Medicina intensiva最新文献

{"title":"An unexpected foramen ovale","authors":"Pablo Carrión Montaner, Mario Sutil-Vega, Jordi Sans Roselló","doi":"10.1016/j.medine.2024.06.017","DOIUrl":"10.1016/j.medine.2024.06.017","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 3","pages":"Page 186"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494652","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":"Erratum to “Practical approach to inhaled sedation in the Critically ill patient. Sedation, analgesia and Delirium Working Group (GTSAD) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC)” [Med Intensiva (Engl Ed) (2024) 467-476]","authors":"Sofía Contreras , Carola Giménez-Esparza Vich , Jesús Caballero , en representación del Grupo de Trabajo de Sedación, Analgesia y Delirium (GTSAD) de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)","doi":"10.1016/j.medine.2024.11.008","DOIUrl":"10.1016/j.medine.2024.11.008","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 3","pages":"Page 190"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaled sedation in the ICU. Still a long road ahead","authors":"Hernán Aguirre-Bermeo , Pedro D. Wendel-García , Óscar Peñuelas , Ferran Roche-Campo","doi":"10.1016/j.medine.2024.11.003","DOIUrl":"10.1016/j.medine.2024.11.003","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 3","pages":"Pages 184-185"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634713","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":"Videolaryngoscopy vs. direct laryngoscopy in orotracheal intubation in obese critical patients: Systematic review and meta-analysis.","authors":"Samuel David Gil-Bazán, Gustavo Adolfo Vásquez-Tirado, Edward Chávez-Cruzado, Edinson Dante Meregildo-Rodríguez, Claudia Vanessa Quispe-Castañeda, Wilson Marcial Guzmán-Aguilar, Leslie Jacqueline Liñán-Díaz","doi":"10.1016/j.medine.2025.502168","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502168","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the use of videolaryngoscopy (VL) is more effective than direct laryngoscopy (DL) for orotracheal intubation in obese patients.</p><p><strong>Design: </strong>This is a systematic review and meta-analysis.</p><p><strong>Setting: </strong>A comprehensive search was conducted in five databases for studies published up to December 26, 2023, using a PICO strategy. Fifteen studies were identified for quantitative analysis and included in our meta-analysis.</p><p><strong>Participants: </strong>The participants of the included primary studies (obese patients).</p><p><strong>Interventions: </strong>Orotracheal intubation with videolaryngoscopy or direct laryngoscopy.</p><p><strong>Main variables of interest: </strong>Videolaryngoscopy, direct laryngoscopy, intubation time, first--pass success rate, minor complications.</p><p><strong>Results: </strong>No significant differences were found in intubation time between VL and DL in obese patients (MD: -4.84; 95% CI: -13.49 to 3.80; I²: 90%). In the subgroup analysis, the Airtaq technique showed a significant difference in intubation time compared to the Macintosh technique (MD: -25.29; 95% CI: -49.17 to -1.38; I²: 95%). However, no significant differences were observed in the first--pass success rate (OR: 1.58; 95% CI: 0.77-3.23; I²: 33%) or in complications such as pain (OR: 1.15; 95% CI: 0.75-1.75; I²: 0%) and voice changes (OR: 0.76; 95% CI: 0.46-1.26; I²: 0%) between the two methods.</p><p><strong>Conclusion: </strong>There are no significant differences in intubation time, first--pass success rate, or complications between VL and DL in obese critical patients.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502168"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538273","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":"Relationship between fluid overload and mortality and morbidity in pediatric intensive care unit","authors":"Hilmi Bayirli ,&nbsp;Nazan Ulgen Tekerek ,&nbsp;Alper Koker ,&nbsp;Oguz Dursun","doi":"10.1016/j.medine.2024.09.001","DOIUrl":"10.1016/j.medine.2024.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship between fluid overload and clinical outcomes was investigated.</div></div><div><h3>Design</h3><div>This study is an observational and analytic study of a retrospective cohort.</div></div><div><h3>Settings</h3><div>Pediatric intensive care units.</div></div><div><h3>Patients or participants</h3><div>Between 2019 and 2021 children who needed intensive care were included in the study.</div></div><div><h3>Interventions</h3><div>No intervention.</div></div><div><h3>Main variable of interest</h3><div>Early, peak and cumulative fluid overload were evaluated.</div></div><div><h3>Results</h3><div>The mortality rate was 11.7% (68/513). When fluid overloads were examined in terms of mortality, the percentage of early fluid overload was 1.86 and 3.35, the percent of peak fluid overload was 2.87 and 5.54, and the percent of cumulative fluid overload was 3.40 and 8.16, respectively, in the survivor and the non-survivor groups. After adjustment for age, severity of illness, and other potential confounders, peak (aOR = 1.15; 95%CI 1.05−1.26; p: 0.002) and cumulative (aOR = 1.10; 95%CI 1.04−1.16; p &lt; 0.001) fluid overloads were determined as independent risk factors associated with mortality. When the cumulative fluid overload is 10% or more, a 3.9-fold increase mortality rate was calculated. It is found that the peak and cumulative fluid overload, had significant negative correlation with intensive care unit free days and ventilator free days.</div></div><div><h3>Conclusions</h3><div>It is found that peak and cumulative fluid overload in critically ill children were independently associated with intensive care unit mortality and morbidity.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 3","pages":"Pages 125-134"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305043","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":"Early blood pressure drop predicts renal function deterioration and mortality in ICU patients with liver failure: a retrospective cohort study","authors":"Rubing Guo ,&nbsp;Jingjing Tong ,&nbsp;Li Wang ,&nbsp;Bo Yang ,&nbsp;Liang Ma ,&nbsp;Yongtong Cao ,&nbsp;Wei Zhao","doi":"10.1016/j.medine.2024.10.005","DOIUrl":"10.1016/j.medine.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between early blood pressure drop and worsening renal function (WRF) in ICU patients with liver failure and to evaluate their clinical outcomes.</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Setting</h3><div>Intensive Care Medicine.</div></div><div><h3>Patients</h3><div>Patients admitted to the ICU for the first time during their first hospitalization; diagnosed with liver failure according to the International Classification of Diseases, Ninth and Tenth Revision codes; and aged ≥18 years were included. Patients with a peak systolic blood pressure (SBP) drop of &lt;0 mmHg were excluded.</div></div><div><h3>Intervention</h3><div>We analyzed data of ICU patients with liver failure from the Medical Information Mart for Intensive Care IV version 2.2 database. Descriptive statistics, analysis of variance, Kruskal–Wallis test, and chi-square test were employed for analysis. Multivariate linear regression models were used to assess the determinants of blood pressure decline. Cox proportional hazards and generalized additive models were used to evaluate</div></div><div><h3>Main variables of interest</h3><div>The relationship between blood pressure decline, WRF, and 60-day in-hospital mortality were evaluated, along with subgroup analyses.</div></div><div><h3>Results</h3><div>Peak SBP drop was independently associated with higher risks of WRF (P &lt; 0.001) and 60-day in-hospital mortality (P &lt; 0.001), even after adjusting for potential confounders, including baseline SBP. The independent risk relationship observed between peak diastolic blood pressure, mean arterial pressure drop, and the occurrence of WRF and 60-day in-hospital mortality was similar.</div></div><div><h3>Conclusions</h3><div>In ICU patients with liver failure, a significant early drop in blood pressure was associated with a higher incidence of WRF, increased risk of 60-day in-hospital mortality, and poorer prognoses.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 3","pages":"Pages 145-153"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515539","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":"Analysis of frailty as a prognostic factor independent of age: A prospective observational study.","authors":"Rosario Molina Lobo, Federico Gordo Vidal, Lola Prieto López, Inés Torrejón Pérez, Antonio Naharro Abellán, Irene Salinas Gabiña, Beatriz Lobo Valbuena","doi":"10.1016/j.medine.2025.502144","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502144","url":null,"abstract":"<p><strong>Objective: </strong>Analyze the effects of frailty and prefrailty in patients admitted to the ICU without age limits and to determine the factors associated with mortality.</p><p><strong>Design: </strong>Prospective cohort.</p><p><strong>Setting: </strong>Intensive Care Unit, Spain.</p><p><strong>Patients: </strong>1462 critically ill patients without age limits.</p><p><strong>Intervention: </strong>None.</p><p><strong>Main variables of interest: </strong>Hospital mortality and health outcomes.</p><p><strong>Results: </strong>Patients' ages ranged from 15 to 93 years, median of 66 years. Predisposing factors independently associated with frailty and prefrailty were age older than 65 years, female sex, respiratory and renal comorbidities, longer pre-ICU stays, and weekend admission. There is a greater use of noninvasive mechanical ventilation, greater colonization by multidrug-resistant bacteria, and the development of delirium. The risk of hospital mortality was RR 4.04 (2.11-7.74; P<.001) for prefail and 5.88 (2.45-14.10; P<.001) for frail. Factors associated with in-hospital mortality in prefrail and frail were pre-ICU hospital length of stay (cutpoint 4.5 days [1.6-7.4]), greater severity on admission (SAPS3) (cutpoint 64.5 [63.6-65.4]), Glasgow Coma Scale deterioration (OR 4.14 [1.23-13.98]; P .022) and thrombocytopenia (OR 11.46 [2.21-59.42]; P .004).</p><p><strong>Conclusions: </strong>Lower levels of frailty are most common in ICU patients and are associated with worse health outcomes. Our data suggest that frailty and pre frailty should be determined in all patients admitted to the ICU, regardless of their age.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502144"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517775","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":"Neuroaspergillosis: Diagnostic in immunosuppressed patients illustrated by MRI imaging.","authors":"Almudena Domínguez González, Nuria Medina Cabrera, Alejandro Hueso Mor","doi":"10.1016/j.medine.2025.502151","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502151","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502151"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506703","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":"Improvement in cerebral hypoperfusion by stellate ganglion block in refractory vasospasm.","authors":"Luis Patricio Maskin, Federico Rodríguez Lucci","doi":"10.1016/j.medine.2025.502121","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502121","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502121"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506690","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":"Metastatic abscessed lymphadenopathy as the origin of septic shock.","authors":"Enrique Alfonso Aguilar Valero, Ana María Vela Colmenero, Rosa María Vela Colmenero","doi":"10.1016/j.medine.2025.502127","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502127","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502127"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506694","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}