Pub Date : 2026-01-01DOI: 10.1016/j.medin.2025.502297
Diego Maqueda Lluva, Alberto Garrido Callén, Manuel Pérez Torres
{"title":"Cuando la resonancia ve lo que el sodio no muestra: más allá del desequilibrio osmótico en la mielinólisis central pontina","authors":"Diego Maqueda Lluva, Alberto Garrido Callén, Manuel Pérez Torres","doi":"10.1016/j.medin.2025.502297","DOIUrl":"10.1016/j.medin.2025.502297","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 1","pages":"Article 502297"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886168","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}
Pub Date : 2026-01-01DOI: 10.1016/j.medin.2025.502344
Elena Cuenca Fito , Eric Mayor-Vázquez , Cándido Díaz Lagares , Bárbara Vidal Tegedor , Noelia Isabel Lázaro Martín , Alba López Fernández , Laura Sanchez Montori , Íñigo Isern , Amparo Cabanillas Carrillo , Jorge Sánchez Gómez , Maria Luisa Gómez Grande , Alba Fernández Rodríguez , Anastasio Espejo , Domingo Díaz Díaz , Alejandra García Roche , Margarita Márquez , Mireya Molina Cortés , Natalia Valero , Manuel Gracia Romero , Fernando Eiras Abalde , Inés Gómez-Acebo
Objective
This study compares the clinical, functional, and oncological characteristics of patients with cancer assessed for ICU admission, with the aim of identifying factors associated with admission and of developing specific predictive models.
Design
A prospective, observational, multicentre study.
Setting
Thirty-three Intensive Care Units (ICUs) across Spain.
Patients or participants
Patients aged 18 years or older with solid tumors or haematological malignancies assessed for ICU admission between January and June 2024 were included.
Interventions
None.
Main variables of interest
Demographic, clinical, functional, oncological, and severity variables were collected. Differences between admitted and non-admitted patients were analyzed using multivariate logistic regression and LASSO-type predictive models.
Results
One thousand three hundred forty-one patients were included, with 1,177 (87.8%) admitted to ICU. Neutropenia, younger age, and recent oncologic treatment, among other factors, were associated with a higher likelihood of ICU admission. Patients with metastasis or progression of the haematological disease had a lower probability of admission. The predictive models demonstrated high discriminative ability for both solid tumors (AUC 0.79) and haematological malignancies (AUC 0.82).
Conclusions
We developed prognostic models for ICU admission by applying a multivariable approach, whereby variables were selected based on their joint contribution to the overall predictive accuracy rather than in isolation. The full model (Model 1) showed the best predictive capacity, with an area under the curve (AUC) of 0.79 (95% CI: 0.75-0.84) for solid and 0.82 (95% CI: 0.76-0.88) for haematological tumors.
{"title":"Factores determinantes en la decisión de ingreso de pacientes oncológicos en la unidad de cuidados intensivos: estudio español prospectivo multicéntrico","authors":"Elena Cuenca Fito , Eric Mayor-Vázquez , Cándido Díaz Lagares , Bárbara Vidal Tegedor , Noelia Isabel Lázaro Martín , Alba López Fernández , Laura Sanchez Montori , Íñigo Isern , Amparo Cabanillas Carrillo , Jorge Sánchez Gómez , Maria Luisa Gómez Grande , Alba Fernández Rodríguez , Anastasio Espejo , Domingo Díaz Díaz , Alejandra García Roche , Margarita Márquez , Mireya Molina Cortés , Natalia Valero , Manuel Gracia Romero , Fernando Eiras Abalde , Inés Gómez-Acebo","doi":"10.1016/j.medin.2025.502344","DOIUrl":"10.1016/j.medin.2025.502344","url":null,"abstract":"<div><h3>Objective</h3><div>This study compares the clinical, functional, and oncological characteristics of patients with cancer assessed for ICU admission, with the aim of identifying factors associated with admission and of developing specific predictive models.</div></div><div><h3>Design</h3><div>A prospective, observational, multicentre study.</div></div><div><h3>Setting</h3><div>Thirty-three Intensive Care Units (ICUs) across Spain.</div></div><div><h3>Patients or participants</h3><div>Patients aged 18 years or older with solid tumors or haematological malignancies assessed for ICU admission between January and June 2024 were included.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>Demographic, clinical, functional, oncological, and severity variables were collected. Differences between admitted and non-admitted patients were analyzed using multivariate logistic regression and LASSO-type predictive models.</div></div><div><h3>Results</h3><div>One thousand three hundred forty-one patients were included, with 1,177 (87.8%) admitted to ICU. Neutropenia, younger age, and recent oncologic treatment, among other factors, were associated with a higher likelihood of ICU admission. Patients with metastasis or progression of the haematological disease had a lower probability of admission. The predictive models demonstrated high discriminative ability for both solid tumors (AUC 0.79) and haematological malignancies (AUC 0.82).</div></div><div><h3>Conclusions</h3><div>We developed prognostic models for ICU admission by applying a multivariable approach, whereby variables were selected based on their joint contribution to the overall predictive accuracy rather than in isolation. The full model (Model 1) showed the best predictive capacity, with an area under the curve (AUC) of 0.79 (95% CI: 0.75-0.84) for solid and 0.82 (95% CI: 0.76-0.88) for haematological tumors.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 1","pages":"Article 502344"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886158","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}
Pub Date : 2026-01-01DOI: 10.1016/j.medin.2025.502251
Seo Hee Yoon, Sohyun Eun
Objective
Sepsis remains a major cause of mortality worldwide. While neutrophil CD64 (nCD64) has demonstrated superior performance in detecting sepsis compared to conventional biomarkers, its prognostic value remains unclear. This meta-analysis evaluates the performance of nCD64 in predicting mortality in patients with sepsis.
Design
Systematic review and meta-analysis.
Settings
A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted up to January 28, 2025, to identify relevant studies.
Patients
Patients aged 16 years or older diagnosed with sepsis based on Sepsis-1, Sepsis-2, or Sepsis-3 criteria.
Interventions
Studies assessing the predictive accuracy of nCD64 for mortality and providing sufficient data for contingency table construction were included.
Main variables of interest
Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated with 95% confidence intervals (CIs). Overall predictive accuracy was assessed using the area under the summary receiver operating characteristic curve.
Results
Eight studies involving 756 patients were included. The pooled sensitivity, specificity, and DOR of nCD64 for predicting mortality were 0.79 (95% CI: 0.68–0.87), 0.67 (95% CI: 0.56–0.77), and 7.71 (95% CI: 4.38–13.57), respectively. The predictive accuracy was 0.80.
Conclusions
Our findings suggest that nCD64 may serve as a valuable auxiliary biomarker for identifying patients with sepsis at higher risk of mortality.
{"title":"Neutrophil CD64 as a prognostic biomarker for mortality in sepsis: A systematic review and meta-analysis","authors":"Seo Hee Yoon, Sohyun Eun","doi":"10.1016/j.medin.2025.502251","DOIUrl":"10.1016/j.medin.2025.502251","url":null,"abstract":"<div><h3>Objective</h3><div>Sepsis remains a major cause of mortality worldwide. While neutrophil CD64 (nCD64) has demonstrated superior performance in detecting sepsis compared to conventional biomarkers, its prognostic value remains unclear. This meta-analysis evaluates the performance of nCD64 in predicting mortality in patients with sepsis.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Settings</h3><div>A systematic search of PubMed, Embase, the Cochrane Library, and Web of Science was conducted up to January 28, 2025, to identify relevant studies.</div></div><div><h3>Patients</h3><div>Patients aged 16 years or older diagnosed with sepsis based on Sepsis-1, Sepsis-2, or Sepsis-3 criteria.</div></div><div><h3>Interventions</h3><div>Studies assessing the predictive accuracy of nCD64 for mortality and providing sufficient data for contingency table construction were included.</div></div><div><h3>Main variables of interest</h3><div>Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated with 95% confidence intervals (CIs). Overall predictive accuracy was assessed using the area under the summary receiver operating characteristic curve.</div></div><div><h3>Results</h3><div>Eight studies involving 756 patients were included. The pooled sensitivity, specificity, and DOR of nCD64 for predicting mortality were 0.79 (95% CI: 0.68–0.87), 0.67 (95% CI: 0.56–0.77), and 7.71 (95% CI: 4.38–13.57), respectively. The predictive accuracy was 0.80.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that nCD64 may serve as a valuable auxiliary biomarker for identifying patients with sepsis at higher risk of mortality.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 1","pages":"Article 502251"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886160","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}
Pub Date : 2026-01-01DOI: 10.1016/j.medin.2025.502226
Alberto García-Salido , Yolanda López-Fernández , Alberto Medina Villanueva , María José Santiago Lozano
{"title":"Introducción a la serie de «Puesta al día en cuidados intensivos pediátricos»","authors":"Alberto García-Salido , Yolanda López-Fernández , Alberto Medina Villanueva , María José Santiago Lozano","doi":"10.1016/j.medin.2025.502226","DOIUrl":"10.1016/j.medin.2025.502226","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 1","pages":"Article 502226"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886166","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}
Pub Date : 2026-01-01DOI: 10.1016/j.medin.2025.502217
Nuria del Amo Carramiñana , Paula Lasarte Merino , Celia Pascual Alonso , Jesús López-Herce , Rafael González Cortés
{"title":"Alteraciones en el fosfato sérico en los niños en estado crítico","authors":"Nuria del Amo Carramiñana , Paula Lasarte Merino , Celia Pascual Alonso , Jesús López-Herce , Rafael González Cortés","doi":"10.1016/j.medin.2025.502217","DOIUrl":"10.1016/j.medin.2025.502217","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"50 1","pages":"Article 502217"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886162","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}
Pub Date : 2025-12-01DOI: 10.1016/j.medin.2025.502305
Daniel Agustín Godoy , Jon Pérez-Bárcena , Francisco de Paula Delgado-Moya , Jesús Abelardo Barea-Mendoza , Juan Antonio Llompart-Pou
Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization.
{"title":"Noninvasive bedside neuromonitoring in acute brain injury. A narrative review","authors":"Daniel Agustín Godoy , Jon Pérez-Bárcena , Francisco de Paula Delgado-Moya , Jesús Abelardo Barea-Mendoza , Juan Antonio Llompart-Pou","doi":"10.1016/j.medin.2025.502305","DOIUrl":"10.1016/j.medin.2025.502305","url":null,"abstract":"<div><div>Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 12","pages":"Article 502305"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645900","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}
Pub Date : 2025-12-01DOI: 10.1016/j.medin.2025.502205
Gonzalo Ballesteros-Reviriego , Joan-Daniel Martí
{"title":"Fisioterapia en UCI: pasado, presente y futuro","authors":"Gonzalo Ballesteros-Reviriego , Joan-Daniel Martí","doi":"10.1016/j.medin.2025.502205","DOIUrl":"10.1016/j.medin.2025.502205","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 12","pages":"Article 502205"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645901","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}
Pub Date : 2025-12-01DOI: 10.1016/j.medin.2025.502268
Leonardo Lorente , Jonathan González García , Sergio Pérez Reyes , Cristo Yared Pérez Martín , Mario Rodín , Santiago Viera , Alejandro Jiménez
Objective
Different studies have determined blood linezolid concentrations. However, the largest studies reporting data on factors associated with subtherapeutic linezolid concentrations in critically ill patients account for less than 60 patients. Thus, the objective of our study was to determine what factors were associated with subtherapeutic linezolid concentrations in critically ill patients in a larger series of patients.
Design
Historical cohort study.
Setting
One Spanish Intensive Care Unit.
Patients
Critically ill adult patients who received linezolid due to suspected or confirmed infection by multidrug-drug-resistant Gram-positive bacteria during 2022 and 2023.
Interventions
Blood samples were collected to determine linezolid concentrations (Cmin) immediately before dosing after at least 48 h from starting linezolid therapy.
Main variable of interest
Subtherapeutic linezolid concentrations.
Results
We included a total of 168 patients. We found 79 (47.0%) patients with and 89 (53.0%) patients without subtherapeutic linezolid concentrations. Multiple logistic regression showed that linezolid continuous infusion (OR = 0.192; 95% CI = 0.053–0.694; p = 0.01) and older age (OR = 0.952; 95% CI = 0.926–0.980; p = 0.001) were associated with lower risk of subtherapeutic linezolid concentrations.
Conclusions
As far as we know, this is the largest study reporting data on factors associated with subtherapeutic linezolid concentrations in critically ill patients. To our knowledge, our study is the first to report that linezolid continuous infusion was independently associated with lower risk of subtherapeutic linezolid concentrations in critically ill patients.
目的不同的研究测定了利奈唑胺的血药浓度。然而，报道重症患者亚治疗利奈唑胺浓度相关因素数据的最大研究只涉及不到60例患者。因此，我们研究的目的是在更大的患者系列中确定哪些因素与危重患者的亚治疗利奈唑胺浓度相关。设计：历史队列研究。设置一个西班牙重症监护病房。患者：在2022年和2023年期间，因怀疑或确认感染多重耐药革兰氏阳性菌而接受利奈唑胺治疗的危重成人患者。干预措施：在开始利奈唑胺治疗至少48小时后，在给药前立即采集血液样本以测定利奈唑胺浓度（Cmin）。感兴趣的主要变量亚治疗利奈唑胺浓度。结果共纳入168例患者。我们发现79例（47.0%）患者有亚治疗性利奈唑胺浓度，89例（53.0%）患者没有。多元logistic回归分析显示，持续输注利奈唑胺（OR = 0.192; 95% CI = 0.053-0.694; p = 0.01）和年龄较大（OR = 0.952; 95% CI = 0.926-0.980; p = 0.001）与利奈唑胺亚治疗浓度风险降低相关。结论：据我们所知，这是报道重症患者亚治疗利奈唑胺浓度相关因素的最大研究。据我们所知，我们的研究是第一个报道利奈唑胺持续输注与危重患者亚治疗利奈唑胺浓度降低风险独立相关的研究。
{"title":"Linezolid continuous infusion protects from subtherapeutic linezolid concentrations in critically ill patients","authors":"Leonardo Lorente , Jonathan González García , Sergio Pérez Reyes , Cristo Yared Pérez Martín , Mario Rodín , Santiago Viera , Alejandro Jiménez","doi":"10.1016/j.medin.2025.502268","DOIUrl":"10.1016/j.medin.2025.502268","url":null,"abstract":"<div><h3>Objective</h3><div>Different studies have determined blood linezolid concentrations. However, the largest studies reporting data on factors associated with subtherapeutic linezolid concentrations in critically ill patients account for less than 60 patients. Thus, the objective of our study was to determine what factors were associated with subtherapeutic linezolid concentrations in critically ill patients in a larger series of patients.</div></div><div><h3>Design</h3><div>Historical cohort study.</div></div><div><h3>Setting</h3><div>One Spanish Intensive Care Unit.</div></div><div><h3>Patients</h3><div>Critically ill adult patients who received linezolid due to suspected or confirmed infection by multidrug-drug-resistant Gram-positive bacteria during 2022 and 2023.</div></div><div><h3>Interventions</h3><div>Blood samples were collected to determine linezolid concentrations (<em>C</em><sub>min</sub>) immediately before dosing after at least 48<!--> <!-->h from starting linezolid therapy.</div></div><div><h3>Main variable of interest</h3><div>Subtherapeutic linezolid concentrations.</div></div><div><h3>Results</h3><div>We included a total of 168 patients. We found 79 (47.0%) patients with and 89 (53.0%) patients without subtherapeutic linezolid concentrations. Multiple logistic regression showed that linezolid continuous infusion (OR<!--> <!-->=<!--> <!-->0.192; 95% CI<!--> <!-->=<!--> <!-->0.053–0.694; <em>p</em> <!-->=<!--> <!-->0.01) and older age (OR<!--> <!-->=<!--> <!-->0.952; 95% CI<!--> <!-->=<!--> <!-->0.926–0.980; <em>p</em> <!-->=<!--> <!-->0.001) were associated with lower risk of subtherapeutic linezolid concentrations.</div></div><div><h3>Conclusions</h3><div>As far as we know, this is the largest study reporting data on factors associated with subtherapeutic linezolid concentrations in critically ill patients. To our knowledge, our study is the first to report that linezolid continuous infusion was independently associated with lower risk of subtherapeutic linezolid concentrations in critically ill patients.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 12","pages":"Article 502268"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645950","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}
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