Medicina intensiva最新文献

{"title":"A rare complication of Bordetella pertussis infection.","authors":"Carolina V Monteiro, Paulo Martins Fernandes, João Lourinho","doi":"10.1016/j.medine.2025.502265","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502265","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502265"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984382","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":"Septic shock secondary to Capnocytophaga canimorsus bite acquired without celulitis.","authors":"Hugo Arrando Barbera, Ángel Orera Pérez, Juan Díaz Nohales","doi":"10.1016/j.medine.2025.502233","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502233","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502233"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984354","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":"Advances in extracorporeal liver support for acute and acute-on-chronic liver failure.","authors":"David Toapanta-Gaibor, Jesús Sánchez-Ballesteros, María González-Fernández, María Jesús Broch-Porcar","doi":"10.1016/j.medine.2025.502291","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502291","url":null,"abstract":"<p><p>Liver failure, either acute (ALF) or acute-on-chronic (ACLF), is characterized by hepatocellular dysfunction, systemic inflammation, and multiorgan failure, leading to high mortality without liver transplantation (LT). However, LT is limited by organ shortages and medical contraindications, necessitating alternative therapeutic strategies. Biological liver support systems, incorporate functional hepatocytes to partially restore hepatic metabolic functions, though clinical trials have not demonstrated a survival benefit. Artificial systems, such as albumin dialysis (MARS, Prometheus), facilitate toxin removal, though evidence remains limited. Continuous renal replacement therapy, while not specific for liver failure, is essential in patients with severe hyperammonemia or acute kidney injury, aiding in ammonia clearance and fluid balance control. Plasma exchange (PE) has promising detoxification and immunomodulatory effects, improving survival in ALF. In ACLF, PE may reduce systemic inflammation, though evidence remains limited. Further studies are needed to optimize ECLS therapies, refine patient selection, and establish their role in ALF and ACLF management.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502291"},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839534","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":"Quality of life in post-COVID-19 patients after discharge from a weaning and rehabilitation center: a retrospective cohort study.","authors":"Emilio Sebastián Rositi, Emiliano Navarro, Mirian Lorena Delvalle, Agustín García, Miguel Antonio Escobar, Javier Cromberg, Gastón Germán Morel Vulliez, Melina Calvo Delfino, Eduardo Luis De Vito","doi":"10.1016/j.medine.2025.502257","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502257","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502257"},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839535","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":"Logistic regression model for predicting higher hospital costs in ICU-COVID patients during the pandemic: Results from a tertiary hospital.","authors":"Carmen Huertas Marín, Trinidad Dierssen-Soto, Yhivian Peñasco, Elena Cuenca-Fito, Reinhard Wallmann, Raquel Ferrero-Franco, Juan Carlos Rodríguez-Borregán, Alejandro González-Castro","doi":"10.1016/j.medine.2025.502255","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502255","url":null,"abstract":"<p><strong>Objective: </strong>To analyse which variables associated with ICU admission for COVID-19 were linked to higher hospital costs according to the APR-DRG classification.</p><p><strong>Design: </strong>Retrospective, observational, and analytical study.</p><p><strong>Setting: </strong>COVID-19 ICU in a tertiary hospital.</p><p><strong>Patients: </strong>Adults (>18 years) with a confirmed diagnosis of SARS-CoV-2 infection.</p><p><strong>Interventions: </strong>Predictive models using multiple logistic regression.</p><p><strong>Main variables of interest: </strong>Hospital cost, APR-DRG, mechanical ventilation.</p><p><strong>Results: </strong>A total of 799 patients were analyzed and categorized into tertiles based on hospital stay costs, resulting in three groups: 266 patients with lower costs (median €6160 [p25: 3962-p75: 6160]), 314 with intermediate costs (median €16,446 [p25: 10,653-p75: 18,274]), and 219 with higher costs (median €26,085 [p25: 26,085-p75: 51,523]). The best predictive model, with an AIC of 490.09 and an R² of 0.32, identified the following factors as significantly associated with higher hospital costs: ICU length of stay (OR: 1.05; 95% CI: 1.03-1.07; p < 0.01), development of VAT/VAP (OR: 4.72; 95% CI: 2.83-7.85; p < 0.01), OXA-48 infection (OR: 2.65; 95% CI: 1.25-5.61; p = 0.01), pulmonary embolism (OR: 6.42; 95% CI: 2.17-19.26; p < 0.01), smoking history (OR: 2.22; 95% CI: 1.49-3.74; p < 0.01), and vasopressor requirement (OR: 1.79; 95% CI: 1.22-2.86; p = 0.01). The area under the curve (AUC) was 0.866 (p < 0.01).</p><p><strong>Conclusions: </strong>Prolonged ICU stay, infectious and thromboembolic complications, smoking history, and vasopressor requirement were significantly associated with higher hospital costs.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502255"},"PeriodicalIF":0.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812774","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":"Enhancing methodological rigor in mechanical insufflation-exsufflation weaning studies: Commentary on patient selection, long-term outcomes, and psychological assessment.","authors":"Yueqi Wang, Yan Cui, Moxuan Han, Donghui Yue","doi":"10.1016/j.medine.2025.502290","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502290","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502290"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805473","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":"Development and validation of predictive mortality models in critically ill oncological patients in the ICU: An urgent need","authors":"Elena Cuenca Fito ,&nbsp;Inés Gómez-Acebo ,&nbsp;Alejandro González Castro","doi":"10.1016/j.medine.2025.502163","DOIUrl":"10.1016/j.medine.2025.502163","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502163"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055892","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":"Experience with ECMO therapy for acute respiratory distress syndrome treatment throughout the COVID-19 pandemic","authors":"José María Arribas-Leal ,&nbsp;José Miguel Rivera-Caravaca ,&nbsp;Claudia Vicente-Andreu ,&nbsp;Alicia Verdú-Verdú ,&nbsp;Ángel Sornichero ,&nbsp;Daniel Pérez-Martínez ,&nbsp;Juan Blanco-Morillo ,&nbsp;Francisco Gutiérrez ,&nbsp;Marina Simón-Páez ,&nbsp;Rubén Jara ,&nbsp;Sergio J. Canovas-Lopez ,&nbsp;Carlos Albacete-Moreno","doi":"10.1016/j.medine.2025.502207","DOIUrl":"10.1016/j.medine.2025.502207","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze our experience with extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory distress syndrome (ARDS) treatment during the COVID-19 pandemic.</div></div><div><h3>Design</h3><div>Retrospective, observational, single center study.</div></div><div><h3>Setting</h3><div>Third-level hospital in Spain.</div></div><div><h3>Patients</h3><div>Adult patients with COVID-19 ARDS treated with an ECMO system in our center between March 2020 and March 2023.</div></div><div><h3>Interventions</h3><div>Retrospective collection of variables during hospital admission and follow-up.</div></div><div><h3>Main Variables of Interest</h3><div>Demographic variables, clinical history, variables related to ECMO therapy, COVID-19 wave number, in-hospital mortality, adverse events, ICU and hospital length of stay, and functional status at follow-up were collected.</div></div><div><h3>Results</h3><div>Eighty-one patients were included. Of these, 61 patients (75%) died during hospitalization. Patients who died were older and had more comorbidities. During the second, third, and sixth waves, mortality was higher. In the multivariate analysis, the only independent predictor of mortality was age (OR 1.24 95% CI (1.027–1.5, <em>P</em> = 0.025). After discharge, 40% of patients had difficulties returning to normal life due to respiratory failure requiring oxygen and arthropathies.</div></div><div><h3>Conclusion</h3><div>In-hospital mortality increased during the pandemic. Older age was the only independent predictor of mortality. After discharge, no deaths were recorded during the first 18 months of follow-up, although 40% of surviving patients had respiratory and motor sequelae making it difficult for them to return to a normal life.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502207"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048956","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":"Changes in the stress hormone cortisol during intensive care unit stay as a predictor of objective cognition at discharge","authors":"Guillem Navarra-Ventura ,&nbsp;Marta Godoy-González ,&nbsp;Lluís Blanch ,&nbsp;Josefina López-Aguilar ,&nbsp;Sol Fernández-Gonzalo","doi":"10.1016/j.medine.2025.502166","DOIUrl":"10.1016/j.medine.2025.502166","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502166"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460696","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":"Pneumomediastinum radiologic signs: Naclerio's V and continuous diaphragm sign","authors":"Christopher Barrera-Hoffmann ,&nbsp;Yadira Mariaca-Ortíz ,&nbsp;Enrique Monares-Zepeda","doi":"10.1016/j.medine.2025.502171","DOIUrl":"10.1016/j.medine.2025.502171","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502171"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756914","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}