction ventricular septal defect","authors":"Emilio Curiel Balsera,&nbsp;Guillermo Gómez Gallego,&nbsp;Alejandro Navarro Cruz","doi":"10.1016/j.medine.2025.502202","DOIUrl":"10.1016/j.medine.2025.502202","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 9","pages":"Article 502202"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028472","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":"Monitoring through electrical impedance tomography in pediatric ECMO","authors":"Gabriel Appendino,&nbsp;Fernando Paziencia,&nbsp;Carlos Lovesio","doi":"10.1016/j.medine.2025.502155","DOIUrl":"10.1016/j.medine.2025.502155","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 9","pages":"Article 502155"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506696","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}