Medicina Intensiva最新文献

英文中文

Aplicación de un entorno multisensorial en la UCI: efecto sobre el delirium y la regulación del ritmo circadiano 多感官环境在UCI中的应用：对精神错乱和昼夜节律调节的影响

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-02-01 DOI: 10.1016/j.medin.2025.502347

Francisco Esteve Urbano , Gemma Vía Clavero , Carlos González López , Paola Cárdenas Campos , Herminia Torrado Santos , Rosa María Granada Vicente , Rafael Justel García

Objective

To evaluate the impact of a multisensory environmental intervention designed to simulate and synchronize physiological circadian rhythms on the incidence of delirium and other clinical outcomes in critically ill patients admitted to an intensive care unit (ICU).

Design

Pre-post quasi-experimental study without randomization, conducted between September 2023 and June 2024.

Setting

Adult Intensive Care Unit in a tertiary university hospital.

Patients

538 consecutive patients were included: 251 during the control period and 287 after implementation of the intervention.

Intervention

Installation of the SHX® environmental stimulation system, which provides programmed transitions of light, image, and sound simulating sunrise and sunset, aimed at supporting circadian synchronization.

Main outcome variables

Incidence of delirium (assessed using the CAM-ICU tool), levels of sedation-agitation (RASS scale), and daily consumption of sedative drugs per day of ICU stay.

Results

A non-significant reduction in the incidence of delirium was observed (14.3% vs. 9.1%; p = 0.075), along with a significant redistribution in sedation-agitation levels (p < 0.001) and a significant decrease in daily midazolam consumption per day of stay (9.6 mg vs. 3.8 mg; p = 0.019).

Conclusions

The implementation of a multisensory environment synchronized with the circadian rhythm was associated with improvements in delirium-related outcomes, sedation-agitation profiles, and benzodiazepine use. These findings support the use of non-pharmacological environmental interventions as complementary tools in the prevention of ICU delirium.

目的评估模拟和同步生理昼夜节律的多感官环境干预对重症监护病房（ICU）重症患者谵妄发生率和其他临床结局的影响。设计：2023年9月至2024年6月，无随机分组的前后准实验研究。在某三级大学医院设置成人重症监护室。连续纳入538例患者：对照组251例，干预实施后287例。干预：安装SHX®环境刺激系统，提供模拟日出和日落的程序化光、图像和声音转换，旨在支持昼夜节律同步。主要结局变量：谵妄发生率（使用CAM-ICU工具评估）、镇静-躁动水平（RASS量表）和每天在ICU住院期间镇静药物的每日消耗量。结果谵妄发生率无显著降低（14.3% vs. 9.1%, p = 0.075），镇静-躁动水平有显著的再分布（p < 0.001），每日咪达唑仑每日消耗量显著降低（9.6 mg vs. 3.8 mg, p = 0.019）。结论：与昼夜节律同步的多感官环境的实施与谵妄相关结局、镇静-躁动特征和苯二氮卓类药物使用的改善有关。这些发现支持使用非药物环境干预作为预防ICU谵妄的补充工具。

{"title":"Aplicación de un entorno multisensorial en la UCI: efecto sobre el delirium y la regulación del ritmo circadiano","authors":"Francisco Esteve Urbano , Gemma Vía Clavero , Carlos González López , Paola Cárdenas Campos , Herminia Torrado Santos , Rosa María Granada Vicente , Rafael Justel García","doi":"10.1016/j.medin.2025.502347","DOIUrl":"10.1016/j.medin.2025.502347","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of a multisensory environmental intervention designed to simulate and synchronize physiological circadian rhythms on the incidence of delirium and other clinical outcomes in critically ill patients admitted to an intensive care unit (ICU).</div></div><div><h3>Design</h3><div>Pre-post quasi-experimental study without randomization, conducted between September 2023 and June 2024.</div></div><div><h3>Setting</h3><div>Adult Intensive Care Unit in a tertiary university hospital.</div></div><div><h3>Patients</h3><div>538 consecutive patients were included: 251 during the control period and 287 after implementation of the intervention.</div></div><div><h3>Intervention</h3><div>Installation of the SHX® environmental stimulation system, which provides programmed transitions of light, image, and sound simulating sunrise and sunset, aimed at supporting circadian synchronization.</div></div><div><h3>Main outcome variables</h3><div>Incidence of delirium (assessed using the CAM-ICU tool), levels of sedation-agitation (RASS scale), and daily consumption of sedative drugs per day of ICU stay.</div></div><div><h3>Results</h3><div>A non-significant reduction in the incidence of delirium was observed (14.3% vs. 9.1%; p = 0.075), along with a significant redistribution in sedation-agitation levels (p < 0.001) and a significant decrease in daily midazolam consumption per day of stay (9.6mg vs. 3.8mg; p = 0.019).</div></div><div><h3>Conclusions</h3><div>The implementation of a multisensory environment synchronized with the circadian rhythm was associated with improvements in delirium-related outcomes, sedation-agitation profiles, and benzodiazepine use. These findings support the use of non-pharmacological environmental interventions as complementary tools in the prevention of ICU delirium.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 2","pages":"Article 502347"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respuesta a: «El manejo de la vía aérea en el paciente crítico. Necesidad de adaptar las guías a nuestra realidad y nosotros adherirnos a ellas» 对：“危重病人的气道管理。有必要使指导方针适应我们的现实，我们必须遵守它们”。

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-02-01 DOI: 10.1016/j.medin.2025.502300

Rodrigo Albillos-Almaraz , Salvador Balboa-Palomino , Eva María Pérez-Cabo

引用次数: 0

Improving monitoring of patient-ventilator interaction using tracheal pressure 利用气管压力改善患者与呼吸机相互作用的监测

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-02-01 DOI: 10.1016/j.medin.2025.502312

Manuel Valdivia Marchal, Lorena Prados Acién, José Manuel Serrano Simón

引用次数: 0

Ventilación mecánica prolongada y paciente traqueostomizado en cuidados intensivos pediátricos 在儿科重症监护中延长机械通气和气管造口术患者

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-01-01 DOI: 10.1016/j.medin.2025.502294

Rafael González Cortés , Martí Pons Òdena , Mirella Gaboli , María Angeles García-Teresa

Prolonged mechanical ventilation (PMV) in paediatric intensive care (PICU) is increasing due to health advances and ethical criteria favouring the survival of chronically ill children. These patients require resources, generate high family demand and present a high risk of complications and mortality. Among the most frequent underlying pathologies are chronic respiratory diseases, neuromuscular diseases, prematurity, bronchopulmonary dysplasia and heart disease, with oncological pathology emerging in recent years.

In PICU, PMV is mainly performed by invasive MV with an endotracheal or tracheostomy tube (TQ), with non-invasive ventilation (NIV) being less frequent. Successful weaning from MV requires strategies aimed at identifying and correcting factors that alter the balance between respiratory system load and respiratory work capacity. Both TQ and NIV can facilitate ventilatory weaning or be solutions for long-term ventilation. There is no defined optimal time to perform TQ in children; this decision should be individualised on a risk-benefit basis. TQ tends to be delayed in children much longer than in adults. One-piece cannulae are used in paediatrics; in addition, if there is clinical stability and the possibility of connection to a home ventilator, uncuffed cannulae should be prioritised because of their better tolerance and safety. Home ventilation allows for a return to the home environment, improving quality of life and favouring neurodevelopment. However, institutional support can be insufficient to cope with the high responsibility and burden assumed by families.

由于健康进步和有利于慢性病儿童生存的伦理标准，儿科重症监护（PICU）的延长机械通气（PMV）正在增加。这些患者需要资源，产生很高的家庭需求，并有很高的并发症和死亡风险。其中最常见的潜在病理是慢性呼吸系统疾病、神经肌肉疾病、早产、支气管肺发育不良和心脏病，近年来出现了肿瘤病理。在PICU中，PMV主要通过气管内或气管造口管（TQ）进行有创MV，无创通气（NIV）较少。成功脱离中压需要确定和纠正改变呼吸系统负荷和呼吸工作能力之间平衡的因素的策略。TQ和NIV都可以促进通气脱机或长期通气的解决方案。对儿童进行TQ测试没有确定的最佳时间；这个决定应该在风险-收益的基础上个人化。儿童的TQ往往比成人晚得多。一件式插管用于儿科；此外，如果临床稳定且有可能连接家用呼吸机，则应优先使用无套管插管，因为它们的耐受性和安全性更好。家庭通风允许回到家庭环境，提高生活质量，有利于神经发育。然而，体制支助可能不足以应付家庭承担的高度责任和负担。

{"title":"Ventilación mecánica prolongada y paciente traqueostomizado en cuidados intensivos pediátricos","authors":"Rafael González Cortés , Martí Pons Òdena , Mirella Gaboli , María Angeles García-Teresa","doi":"10.1016/j.medin.2025.502294","DOIUrl":"10.1016/j.medin.2025.502294","url":null,"abstract":"<div><div>Prolonged mechanical ventilation (PMV) in paediatric intensive care (PICU) is increasing due to health advances and ethical criteria favouring the survival of chronically ill children. These patients require resources, generate high family demand and present a high risk of complications and mortality. Among the most frequent underlying pathologies are chronic respiratory diseases, neuromuscular diseases, prematurity, bronchopulmonary dysplasia and heart disease, with oncological pathology emerging in recent years.</div><div>In PICU, PMV is mainly performed by invasive MV with an endotracheal or tracheostomy tube (TQ), with non-invasive ventilation (NIV) being less frequent. Successful weaning from MV requires strategies aimed at identifying and correcting factors that alter the balance between respiratory system load and respiratory work capacity. Both TQ and NIV can facilitate ventilatory weaning or be solutions for long-term ventilation. There is no defined optimal time to perform TQ in children; this decision should be individualised on a risk-benefit basis. TQ tends to be delayed in children much longer than in adults. One-piece cannulae are used in paediatrics; in addition, if there is clinical stability and the possibility of connection to a home ventilator, uncuffed cannulae should be prioritised because of their better tolerance and safety. Home ventilation allows for a return to the home environment, improving quality of life and favouring neurodevelopment. However, institutional support can be insufficient to cope with the high responsibility and burden assumed by families.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 1","pages":"Article 502294"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validez de la escala FRAIL-España en pacientes críticos FRAIL-西班牙重症患者量表的有效性

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-01-01 DOI: 10.1016/j.medin.2025.502259

Susana Arias-Rivera , Fernando Frutos-Vivar , María Nieves Moro-Tejedor , María Mar Sánchez-Sánchez , Emilia Romero-de San Pío , Yeray Gabriel Santana-Padilla , Gemma Via-Clavero , María del Rosario Villar-Redondo , María Jesús Frade-Mera , Mónica Juncos Gozalo , Elisabet Gallart-Vivé , Marta Raurell-Torredà , Grupo FRAIL-Es-UCI

Objective

To evaluate the validity and sensitivity to change of the FRAIL-Spain scale in critically ill adult patients admitted to intensive care units (ICUs) in Spain.

Design

Descriptive, observational, prospective, multicenter, metric in nature.

Setting

ICUs in Spain.

Patients

Patients > 18 years old with ICU stay > 48 hours.

Interventions

None.

Main variables of interest

Frailty (FRAIL-Spain), sociodemographic characteristics, dependency, ICU stay clinical variables, stay, mortality, destination at discharge.

Results

The prevalence of frailty at ICU admission, among the 493 patients in the cohort, was 23.9%. Multivariate risk factors for frailty were age and hospital admissions in the year prior to the current admission. Being independent, having a stable partner, and good physical quality of life are protective factors for frailty. Frailty is associated with greater resource utilization, increased mortality, and a higher likelihood of discharge to a long-stay facility. The effect size of the observed change was moderate-large (d = .850).

Conclusions

The FRAIL-Spain model shows good convergent validity with age, dependency, marital status, comorbidities, perceived physical quality of life, and hospitalization in an acute care facility in the previous year. It has good predictive validity for ICU-acquired weakness, alterations in glycemic control and resource use, hospital discharge, and mortality. It is sensitive for detecting changes in frailty.

目的评价西班牙重症监护病房（icu）危重成人患者ail -Spain量表变化的有效性和敏感性。设计：描述性、观察性、前瞻性、多中心、度量性。我在西班牙。患者年龄18岁，ICU住院48小时。干预措施：主要感兴趣的变量虚弱（西班牙）、社会人口学特征、依赖性、ICU住院临床变量、住院时间、死亡率、出院目的地。结果493例患者在ICU入院时的虚弱患病率为23.9%。导致虚弱的多变量危险因素是年龄和入院前一年的住院情况。独立，有一个稳定的伴侣，良好的身体生活质量是脆弱的保护因素。体弱多病与更高的资源利用率、更高的死亡率以及更有可能进入长期住院设施有关。观察到的变化的效应量为中大型（d = 0.850）。结论FRAIL-Spain模型在年龄、依赖关系、婚姻状况、合并症、感知身体生活质量和前一年在急症护理机构的住院情况方面具有良好的收敛效度。它对icu获得性虚弱、血糖控制和资源使用的改变、出院和死亡率具有良好的预测效度。它对检测虚弱的变化很敏感。

{"title":"Validez de la escala FRAIL-España en pacientes críticos","authors":"Susana Arias-Rivera , Fernando Frutos-Vivar , María Nieves Moro-Tejedor , María Mar Sánchez-Sánchez , Emilia Romero-de San Pío , Yeray Gabriel Santana-Padilla , Gemma Via-Clavero , María del Rosario Villar-Redondo , María Jesús Frade-Mera , Mónica Juncos Gozalo , Elisabet Gallart-Vivé , Marta Raurell-Torredà , Grupo FRAIL-Es-UCI","doi":"10.1016/j.medin.2025.502259","DOIUrl":"10.1016/j.medin.2025.502259","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the validity and sensitivity to change of the FRAIL-Spain scale in critically ill adult patients admitted to intensive care units (ICUs) in Spain.</div></div><div><h3>Design</h3><div>Descriptive, observational, prospective, multicenter, metric in nature.</div></div><div><h3>Setting</h3><div>ICUs in Spain.</div></div><div><h3>Patients</h3><div>Patients >18years old with ICU stay >48hours.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Frailty (FRAIL-Spain), sociodemographic characteristics, dependency, ICU stay clinical variables, stay, mortality, destination at discharge.</div></div><div><h3>Results</h3><div>The prevalence of frailty at ICU admission, among the 493 patients in the cohort, was 23.9%. Multivariate risk factors for frailty were age and hospital admissions in the year prior to the current admission. Being independent, having a stable partner, and good physical quality of life are protective factors for frailty. Frailty is associated with greater resource utilization, increased mortality, and a higher likelihood of discharge to a long-stay facility. The effect size of the observed change was moderate-large (d=.850).</div></div><div><h3>Conclusions</h3><div>The FRAIL-Spain model shows good convergent validity with age, dependency, marital status, comorbidities, perceived physical quality of life, and hospitalization in an acute care facility in the previous year. It has good predictive validity for ICU-acquired weakness, alterations in glycemic control and resource use, hospital discharge, and mortality. It is sensitive for detecting changes in frailty.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 1","pages":"Article 502259"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Síndrome de liberación de citocinas y síndrome hemofagocítico asociados a inmunoterapia: una revisión narrativa 细胞因子释放综合征和免疫治疗相关的吞噬血细胞综合征：叙述综述

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-01-01 DOI: 10.1016/j.medin.2025.502254

Eric Mayor-Vázquez , Elena Cuenca Fito , Pilar Marcos-Neira , Cándido Díaz-Lagares , Carme Gomila-Sintes , Noelia Albalá , Alejandra García-Roche , Pedro Castro

In recent years, there has been an increase in the number of patients affected by oncohematologic diseases in developed countries due to the improved survival rates and quality of life. This increase has generated a greater need for care in intensive care units (ICU), mainly due to complications related to immunosuppression, treatment toxicity or complications derived from cancer itself. Immunotherapy has transformed cancer treatment, but it can cause serious side effects such as cytokine release syndrome and hemophagocytic syndrome, which often require ICU admission. This review seeks to expand knowledge and management strategies for these complications in the ICU.

近年来，由于生存率和生活质量的提高，发达国家受血液肿瘤疾病影响的患者人数有所增加。这一增加增加了对重症监护病房（ICU）护理的更大需求，主要是由于与免疫抑制、治疗毒性或癌症本身引起的并发症有关的并发症。免疫疗法已经改变了癌症的治疗方式，但它可能会导致严重的副作用，如细胞因子释放综合征和噬血细胞综合征，这往往需要住院治疗。本综述旨在扩展ICU中这些并发症的知识和管理策略。

引用次数: 0

Hallazgo de vena cava superior izquierda persistente durante el implante de marcapasos 在起搏器植入过程中发现持续的左上腔静脉

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-01-01 DOI: 10.1016/j.medin.2025.502232

Eugenia Anabel Liger Borja, Jose Joaquín Cortina Gomez, Gabriela Carolina El Ashkar Palacios

引用次数: 0

Enhancing methodological rigor in mechanical insufflation-exsufflation weaning studies: Commentary on patient selection, long-term outcomes, and psychological assessment 提高机械充气-呼气断奶研究方法的严谨性：对患者选择、长期结果和心理评估的评论

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-01-01 DOI: 10.1016/j.medin.2025.502290

Yueqi Wang , Yan Cui , Moxuan Han , Donghui Yue

引用次数: 0

Reply to “Enhancing methodological rigor in mechanical insufflation-exsufflation weaning studies: Commentary on patient selection, long-term outcomes, and psychological assessment” 回复“提高机械充气-呼气断奶研究方法的严谨性：对患者选择、长期结果和心理评估的评论”

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-01-01 DOI: 10.1016/j.medin.2025.502302

Cristiane Bastos Netto , Maycon Moura Reboredo , Erich Vidal Carvalho , Bruno Valle Pinheiro

引用次数: 0

Association between time weighted average mechanical power normalized to compliance and prognosis of critically ill patients: A retrospective cohort study based on the MIMIC-IV database 时间加权平均机械功率标准化与危重患者依从性与预后之间的关系：基于MIMIC-IV数据库的回顾性队列研究

IF 3.1 4区医学 Q2 CRITICAL CARE MEDICINE

Medicina Intensiva

Pub Date : 2026-01-01 DOI: 10.1016/j.medin.2025.502258

Yukang Dong , Guiyun Li , Jiangquan Fu , Rui Huang , Huan Yao , Jingni Wang , Ying Wang , Feng Shen

Objective

This study aims to evaluate the association of time‑weighted average mechanical power normalized to compliance (TWA-MP_CRS) with all-cause mortality to determine its value as a prognostic tool in intensive care patients.

Design

Retrospective observational study.

Setting

Intensive care unit (ICU).

Patients or participants

4387 first-time ICU-admitted patients in the Medical Information Mart for Intensive Care (MIMIC) IV.

Interventions

None.

Main variables of interest

TWA-MP_CRS, ICU mortality and in-hospital mortality.

Results

Participants' mean age was 61.4 ± 16.9 years and the median [IQR] baseline TWA-MP_CRS was 0.3 (0.2, 0.6) J/min/mL/cmH₂O. When TWA-MP_CRS was divided into quintiles (with quintile 1 representing the lowest values), after adjusting for covariates, the odds ratios [95% confidence intervals (CIs)] for ICU mortality were 1.49 (95% CI: 1.15–1.94), 1.67 (95% CI: 1.29–2.16), 1.79 (95% CI: 1.37–2.33), and 3.96 (95% CI: 3.01–5.21) for quintiles 2, 3, 4, and 5 respectively, with quintile 1 as reference. Similar results were found for hospital mortality.

Conclusion

Higher TWA-MP_CRS is associated with poor clinical outcomes in critically ill patients. Higher TWA-MP_CRS can lead to a higher mortality among ICU and in-hospital patients.

目的本研究旨在评估时间加权平均机械功率归一化与依从性（TWA-MPCRS）与全因死亡率的关系，以确定其作为重症监护患者预后工具的价值。设计回顾性观察性研究。重症监护病房（ICU）。患者或参与者4387例重症监护医学信息市场（MIMIC）首次入住重症监护病房的患者。干预措施。主要感兴趣的变量twa - mpcrs、ICU死亡率和住院死亡率。结果参与者平均年龄为61.4 ± 16.9岁，基线TWA-MPCRS中位[IQR]为0.3（0.2,0.6） J/min/mL/cmH2O。将TWA-MPCRS分为五分位数（其中五分位数1代表最低值），在调整协变量后，五分位数2、3、4和5的ICU死亡率比值比[95%可信区间（CI）]分别为1.49 （95% CI: 1.15-1.94）、1.67 （95% CI: 1.29-2.16）、1.79 （95% CI: 1.37-2.33）和3.96 (95% CI: 3.01-5.21)，以五分位数1为参考。在医院死亡率方面也发现了类似的结果。结论危重患者TWA-MPCRS升高与临床预后差相关。较高的TWA-MPCRS可导致ICU和住院患者较高的死亡率。

{"title":"Association between time weighted average mechanical power normalized to compliance and prognosis of critically ill patients: A retrospective cohort study based on the MIMIC-IV database","authors":"Yukang Dong , Guiyun Li , Jiangquan Fu , Rui Huang , Huan Yao , Jingni Wang , Ying Wang , Feng Shen","doi":"10.1016/j.medin.2025.502258","DOIUrl":"10.1016/j.medin.2025.502258","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the association of time‑weighted average mechanical power normalized to compliance (TWA-MP<sub>CRS</sub>) with all-cause mortality to determine its value as a prognostic tool in intensive care patients.</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Setting</h3><div>Intensive care unit (ICU).</div></div><div><h3>Patients or participants</h3><div>4387 first-time ICU-admitted patients in the Medical Information Mart for Intensive Care (MIMIC) IV.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>TWA-MP<sub>CRS</sub>, ICU mortality and in-hospital mortality.</div></div><div><h3>Results</h3><div>Participants' mean age was 61.4 ± 16.9 years and the median [IQR] baseline TWA-MP<sub>CRS</sub> was 0.3 (0.2, 0.6) J/min/mL/cmH<sub>2</sub>O. When TWA-MP<sub>CRS</sub> was divided into quintiles (with quintile 1 representing the lowest values), after adjusting for covariates, the odds ratios [95% confidence intervals (CIs)] for ICU mortality were 1.49 (95% CI: 1.15–1.94), 1.67 (95% CI: 1.29–2.16), 1.79 (95% CI: 1.37–2.33), and 3.96 (95% CI: 3.01–5.21) for quintiles 2, 3, 4, and 5 respectively, with quintile 1 as reference. Similar results were found for hospital mortality.</div></div><div><h3>Conclusion</h3><div>Higher TWA-MP<sub>CRS</sub> is associated with poor clinical outcomes in critically ill patients. Higher TWA-MP<sub>CRS</sub> can lead to a higher mortality among ICU and in-hospital patients.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 1","pages":"Article 502258"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Medicina Intensiva

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀