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Hemodynamic monitoring and echocardiographic evaluation in cardiogenic shock 心源性休克的血流动力学监测和超声心动图评估。
Medicina intensiva Pub Date : 2024-08-02 DOI: 10.1016/j.medine.2024.07.001
Ana Ochagavía , Nora Palomo-López , Virginia Fraile , Luis Zapata
{"title":"Hemodynamic monitoring and echocardiographic evaluation in cardiogenic shock","authors":"Ana Ochagavía ,&nbsp;Nora Palomo-López ,&nbsp;Virginia Fraile ,&nbsp;Luis Zapata","doi":"10.1016/j.medine.2024.07.001","DOIUrl":"10.1016/j.medine.2024.07.001","url":null,"abstract":"<div><div>Cardiogenic shock (CS) is characterized by the presence of a state of tissue hypoperfusion secondary to ventricular dysfunction. Hemodynamic monitoring allows us to obtain information about cardiovascular pathophysiology that will help us make the diagnosis and guide therapy in CS situations. The most used monitoring system in CS is the pulmonary artery catheter since it provides key hemodynamic variables in CS, such as cardiac output, pulmonary artery pressure, and pulmonary artery occlusion pressure. On the other hand, echocardiography makes it possible to obtain, at the bedside, anatomical and hemodynamic data that complement the information obtained through continuous monitoring devices.</div><div>CS monitoring can be considered multimodal and integrative by including hemodynamic, metabolic, and echocardiographic parameters that allow describing the characteristics of CS and guiding therapeutic interventions during hemodynamic resuscitation.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 10","pages":"Pages 602-613"},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891448","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
Ventricular tachycardia in a young female 一名年轻女性的室性心动过速。
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.02.004
{"title":"Ventricular tachycardia in a young female","authors":"","doi":"10.1016/j.medine.2024.02.004","DOIUrl":"10.1016/j.medine.2024.02.004","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 497-498"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041209","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
Muscle wasting in ICU-patients with COVID-19 - Descriptive analysis and risk factors identification COVID-19重症监护病房患者的肌肉萎缩--描述性分析和风险因素识别。
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.04.010
{"title":"Muscle wasting in ICU-patients with COVID-19 - Descriptive analysis and risk factors identification","authors":"","doi":"10.1016/j.medine.2024.04.010","DOIUrl":"10.1016/j.medine.2024.04.010","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 487-490"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873303","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
High rate-trauma: the new world order? 高频创伤：世界新秩序？
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.03.010
{"title":"High rate-trauma: the new world order?","authors":"","doi":"10.1016/j.medine.2024.03.010","DOIUrl":"10.1016/j.medine.2024.03.010","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 490-492"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777837","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
Postintensive care syndrome in patients and family members. Analysis of COVID-19 and non-COVID-19 cohorts, with face-to-face follow-up at three months and one year 患者和家属的重症监护后综合征。对 COVID-19 和非 COVID-19 组群进行分析，并在三个月和一年后进行面对面随访。
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.04.004
{"title":"Postintensive care syndrome in patients and family members. Analysis of COVID-19 and non-COVID-19 cohorts, with face-to-face follow-up at three months and one year","authors":"","doi":"10.1016/j.medine.2024.04.004","DOIUrl":"10.1016/j.medine.2024.04.004","url":null,"abstract":"<div><h3>Objective</h3><p>Compare prevalence and profile of post-intensive care patient (P-PICS) and family/caregiver (F-PICS) syndrome in two cohorts (COVID and non-COVID) and analyse risk factors for P-PICS.</p></div><div><h3>Design</h3><p>Prospective, observational cohort (March 2018–2023), follow-up at three months and one year.</p></div><div><h3>Setting</h3><p>14-bed polyvalent Intensive Care Unit (ICU), Level II Hospital.</p></div><div><h3>Patients or participants</h3><p>265 patients and 209 relatives. Inclusion criteria patients: age &gt; 18 years, mechanical ventilation &gt; 48 h, ICU stay &gt; 5 days, delirium, septic shock, acute respiratory distress syndrome, cardiac arrest. Inclusion criteria family: those who attended.</p></div><div><h3>Interventions</h3><p>Follow-up 3 months and 1 year after hospital discharge.</p></div><div><h3>Main variables of interest</h3><p>Patients: sociodemographic, clinical, evolutive, physical, psychological and cognitive alterations, dependency degree and quality of life. Main caregivers: mental state and physical overload.</p></div><div><h3>Results</h3><p>64.9% PICS-P, no differences between groups. COVID patients more physical alterations than non-COVID (<em>P</em> = .028). These more functional deterioration (<em>P</em> = .005), poorer quality of life (<em>P</em> = .003), higher nutritional alterations (<em>P</em> = .004) and cognitive deterioration (<em>P</em> &lt; .001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; <em>P</em> = .013). Independent predictors of PICS-P: first years of the study (OR: 0.484), higher comorbidity (OR: 1.158), delirium (OR: 2.935), several reasons for being included (OR: 3.171) and midazolam (OR: 4.265).</p></div><div><h3>Conclusions</h3><p>Prevalence PICS-P and PICS-F between both cohorts was similar. Main factors associated with the development of SPCI-P were: higher comorbidity, delirium, midazolan, inclusion for more than one reason and during the first years.</p></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 445-456"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909634","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
Fistula from subclavian artery to right internal jugular vein secondary to firearm injury. 枪伤导致锁骨下动脉至右颈内静脉瘘。
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.07.011
Antonio Padilla-Serrano, Ala Eddine Daoudi El Boukhrissi, Genaro López Milena
{"title":"Fistula from subclavian artery to right internal jugular vein secondary to firearm injury.","authors":"Antonio Padilla-Serrano, Ala Eddine Daoudi El Boukhrissi, Genaro López Milena","doi":"10.1016/j.medine.2024.07.011","DOIUrl":"https://doi.org/10.1016/j.medine.2024.07.011","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879992","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
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) 重症患者吸入镇静的实用方法。西班牙重症监护医学和冠心病病房学会镇静、镇痛和谵妄工作组（GTSAD）。
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.05.011
{"title":"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)","authors":"","doi":"10.1016/j.medine.2024.05.011","DOIUrl":"10.1016/j.medine.2024.05.011","url":null,"abstract":"<div><p>The use of sedatives in Intensive Care Units (ICU) is essential for relieving anxiety and stress in mechanically ventilated patients, and it is related to clinical outcomes, duration of mechanical ventilation, and length of stay in the ICU. Inhaled sedatives offer benefits such as faster awakening and extubation, decreased total opioid and neuromuscular blocking agents (NMB) doses, as well as bronchodilator, anticonvulsant, and cardiopulmonary and neurological protective effects. Inhaled sedation is administered using a specific vaporizer. Isoflurane is the recommended agent due to its efficacy and safety profile. Inhaled sedation is recommended for moderate and deep sedation, prolonged sedation, difficult sedation, patients with acute respiratory distress syndrome (ARDS), status asthmaticus, and super-refractory status epilepticus. By offering these significant advantages, the use of inhaled sedatives allows for a personalized and controlled approach to optimize sedation in the ICU.</p></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 467-476"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307707","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
McConnell’s sign in fat embolism syndrome 脂肪栓塞综合征的麦康奈尔征兆
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.01.010
{"title":"McConnell’s sign in fat embolism syndrome","authors":"","doi":"10.1016/j.medine.2024.01.010","DOIUrl":"10.1016/j.medine.2024.01.010","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 499-500"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934927","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
The medical treatment of cardiogenic shock 心源性休克的医学治疗。
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.05.012
{"title":"The medical treatment of cardiogenic shock","authors":"","doi":"10.1016/j.medine.2024.05.012","DOIUrl":"10.1016/j.medine.2024.05.012","url":null,"abstract":"<div><p>Cardiogenic shock is characterized by tissue hypoperfusion due to the inadequate cardiac output to maintain the tissue oxygen demand. Despite some advances in cardiogenic shock management, extremely high mortality is still associated with this clinical syndrome. Its management is based on the immediate stabilization of hemodynamic parameters through medical care and the use of mechanical circulatory supports in specialized centers. This review aims to understand the cardiogenic shock current medical treatment, consisting mainly of inotropic drugs, vasopressors and coronary revascularization. In addition, we highlight the relevance of applying measures to other organ levels based on the optimization of mechanical ventilation and the appropriate initiation of renal replacement therapy.</p></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 477-486"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249212","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
Evaluation of the response to the prone position through electrical impedance tomography 通过电阻抗断层扫描评估俯卧位的反应。
Medicina intensiva Pub Date : 2024-08-01 DOI: 10.1016/j.medine.2024.02.010
{"title":"Evaluation of the response to the prone position through electrical impedance tomography","authors":"","doi":"10.1016/j.medine.2024.02.010","DOIUrl":"10.1016/j.medine.2024.02.010","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 8","pages":"Pages 495-496"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069035","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
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