Medicina intensiva最新文献

{"title":"Implications of opioid-sparing medications in critically ill patients: A scoping review","authors":"Gabriella Gambadoro ,&nbsp;Brian J. Kopp ,&nbsp;Brian L. Erstad","doi":"10.1016/j.medine.2024.06.020","DOIUrl":"10.1016/j.medine.2024.06.020","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this scoping review was to evaluate literature involving opioid-sparing medications in critically ill patients with a focus on clinically meaningful outcomes.</div></div><div><h3>Design</h3><div>Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.</div></div><div><h3>Setting</h3><div>Intensive care unit.</div></div><div><h3>Patients or participants</h3><div>Adult patients in an intensive care unit setting.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div><span>PubMed and Cochrane Library were searched from October 1, 2019 to June 1, 2023. Inclusion criteria consisted of </span>randomized controlled trials<span> evaluating adjunctive analgesic use in adult patients in an intensive care unit setting.</span></div></div><div><h3>Results</h3><div>There were 343 citations and titles identified in the initial search, with 328 remaining after removal of duplicates, 294 excluded at title and abstract screening, 34 available for full text review, and six included in the scoping review. Most studies reported modest reductions in opioid use as a secondary endpoint. Improvement in clinical outcomes such as reduction in duration of mechanical ventilation<span> or delirium were reported in two trials with dexmedetomidine.</span></div></div><div><h3>Conclusions</h3><div>In recently published trials of adjunctive agents in critically ill patients, opioid-sparing effects were small. Data to support improvements in clinical outcomes remains limited.</div></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 12","pages":"Pages 693-703"},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602395","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":"Meropenem for the management of valproic acid intoxication: a case report and a review of the literature","authors":"","doi":"10.1016/j.medine.2024.06.014","DOIUrl":"10.1016/j.medine.2024.06.014","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 10","pages":"Pages 620-622"},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602396","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":"Un foramen oval inesperado","authors":"Pablo Carrión Montaner, Mario Sutil-Vega, Jordi Sans-Roselló","doi":"10.1016/j.medin.2024.06.005","DOIUrl":"https://doi.org/10.1016/j.medin.2024.06.005","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847906","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":"Hacia una mejor predicción de la mortalidad en pacientes oncológicos en UCI: análisis comparativo de escalas pronósticas: revisión sistemática de la literatura","authors":"Andrea Cabrera Losada, Maria Alejandra Correa Oviedo, Vanessa Carolina Herrera Villazón, Sebastián Gil-Tamayo, Carlos Federico Molina, Carola Giménez-Esparza Vich, Víctor Hugo Nieto Estrada","doi":"10.1016/j.medin.2024.06.008","DOIUrl":"https://doi.org/10.1016/j.medin.2024.06.008","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"28 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840890","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":"Frailty in severe COVID-19 survivors after ICU admission. A prospective and multicenter study in Mexico","authors":"Oscar Peñuelas ,&nbsp;Manuel Lomelí ,&nbsp;Laura del Campo-Albendea ,&nbsp;Sara I. Toledo ,&nbsp;Alfredo Arellano ,&nbsp;Uriel Chavarría ,&nbsp;Maria Carmen Marín ,&nbsp;Karina Rosas ,&nbsp;María Alacíen Galván Merlos ,&nbsp;Roberto Mercado ,&nbsp;Héctor R. García-Lerma ,&nbsp;Enrique Monares ,&nbsp;Daira González ,&nbsp;Juan Pérez ,&nbsp;Andrés Esteban-Fernández ,&nbsp;Alfonso Muriel ,&nbsp;Fernando Frutos-Vivar ,&nbsp;Andrés Esteban","doi":"10.1016/j.medine.2024.03.002","DOIUrl":"10.1016/j.medine.2024.03.002","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the presence of frailty in survivors of severe COVID-19 admitted in the Intensive Care Unit (ICU) and followed six months after discharge.</p></div><div><h3>Design</h3><p>An observational, prospective and multicenter, nation-wide study.</p></div><div><h3>Setting</h3><p>Eight adult ICU across eight academic acute care hospitals in Mexico.</p></div><div><h3>Patients</h3><p>All consecutive adult COVID-19 patients admitted in the ICU with acute respiratory failure between March 8, 2020 to February 28, 2021 were included. Frailty was defined according to the FRAIL scale, and was obtained at ICU admission and 6-month after hospital discharge.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Main variables of interest</h3><p>The primary endpoint was the frailty status 6-months after discharge. A regression model was used to evaluate the predictors during ICU stay associated with frailty.</p></div><div><h3>Results</h3><p>196 ICU survivors were evaluated for basal frailty at ICU admission and were included in this analysis. After 6-months from discharge, 164 patients were evaluated for frailty: 40 patients (20.4%) were classified as non-frail, 67 patients (34.2%) as pre-frail and 57 patients (29.1%) as frail. After adjustment, the need of invasive mechanical ventilation was the only factor independently associated with frailty at 6 month follow-up (Odds Ratio [OR] 3.70, 95% confidence interval 1.40–9.81, <em>P</em> = .008).</p></div><div><h3>Conclusions</h3><p>Deterioration of frailty was reported frequently among ICU survivors with severe COVID-19 at 6-months. The need of invasive mechanical ventilation in ICU survivors was the only predictor independently associated with frailty.</p></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 7","pages":"Pages 377-385"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763590","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":"Electrical impedance tomography: Usefulness for respiratory physiotherapy in critical illnesses","authors":"Ricardo Arriagada ,&nbsp;María Consuelo Bachmann ,&nbsp;Constanza San Martin ,&nbsp;Michela Rauseo ,&nbsp;Denise Battaglini","doi":"10.1016/j.medine.2024.03.006","DOIUrl":"10.1016/j.medine.2024.03.006","url":null,"abstract":"<div><p>Respiratory physiotherapy, including the management of invasive mechanical ventilation (MV) and noninvasive mechanical ventilation (NIV), is a key supportive intervention for critically ill patients. MV has potential for inducing ventilator-induced lung injury (VILI) as well as long-term complications related to prolonged bed rest, such as post-intensive care syndrome and intensive care unit acquired weakness. Physical and respiratory therapy, developed by the critical care team, in a timely manner, has been shown to prevent these complications. In this pathway, real-time bedside monitoring of changes in pulmonary aeration and alveolar gas distribution associated with postural positioning, respiratory physiotherapy techniques and changes in MV strategies can be crucial in guiding these procedures, providing safe therapy and prevention of potential harm to the patient. Along this path, electrical impedance tomography (EIT) has emerged as a new key non-invasive bedside strategy free of radiation, to allow visualization of lung recruitment. This review article presents the main and potential applications of EIT in relation to physiotherapy techniques in the ICU setting.</p></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 7","pages":"Pages 403-410"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308452","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":"Descending necrotizing mediastinitis in an immunocompetent patient","authors":"David Roa Alonso,&nbsp;Juan Pedro Martínez García-Rodrigo,&nbsp;Fernando Fong Ruiz","doi":"10.1016/j.medine.2024.01.009","DOIUrl":"10.1016/j.medine.2024.01.009","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 7","pages":"Page 435"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898409","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":"Challenges in the use of intravenous albumin in critically ill patients: Reflections and future perspectives","authors":"Alejandro González-Castro ,&nbsp;Raquel Ferrero-Franco ,&nbsp;Carmen Blanco Huelga","doi":"10.1016/j.medine.2024.04.016","DOIUrl":"10.1016/j.medine.2024.04.016","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 7","pages":"Pages 429-430"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913491","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":"Critical pregnancy at altitude: A look at Latin America","authors":"Adrián Avila-Hilari ,&nbsp;Amilcar Tinoco-Solórzano ,&nbsp;Jorge Vélez-Páez ,&nbsp;Manuel Luis Avellanas-Chavala ,&nbsp;on behalf of Comité de Expertos de Medicina Crítica en la Altitud de la Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva (FEPIMCTI)","doi":"10.1016/j.medine.2024.04.013","DOIUrl":"10.1016/j.medine.2024.04.013","url":null,"abstract":"<div><p>Critical pregnancy at high altitudes increases morbidity and mortality from 2500 m above sea level. In addition to altitude, there are other influential factors such as social inequalities, cultural, prehospital barriers, and lack the appropriate development of healthcare infrastructure. The most frequent causes of critical pregnancy leading to admission to Intensive Care Units are pregnancy hypertensive disorders (native residents seem to be more protected), hemorrhages and infection/sepsis. In Latin America, there are 32 Intensive Care Units above 2500 m above sea level. Arterial blood gases at altitude are affected by changes in barometric pressure. The analysis of their values provides very useful information for the management of obstetric emergencies at very high altitude, especially respiratory and metabolic pathologies.</p></div>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"48 7","pages":"Pages 411-420"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865918","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":"An unexpected foramen ovale.","authors":"Pablo Carrión Montaner, Mario Sutil-Vega, Jordi Sans Roselló","doi":"10.1016/j.medine.2024.06.017","DOIUrl":"https://doi.org/10.1016/j.medine.2024.06.017","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","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}