Medicina intensiva最新文献

{"title":"Does early surfactant improve outcome in late preterm newborn? Retrospective study in a neonatal intensive care unit","authors":"Jorge Bartual Bardisa,&nbsp;Carolina Vizcaíno Díaz,&nbsp;María Jesús Ferrández Berenguer","doi":"10.1016/j.medine.2025.502161","DOIUrl":"10.1016/j.medine.2025.502161","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the early administration of surfactant, before 12 h of life, versus late, in late preterm neonates (born between 34⁺⁰ and 36⁺⁶ weeks of gestation), with moderate-severe respiratory distress.</div></div><div><h3>Design</h3><div>Retrospective, observational, analytical, case-control study, with late preterm infants admitted between 2012–2021. It is divided into 2 groups: surfactant administered ≤ 12 h of life and &gt;12 h and evolution is compared using univariate analysis.</div></div><div><h3>Setting</h3><div>Neonatal Intensive Care Unit (NICU) level III of a Universitary Hospital.</div></div><div><h3>Patients or participants</h3><div>57 patients, 30 in the early group and 27 in the late group. Inclusion criteria: neonates from 34⁺⁰ to 36⁺⁶ weeks of gestation, with respiratory distress syndrome, in need of non-invasive ventilation and surfactant.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Sociodemographic, clinical and evolutionary: redosing, duration of respiratory support, oxygen and time to stop requiring it after surfactant. Also, complications and length of hospitalization.</div></div><div><h3>Results</h3><div>In the early group there was less need for redosing (3.3% vs 48.1%, <em>P</em> &lt; .001) and a decrease in duration, in days, of stay in the NICU (7 vs 10.5, <em>P</em> .002), invasive mechanical ventilation (2.4 vs 3.9, <em>P</em> .034), total respiratory support (4.6 vs 6.6, <em>P</em> .005) and oxygen therapy (0.4 vs 2.8, <em>P</em> &lt; .001). Also, lower incidence of pneumothorax (0% vs 33.3%, <em>P</em> .001). Furthermore, 12 h after administration, 83.4% maintained FiO2 0.21, compared to 44.4% in the late administration.</div></div><div><h3>Conclusions</h3><div>In our study, early administration in late preterm infants provides benefits in terms of respiratory assistance and complications. We suggest expanding studies to establish recommendations in this group of patients.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502161"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607528","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":"Multisystemic involvement due to severe community Streptococcus pyogene’s infection","authors":"Ángel Orera Pérez,&nbsp;Mónica Gordón Sauquillo,&nbsp;Paula Ramírez Galleymore","doi":"10.1016/j.medine.2025.502206","DOIUrl":"10.1016/j.medine.2025.502206","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502206"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032877","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":"Exploring volatile anesthetics in critical care: Facts and uncertainties","authors":"José Manuel Añón ,&nbsp;María Paz Escuela ,&nbsp;Javier Oliva-Navarro ,&nbsp;Arís Pérez-Lucendo ,&nbsp;Fernando Suarez-Sipmann","doi":"10.1016/j.medine.2025.502174","DOIUrl":"10.1016/j.medine.2025.502174","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502174"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618079","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":"Effect of respiratory physiotherapy in a patient with complete atelectasis of the left lung","authors":"Ramón Pérez-Gil ,&nbsp;Gonzalo Ballesteros-Reviriego","doi":"10.1016/j.medine.2025.502204","DOIUrl":"10.1016/j.medine.2025.502204","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502204"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789486","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 endothelium or mitochondrial level therapy: new frontiers in sepsis?","authors":"Rashmi Datta ,&nbsp;Shalendra Singh","doi":"10.1016/j.medine.2024.502130","DOIUrl":"10.1016/j.medine.2024.502130","url":null,"abstract":"<div><div>The host and microbes play complex roles in balancing the pro- and anti-inflammatory pathways that cause sepsis. It is now increasingly recognized as a disorder of the mitochondrial system intrinsically or as a consequence of microcirculatory abnormalities leading to hypoperfusion/hypoxia (\"microcirculatory and mitochondrial distress syndrome”). It is expected that improvements in endothelium or mitochondrial level therapy will lower sepsis-related morbidity and mortality. This article aimed to clarify the mitochondrial and microcirculation abnormalities in patients with sepsis and the futuristic research agenda for the management of sepsis.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502130"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974099","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":"Did intubation procedures for critically ill patients without SARS-CoV-2 infection change during the pandemic? Secondary analysis of the INTUPROS multicenter study","authors":"José Luis García-Garmendia ,&nbsp;Josep Trenado-Álvarez ,&nbsp;Federico Gordo-Vidal ,&nbsp;Elena Gordillo-Escobar ,&nbsp;Esther Martínez-Barrios ,&nbsp;Fernando Onieva-Calero ,&nbsp;Víctor Sagredo-Meneses ,&nbsp;Emilio Rodríguez-Ruiz ,&nbsp;Rafael Ángel Bohollo-de-Austria ,&nbsp;José Moreno-Quintana ,&nbsp;María Isabel Ruiz-García ,&nbsp;José Garnacho-Montero","doi":"10.1016/j.medine.2025.502122","DOIUrl":"10.1016/j.medine.2025.502122","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the changes in intubation procedures of critically ill patients without SARS-CoV-2 infection induced during the COVID-19 pandemic.</div></div><div><h3>Design</h3><div>Secondary Analysis of the INTUPROS Prospective Multicenter Observational Study on Intubation in Intensive Care Units (ICUs).</div></div><div><h3>Setting</h3><div>43 Spanish ICUs between April 2019 and October 2020.</div></div><div><h3>Patients</h3><div>1515 Non-COVID-19 patients intubated before and during the pandemic.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Intubation procedures and medication, first-pass success rate, complications, and mortality.</div></div><div><h3>Results</h3><div>1199 patients intubated before the pandemic and 316 during the pandemic were analyzed. During the pandemic, there were fewer days until intubation (OR 0.95 95% CI [0.92−0.98]), reduced resuscitation bag (OR 0.43 95% CI [0.29−0.63]) and non-invasive ventilation oxygenation (OR 0.51 95% CI [0.34−0.76]), reduced use of capnography (OR 0.55 95% CI [0.33−0.92]) and fentanyl (OR 0.47 95% CI [0.34−0.63]). On the other hand, there was an increase in oxygenation with non-HFNC devices (OR 2.21 95% CI [1.23–3.96]), in use of videolaryngoscopy on the first-pass (OR 2.74 95% CI [1.76–4.24]), and greater use of midazolam (OR 1.95 95% CI [1.39–2.72]), etomidate (OR 1.78 95% CI [1.28–2.47]) and succinylcholine (OR 2.55 95% CI [1.82–3.58]). The first-pass success was higher (68.5% vs. 74.7%; <em>P</em> <!-->=<!--> <!-->.033). There were no pre-post differences in major complications (34.7% vs. 34.8%; <em>P</em> <!-->=<!--> <!-->.970) and in-hospital mortality (42.7% vs. 38.6%; <em>P</em> <!-->=<!--> <!-->.137).</div></div><div><h3>Conclusions</h3><div>The COVID-19 pandemic modified intubation procedures in non-COVID-19 patients, changing the oxygenation strategy, the medication and the use of videolaryngoscopy, with no impact on complications or mortality.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502122"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257278","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":"Complication of cardiogenic shock and use of ultrasound","authors":"Julia Macías Clemente ,&nbsp;Nora Palomo López ,&nbsp;Gerardo Ferrigno Bonilla","doi":"10.1016/j.medine.2025.502150","DOIUrl":"10.1016/j.medine.2025.502150","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 8","pages":"Article 502150"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588899","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":"Sedation and COVID-19. Time to forget, time for a comeback.","authors":"Sara Alcántara Carmona, Miguel Ángel Romera Ortega","doi":"10.1016/j.medine.2025.502264","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502264","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502264"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755524","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":"Evaluation of functional brain damage using resting-state functional magnetic resonance imaging in patients with diffuse axonal injury admitted to the ICU.","authors":"Patricia Serrats-López, Juan Antonio Llompart-Pou, Ana María González-Roldán, Juan Lorenzo Terrasa-Navarro, Apolonia Moll-Servera, Jon Pérez-Bárcena","doi":"10.1016/j.medine.2025.502260","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502260","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502260"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746665","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":"Coagulation disorders in patients with chronic liver disease: A narrative review.","authors":"Daida García Rodríguez, Gabriela Alexandra Narváez Chávez, Sergio Tomás Rodríguez Ramos, Ángel Orera Pérez, Jesús Emilio Barrueco-Francioni, Pedro Merino García","doi":"10.1016/j.medine.2025.502216","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502216","url":null,"abstract":"<p><p>Patients with cirrhosis present a highly vulnerable and rebalanced hemostasis state. Assessing the bleeding risk in these patients is complex. It is essential to recognize that conventional coagulation tests do not adequately reflect the true risk of bleeding or thrombosis. The detailed understanding of this balance and the application of more precise diagnostic tools, such as viscoelastic tests that can more accurately evaluate their coagulation status, facilitate clinical management and can improve the results in these patients. The haemorrhagic risk of this group of patients is conditioned by specific factors of liver disease, such as portal hypertension and altered haemostatic status, and by systemic factors like the presence of infections and kidney disease, which are independent predictors of bleeding during high-risk procedures. These concepts and the recommendations from the most recent clinical practice guidelines are reviewed in this article.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502216"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719296","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}