Medicina intensiva最新文献_第8页

Development and validation of predictive mortality models in critically ill oncological patients in the ICU: An urgent need. ICU危重肿瘤患者预测死亡率模型的开发和验证：迫切需要。

Medicina intensiva Pub Date : 2025-04-15 DOI: 10.1016/j.medine.2025.502163

Elena Cuenca Fito, Inés Gómez-Acebo, Alejandro González Castro

引用次数: 0

0.9% sodium chloride versus ringer's lactate in the management of severe diabetic ketoacidosis: A randomized trial. 0.9%氯化钠与乳酸林格钠对照治疗严重糖尿病酮症酸中毒：一项随机试验

Medicina intensiva Pub Date : 2025-04-14 DOI: 10.1016/j.medine.2025.502203

Ahlem Trifi, Ikram Ben Braik, Hounaida Galai, Noussair Azzouz, Badis Tlili, Asma Mehdi, Lynda Messaoud, Eya Seghir, Asma Ouhibi, Sami Abdellatif

{"title":"0.9% sodium chloride versus ringer's lactate in the management of severe diabetic ketoacidosis: A randomized trial.","authors":"Ahlem Trifi, Ikram Ben Braik, Hounaida Galai, Noussair Azzouz, Badis Tlili, Asma Mehdi, Lynda Messaoud, Eya Seghir, Asma Ouhibi, Sami Abdellatif","doi":"10.1016/j.medine.2025.502203","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502203","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to compare the effect of 0.9% sodium chloride (SC) versus ringer's lactate (RL) in the resolution of diabetic ketoacidosis (DKA).</p><p><strong>Design: </strong>Open randomized trial.</p><p><strong>Setting: </strong>A medical ICU from November 2022 to September 2023.</p><p><strong>Patients: </strong>All patients older than 16 years admitted to the ICU for severe DKA.</p><p><strong>Intervention: </strong>The enrolled patient was assigned to receive RL or 0.9% SC according to the randomization scheme. Insulin therapy protocol was conducted similarly for all patients.</p><p><strong>Main variables of interest: </strong>Resolution of DKA at H48 defined by a composite endpoint (glycemia < 11 mmol/l, bicarbonates > 15 mmol/l or pH > 7.30 and anion gap < 16), change in base excess, insulin needs, fluid administration volume, electrolytes (sodium, potassium, chloride), ICU length of stay, and 28-day mortality.</p><p><strong>Results: </strong>88 patients were included: SC arm (n = 42) versus RL arm (n = 46). No significant differences were observed in diabetic ketoacidosis resolution, other variables of interest or in the subgroup analysis. The monitored biomarkers showed in the RL group: a better improvement of bicarbonate at H12 (p = 0.05), best potassium level both at H24 (p = 0.008) and H48 (0.041), lower chloride at H48 (p = 0.002) and higher glycemia at H24.</p><p><strong>Conclusion: </strong>RL did not lead to faster resolution of diabetic ketoacidosis but decreased the risk of hyperchloremia and hypokalemia without increasingthe chance of hyperlactatemia.</p><p><strong>Clinical trial registration number: </strong>NCT05808972.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502203"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056008","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

Whispers of the heart: The journey of an aortic dissection. 心脏的低语：主动脉夹层的旅程。

Medicina intensiva Pub Date : 2025-04-10 DOI: 10.1016/j.medine.2025.502175

Pablo Carrión Montaner, Mario Sutil-Vega, Jordi Sans-Roselló

引用次数: 0

Effect of respiratory physiotherapy in a patient with complete atelectasis of the left lung. 呼吸物理疗法治疗左肺完全不张1例疗效观察。

Medicina intensiva Pub Date : 2025-04-03 DOI: 10.1016/j.medine.2025.502204

Ramón Pérez-Gil, Gonzalo Ballesteros-Reviriego

引用次数: 0

Airway pressure release ventilation on veno-venous extracorporeal membrane oxigenation (ECMO). 静脉-静脉体外膜氧合（ECMO）下气道压力释放通气。

Medicina intensiva Pub Date : 2025-04-03 DOI: 10.1016/j.medine.2025.502177

Ruben Martín-Latorre, Laura de Rivas-Alcover, Àngela Poquet-Poquet

引用次数: 0

Prediction of COVID-19 mortality using machine learning strategies and a large-scale panel of plasma inflammatory proteins: A cohort study. 使用机器学习策略和大规模血浆炎症蛋白小组预测COVID-19死亡率：一项队列研究

Medicina intensiva Pub Date : 2025-04-03 DOI: 10.1016/j.medine.2025.502200

Luiz Filipe Bastos Mendes, Henrique Ritter Dal-Pizzol, Gabriele Prestes, Carolina Saibro Girardi, Lucas Santos, Daniel Pens Gelain, Glauco A Westphal, Roger Walz, Cristiane Ritter, Felipe Dal-Pizzol, Jose Claudio Fonseca Moreira

{"title":"Prediction of COVID-19 mortality using machine learning strategies and a large-scale panel of plasma inflammatory proteins: A cohort study.","authors":"Luiz Filipe Bastos Mendes, Henrique Ritter Dal-Pizzol, Gabriele Prestes, Carolina Saibro Girardi, Lucas Santos, Daniel Pens Gelain, Glauco A Westphal, Roger Walz, Cristiane Ritter, Felipe Dal-Pizzol, Jose Claudio Fonseca Moreira","doi":"10.1016/j.medine.2025.502200","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502200","url":null,"abstract":"<p><strong>Objective: </strong>To apply machine learning algorithms to generate models capable of predicting mortality in COVID-19 patients, using a large platform of plasma inflammatory mediators.</p><p><strong>Desing: </strong>Prospective, descriptive, cohort study.</p><p><strong>Setting: </strong>6 intensive care units in 2 hospitals in Southern Brazil.</p><p><strong>Patients: </strong>Patients aged > 18 years who were diagnosed with COVID-19 through reverse transcriptase reaction or rapid antigen test.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main variables of interest: </strong>Demographic and clinical variables, 65 inflammatory biomarkers, mortality.</p><p><strong>Results: </strong>Combinations of two or three proteins yield higher predictive value when compared to individual proteins or the full set of the 65 proteins. A proliferation-inducing ligand (APRIL) and cluster of differentiation 40 ligand (CD40L) consistently emerge among the highest-ranking combinations, suggesting a potential synergistic effect in predicting clinical outcomes. The network structure suggested a dysregulated immune response in non-survivors characterized by the failure of regulatory cytokines to temper an overwhelming inflammatory reaction.</p><p><strong>Conclusion: </strong>Our results highlight the value of feature selection and careful consideration of biomarker combinations to improve prediction accuracy in COVID-19 patients.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502200"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789488","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

Pulmonary vein thrombosis following acute type aortic dissection 急性型主动脉夹层后的肺静脉血栓形成。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.09.011

Xiaoyang Zhou , Long Zhao , Bixin Chen

引用次数: 0

Emphysematous cystitis in the postoperative period of aortic valve replacement 主动脉瓣置换术术后气肿性膀胱炎。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.07.007

Iratxe Iriondo Irigoras, M. Ángeles Rodríguez Esteban

引用次数: 0

A rare echocardiographic imaging of a giant atrial mass 罕见的巨大心房肿块超声心动图成像。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.10.004

Pingping Dong , Jianneng Pan , Xiaoyang Zhou

引用次数: 0

Early mobilisation in patients with shock and receiving vasoactive drugs in the intensive care unit: A systematic review and meta-analysis of observational studies 在重症监护室接受血管活性药物治疗的休克患者的早期康复：观察性研究的系统回顾和荟萃分析。

Medicina intensiva Pub Date : 2025-04-01 DOI: 10.1016/j.medine.2024.09.013

Henry Mauricio Parada-Gereda , Luis F. Pardo-Cocuy , Janneth Milena Avendaño , Daniel Molano-Franco , Joan Ramón Masclans

{"title":"Early mobilisation in patients with shock and receiving vasoactive drugs in the intensive care unit: A systematic review and meta-analysis of observational studies","authors":"Henry Mauricio Parada-Gereda , Luis F. Pardo-Cocuy , Janneth Milena Avendaño , Daniel Molano-Franco , Joan Ramón Masclans","doi":"10.1016/j.medine.2024.09.013","DOIUrl":"10.1016/j.medine.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study was to assess the feasibility and safety of early mobilisation in patients with shock requiring vasoactive drugs in the intensive care unit (ICU).</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Setting</h3><div>Intensive care unit (ICU).</div></div><div><h3>Patients or participants</h3><div>Adult patients requiring vasoactive drugs who received early mobilisation in the intensive care unit.</div></div><div><h3>Interventions</h3><div>A systematic search was conducted using the databases PubMed, Cochrane Library, Scopus, Medline Ovid, Science Direct, and CINAHL, including observational studies involving adult patients requiring vasoactive drugs who received early mobilisation. A meta-analysis was performed on the proportion of safety events and the proportion of early mobilisation in patients with high, moderate, and low doses of vasoactive drugs.</div></div><div><h3>Main variables of interest</h3><div>Feasibility, safety events, and the maximum level of activity achieved during early mobilisation.</div></div><div><h3>Results</h3><div>The search yielded 1875 studies, of which 8 were included in the systematic review and 5 in the meta-analysis. The results showed that 64% (95% CI: 34%–95%, p<0.05) of patients were mobilised with low doses of vasoactive drugs, 30% (95% CI: 7%–53%, p<0.05) with moderate doses, and 7% (95% CI: 3%–16%, p 0.17) with high doses. The proportion of adverse events was low, at 2% (95% CI: 1%–4%, p<0.05).</div></div><div><h3>Conclusions</h3><div>Early mobilisation in patients with shock and the need for vasoactive drugs is feasible and generally safe. However, there is an emphasis on the need for further high-quality research to confirm these findings.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 4","pages":"Pages 193-204"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649805","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