Medicina intensiva最新文献_第4页

Combined phrenic and vagal nerve dysfunction after bilateral lung transplantation. 双侧肺移植术后膈神经和迷走神经功能障碍。

Medicina intensiva Pub Date : 2026-09-22 DOI: 10.1016/j.medine.2026.502626

Blanca Lourdes More Sánchez, Manuel Valdivia Marchal, José Manuel Serrano Simón

引用次数: 0

Narrative review of pediatric sepsis and septic shock: update on ultrasound-guided monitoring, diagnostic criteria and treatment. 儿童败血症和脓毒性休克的叙述性回顾：超声引导监测、诊断标准和治疗的最新进展。

Medicina intensiva Pub Date : 2026-09-19 DOI: 10.1016/j.medine.2026.502543

María Slöcker Barrio, Cristina Schüffelmann, Ana Díaz Vico, Eider Oñate Vergara

{"title":"Narrative review of pediatric sepsis and septic shock: update on ultrasound-guided monitoring, diagnostic criteria and treatment.","authors":"María Slöcker Barrio, Cristina Schüffelmann, Ana Díaz Vico, Eider Oñate Vergara","doi":"10.1016/j.medine.2026.502543","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502543","url":null,"abstract":"Sepsis is a common cause of admission to pediatric intensive care and is associated with high morbidity and mortality. Since 2005, diagnostic criteria have evolved, culminating in the Phoenix Criteria (2023), which define sepsis as organ dysfunction secondary to a dysregulated immune response. Given its heterogeneity, monitoring and treatment should be tailored to the phase of shock. During resuscitation, the goal is to restore perfusion with fluids and vasopressors. In the optimization, stabilization, and de-escalation phases, the aim is to maintain perfusion and remove excess fluids without compromising tissue flow. Current strategies favor a more restrictive fluid approach and an early use of vasoactive drugs. Monitoring should be continuous and multimodal, integrating clinical signs, technology, and laboratory test parameters. In this context, ultrasound has become essential, allowing individualized assessment of volemia, cardiac function, fluid responsiveness, and fluid overload. Ultrasound plays a key role in decision-making throughout the management process.","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502543"},"PeriodicalIF":0.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009685","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

From static to dynamic Ultrasound assessment in mechanical ventilation weaning. 从静态到动态超声评估机械通气脱机。

Medicina intensiva Pub Date : 2026-09-17 DOI: 10.1016/j.medine.2026.502572

Gemma Rialp

引用次数: 0

Association between dysglycemia and mortality in patients with delirium: Based on the MIMIC-IV database. 谵妄患者血糖异常与死亡率之间的关系：基于MIMIC-IV数据库。

Medicina intensiva Pub Date : 2026-09-16 DOI: 10.1016/j.medine.2026.502609

Jingwen Zhu, Xinyu Zhao, Wei Pan, Yiyang Hu, Zixin Zhai

{"title":"Association between dysglycemia and mortality in patients with delirium: Based on the MIMIC-IV database.","authors":"Jingwen Zhu, Xinyu Zhao, Wei Pan, Yiyang Hu, Zixin Zhai","doi":"10.1016/j.medine.2026.502609","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502609","url":null,"abstract":"Objective: To investigate the influence of chronic hyperglycemia on the association between acute glycemic metrics and in-hospital mortality in patients with delirium.Design: Observational cohort study.Setting: Medical Information Mart for Intensive Care (MIMIC-IV) database.Patients or participants: 3152 patients with delirium and available HbA1c measurements.Interventions: None.Main variables of interest: Chronic hyperglycemia (categories based on HbA1c: <6.5%, 6.5-7.9%, ≥8.0%); acute glycemic metrics (mean glucose, number of hyperglycemic events, glucose variability, cumulative hyperglycemic dose); in-hospital mortality.Results: Patients with HbA1c 6.5-7.9% showed higher mortality risk compared to the HbA1c <6.5% group (OR = 1.518; P = 0.040). The association between acute hyperglycemia and mortality was modified by chronic glycemic status: mean glucose was associated with mortality only in patients with HbA1c <6.5% (OR = 1.254; P < 0.001) and 6.5-7.9% (OR = 1.190; P = 0.009). The number of hyperglycemic events increased mortality risk only in non-diabetic patients (OR = 1.043; P = 0.005). Glycemic variability and cumulative hyperglycemic dose were associated with mortality exclusively in the HbA1c <6.5% group.Conclusions: The impact of acute glycemic dysregulation on mortality in delirious patients is moderated by underlying chronic hyperglycemia. Individualized glucose management based on chronic glycemic status may be preferable to uniform strict control.","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502609"},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984442","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

Emergencies in the critically ill cancer patient. 危重癌症病人的紧急情况。

Medicina intensiva Pub Date : 2026-09-15 DOI: 10.1016/j.medine.2026.502542

Alba López-Fdez, Rocío Ruiz-Cacho, Sonia Mas-Font, Pedro Castro

引用次数: 0

Not all respiratory failure is asthma. 并不是所有的呼吸衰竭都是哮喘。

Medicina intensiva Pub Date : 2026-09-15 DOI: 10.1016/j.medine.2026.502563

Eva Sampedro Calavia, Jessica Gimenez Lecina, Sara Noblejas Drouot

引用次数: 0

Introduction to the «Update series»: «ECMO. Current uses and challenges of extracorporeal membrane oxygenation in adults». “更新系列”简介：“ECMO”。成人体外膜氧合的当前应用和挑战»。

Medicina intensiva Pub Date : 2026-09-11 DOI: 10.1016/j.medine.2026.502430

Eduard Argudo, Fernando Suárez Sipmann

引用次数: 0

Use of extracorporeal membrane oxygenation (ECMO) in Spain as a method of organ preservation for transplantation. 在西班牙使用体外膜氧合（ECMO）作为器官移植保存的方法。

Medicina intensiva Pub Date : 2026-09-11 DOI: 10.1016/j.medine.2026.502552

Mario Royo-Villanova, María Luisa Rodríguez, Eva Oliver-Juan, Marina Pérez-Redondo

引用次数: 0

Comparison of Takotsubo syndrome with acute myocardial infarction in Spain using hospital discharge data (MBDS). 用出院资料（MBDS）比较西班牙Takotsubo综合征与急性心肌梗死。

Medicina intensiva Pub Date : 2026-09-09 DOI: 10.1016/j.medine.2026.502555

Fernando Alfonso, Jorge Salamanca, Sofía Sánchez-Fernández, Náyade Del Prado, Diego Alvaredo, José Luis Bernal, Cristina Fernández-Pérez, Álvaro Gamarra, Lidia Vilches, Iván Núñez-Gil, Javier Elola

{"title":"Comparison of Takotsubo syndrome with acute myocardial infarction in Spain using hospital discharge data (MBDS).","authors":"Fernando Alfonso, Jorge Salamanca, Sofía Sánchez-Fernández, Náyade Del Prado, Diego Alvaredo, José Luis Bernal, Cristina Fernández-Pérez, Álvaro Gamarra, Lidia Vilches, Iván Núñez-Gil, Javier Elola","doi":"10.1016/j.medine.2026.502555","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502555","url":null,"abstract":"Objective: To compare the profiles and outcomes of patients with Takotsubo syndrome (TTS) and acute myocardial infarction (AMI).Design: A retrospective observational study (2016-2022). Multilevel risk adjustments.Setting: Acute hospitals of the Spanish National Health System (SNS).Patients: Hospitalization episodes using the SNS Minimum Basic Data Set (MBDS).Interventions: TTS episodes without a recorded imaging procedure were excluded.Variables of interest: Crude and risk-adjusted hospital mortality and readmissions at 30 days due to circulatory causes.Results: 4,112 TTS episodes and 275,835 AMI episodes were identified. Significant differences were observed in terms of age, gender, and associated comorbidities. The crude hospital mortality rate was 2.9% for TTS episodes compared to 7.2% for AMI episodes (p < 0.001). After adjusting for confounders, the risks of mortality (OR: 0.34; CI: 0.28-0.41; p < 0.01) and readmission in the first month due to circulatory system diseases (OR: 0.48; CI: 0.39-0.6; p < 0.01) were significantly lower in patients with TTS. The predictors of mortality and hospital readmission differed between the two disorders.Conclusions: TTS differs from AMI in its clinical characteristics. Risk-adjusted hospital mortality and 30-day readmissions due to circulatory causes were lower in patients with TTS than in those with AMI.","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502555"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922318","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

Gender perspective in cardiopulmonary resuscitation training: Evaluation of an educational intervention using a simulator with female anatomy. 心肺复苏训练中的性别视角：利用女性解剖学模拟器进行教育干预的评价。

Medicina intensiva Pub Date : 2026-09-08 DOI: 10.1016/j.medine.2026.502554

José Higinio de Gea García, Diego Lorenzo Adánez, Antonia Del Amor Cantero Sandoval, Roxana Soledad Rojas Luán, M Gracia Adánez Martínez

{"title":"Gender perspective in cardiopulmonary resuscitation training: Evaluation of an educational intervention using a simulator with female anatomy.","authors":"José Higinio de Gea García, Diego Lorenzo Adánez, Antonia Del Amor Cantero Sandoval, Roxana Soledad Rojas Luán, M Gracia Adánez Martínez","doi":"10.1016/j.medine.2026.502554","DOIUrl":"https://doi.org/10.1016/j.medine.2026.502554","url":null,"abstract":"Objective: To evaluate knowledge, skills and attitudes regarding cardiopulmonary resuscitation (CPR) according to patient sex, and to analyze whether a gender-perspective training intervention can influence these aspects.Design: Quasi-experimental study with random allocation and pre-post evaluation.Setting: Faculty of Medicine (University of Murcia).Participants: 96 students; 42% men and 58% women.Interventions: Participants completed a baseline survey and performed a simulation using a mannequin with female anatomy. Subsequently, they were randomized to an experimental or control group. The experimental group received a CPR training workshop with a gender perspective and repeated both the survey and the simulation, while the control group completed both evaluations without training.Main variables of interest: Theoretical knowledge, perception of safety, performance of technical skills, and attitude toward CPR in women.Results: At baseline, no differences were observed between the two groups. After the intervention, the experimental group showed higher perception of safety, with significant improvements in chest exposure (5 [1-8] vs 2 [1-4], P < .001), reduction of fear of misinterpretations (7 [3-8] vs 3 [1-6], P < .001), and perception that breasts may affect CPR (6 [5-8] vs 3 [1-5], P < .001). In addition, better CPR performance and appropriate placement of defibrillator pads (31.6% vs 84.2%, P < .001) in relation to breast anatomy.Conclusions: Training with a gender perspective is associated with improved knowledge, skills, and attitudes toward the resuscitation of women and may contribute to reducing training barriers and increasing confidence of future professionals.","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502554"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914720","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