Pub Date : 2025-11-01DOI: 10.1016/j.medin.2025.502267
Pablo Vidal-Cortés , Rocío Gómez-López , Emilio Rodríguez-Ruiz , Paula Fernández-Ugidos , Fernando Eiras Abalde , Lorena del Río-Carbajo , Jorge Nieto-del Olmo , Daniel Ernesto Suárez Fernández , Ana María Ferreiro González , Mónica Mourelo Fariña , Pedro Rascado Sedes , María José de la Torre Fernández , José Luis Martínez Melgar , Miguel Ángel Fernández López , María José Castro Orjales , Patricia Barral Segade , Víctor José López Ciudad , María Isabel Álvarez Diéguez , Salvador Fojón Polanco
The proper organization of Intensive Care Medicine Departments is a key element in order to ensure high-quality care of critically ill patients and to preserve the well-being of healthcare professionals. Using a Delphi methodology, the Galician Society of Intensive Care Medicine and Coronary Units (SOGAMIUC) has reached a consensus on a set of recommendations covering structure, clinical organization, continuous care, specialized programs, and staffing requirements in ICUs. These recommendations aim to optimize continuity of care and patient safety, promote a healthy work environment, and encourage the development of advanced clinical programs. Implementation of these measures is proposed as an essential step toward improving clinical outcomes and the well-being of healthcare professionals in Intensive Care Departments.
{"title":"Organización de los Servicios de Medicina Intensiva para una asistencia de calidad. Recomendaciones de la SOGAMIUC utilizando una metodología Delphi (con el respaldo de SEMICYUC, SAMI, SBMICIUC, SOCAMICYUC, SNMIUC, SCLMICYUC, SOCMIC, SEXMICYUC, SOMIUC)","authors":"Pablo Vidal-Cortés , Rocío Gómez-López , Emilio Rodríguez-Ruiz , Paula Fernández-Ugidos , Fernando Eiras Abalde , Lorena del Río-Carbajo , Jorge Nieto-del Olmo , Daniel Ernesto Suárez Fernández , Ana María Ferreiro González , Mónica Mourelo Fariña , Pedro Rascado Sedes , María José de la Torre Fernández , José Luis Martínez Melgar , Miguel Ángel Fernández López , María José Castro Orjales , Patricia Barral Segade , Víctor José López Ciudad , María Isabel Álvarez Diéguez , Salvador Fojón Polanco","doi":"10.1016/j.medin.2025.502267","DOIUrl":"10.1016/j.medin.2025.502267","url":null,"abstract":"<div><div>The proper organization of Intensive Care Medicine Departments is a key element in order to ensure high-quality care of critically ill patients and to preserve the well-being of healthcare professionals. Using a Delphi methodology, the Galician Society of Intensive Care Medicine and Coronary Units (SOGAMIUC) has reached a consensus on a set of recommendations covering structure, clinical organization, continuous care, specialized programs, and staffing requirements in ICUs. These recommendations aim to optimize continuity of care and patient safety, promote a healthy work environment, and encourage the development of advanced clinical programs. Implementation of these measures is proposed as an essential step toward improving clinical outcomes and the well-being of healthcare professionals in Intensive Care Departments.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 11","pages":"Article 502267"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425951","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 : 2025-10-01DOI: 10.1016/j.medin.2025.502208
Gökhan Tonkaz, Merve Nur Taşdemir, Mehmet Tonkaz
{"title":"Contrast media extravasation mimicking subarachnoid hemorrhage due to hypertensive encephalopathy","authors":"Gökhan Tonkaz, Merve Nur Taşdemir, Mehmet Tonkaz","doi":"10.1016/j.medin.2025.502208","DOIUrl":"10.1016/j.medin.2025.502208","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502208"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189708","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 : 2025-10-01DOI: 10.1016/j.medin.2025.502147
Cássio Mallmann , Thizá Maria Bianchi Galiotto , Michele Salibe de Oliveira , Rafael Barberena Moraes
Objective
Evaluate the incidence of hypotension during the weaning phase of vasopressors.
Design
A single-center, open-label randomized clinical trial between May and December 2022.
Setting
a tertiary care academic medical center.
Patients
91 adult patients over 18 years of age with septic shock (according to Sepsis-3).
Intervention
Patients were divided into two groups: initial reduction of norepinephrine or initial reduction of vasopressin.
Main variables of interest
The primary outcome was the incidence of hypotension within the first 24 h after reducing vasopressors. Additionally, the clinical impact of this hypotension was assessed through mortality, length of hospital stay, duration of vasopressor use, incidence of arrhythmias, and prevalence of hemodialysis.
Results
Out of a total of 91 patients, 78 were included in the analysis: 39 in the norepinephrine group and 39 in the vasopressin group. Despite a numerically significant difference in the incidence of hypotension between the groups (norepinephrine 43.6%, vasopressin 25.6%), there was no statistical difference (p = 0.153, relative risk = 1.7, 95% confidence interval: 0.9–3.2). In this sample, vasopressin withdrawal was predominantly titrated. There were no differences between the groups in terms of the evaluated clinical outcomes.
Conclusion
No differences were detected in the incidence of hypotension when weaning was initiated with norepinephrine or vasopressin, although it was non significantly higher in norepinephrine group. In our sample, vasopressin withdrawal was titrated, which differs from North American practice. Brazilian Clinical Trials Registry (REBEC: RBR-10smbw65). ClinicalTrials.gov platform (NCT 05506319).
{"title":"Reduction of norepinephrine versus vasopressin in the stabilization phase of septic shock: RENOVA clinical trial","authors":"Cássio Mallmann , Thizá Maria Bianchi Galiotto , Michele Salibe de Oliveira , Rafael Barberena Moraes","doi":"10.1016/j.medin.2025.502147","DOIUrl":"10.1016/j.medin.2025.502147","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the incidence of hypotension during the weaning phase of vasopressors.</div></div><div><h3>Design</h3><div>A single-center, open-label randomized clinical trial between May and December 2022.</div></div><div><h3>Setting</h3><div>a tertiary care academic medical center.</div></div><div><h3>Patients</h3><div>91 adult patients over 18 years of age with septic shock (according to Sepsis-3).</div></div><div><h3>Intervention</h3><div>Patients were divided into two groups: initial reduction of norepinephrine or initial reduction of vasopressin.</div></div><div><h3>Main variables of interest</h3><div>The primary outcome was the incidence of hypotension within the first 24 h after reducing vasopressors. Additionally, the clinical impact of this hypotension was assessed through mortality, length of hospital stay, duration of vasopressor use, incidence of arrhythmias, and prevalence of hemodialysis.</div></div><div><h3>Results</h3><div>Out of a total of 91 patients, 78 were included in the analysis: 39 in the norepinephrine group and 39 in the vasopressin group. Despite a numerically significant difference in the incidence of hypotension between the groups (norepinephrine 43.6%, vasopressin 25.6%), there was no statistical difference (<em>p</em> = 0.153, relative risk = 1.7, 95% confidence interval: 0.9–3.2). In this sample, vasopressin withdrawal was predominantly titrated. There were no differences between the groups in terms of the evaluated clinical outcomes.</div></div><div><h3>Conclusion</h3><div>No differences were detected in the incidence of hypotension when weaning was initiated with norepinephrine or vasopressin, although it was non significantly higher in norepinephrine group. In our sample, vasopressin withdrawal was titrated, which differs from North American practice. Brazilian Clinical Trials Registry (REBEC: RBR-10smbw65). ClinicalTrials.gov platform (NCT 05506319).</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502147"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189701","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 : 2025-10-01DOI: 10.1016/j.medin.2024.502137
Ghali Ballout , Marta Magaldi Mendaña , Bartomeu Ramis Bou , Cristian Torres Quevedo , Adriana Capdevila Freixas , Silvia Moreno-Jurico , Enrique Jesús Carrero Cardenal , Jaime Fontanals Dotras , Comisión a la Atención a la Parada Cardiorrespiratoria del Hospital Clínic de Barcelona
Objective
To analyze whether the characteristics of the patients treated by the in-hospital cardiorespiratory arrest team, IHCA and cardiopulmonary resuscitation (CPR) were different in the period before the COVID-19 compared to the pandemic period; also analyzing the differences between COVID+ and COVID− patients.
Design
Observational and retrospective study from January 1st, 2018, to December 31st, 2021.
Setting
Tertiary hospital.
Patients
All adult patients over 18 years old requiring attention from the IHCA response team.
Interventions
CPR maneuvers according to the advanced life support guidelines of the European Resuscitation Council published in 2015, as well as the modifications made in the COVID era (2020).
Main variables
Demographic and epidemiological data, activations of the IHCA response team, CA data, hospital and intensive care unit (ICU) length of stay, survival and neurological outcome at hospital discharge.
Results
A total of 368 patients were analyzed: 173 in the pre-pandemic group and 195 in the pandemic group. The neurological outcome was better in the pre-pandemic group, and COVID+ patients had a longer ICU length of stay. However, no differences in the response time of the CPR team or in CPR duration were found, nor in immediate survival or at hospital discharge, between both groups or between COVID+ and COVID− patients.
Conclusions
Changes in CPR care protocols due to the COVID-19 pandemia did not seem to affect response times from IHCA team neither immediate nor discharge survival.
{"title":"Impacto de la COVID-19 en las activaciones del equipo de parada cardiorrespiratoria intrahospitalaria: estudio retrospectivo","authors":"Ghali Ballout , Marta Magaldi Mendaña , Bartomeu Ramis Bou , Cristian Torres Quevedo , Adriana Capdevila Freixas , Silvia Moreno-Jurico , Enrique Jesús Carrero Cardenal , Jaime Fontanals Dotras , Comisión a la Atención a la Parada Cardiorrespiratoria del Hospital Clínic de Barcelona","doi":"10.1016/j.medin.2024.502137","DOIUrl":"10.1016/j.medin.2024.502137","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze whether the characteristics of the patients treated by the in-hospital cardiorespiratory arrest team, IHCA and cardiopulmonary resuscitation (CPR) were different in the period before the COVID-19 compared to the pandemic period; also analyzing the differences between COVID+ and COVID− patients.</div></div><div><h3>Design</h3><div>Observational and retrospective study from January 1st, 2018, to December 31st, 2021.</div></div><div><h3>Setting</h3><div>Tertiary hospital.</div></div><div><h3>Patients</h3><div>All adult patients over 18<!--> <!-->years old requiring attention from the IHCA response team.</div></div><div><h3>Interventions</h3><div>CPR maneuvers according to the advanced life support guidelines of the European Resuscitation Council published in 2015, as well as the modifications made in the COVID era (2020).</div></div><div><h3>Main variables</h3><div>Demographic and epidemiological data, activations of the IHCA response team, CA data, hospital and intensive care unit (ICU) length of stay, survival and neurological outcome at hospital discharge.</div></div><div><h3>Results</h3><div>A total of 368 patients were analyzed: 173 in the pre-pandemic group and 195 in the pandemic group. The neurological outcome was better in the pre-pandemic group, and COVID+ patients had a longer ICU length of stay. However, no differences in the response time of the CPR team or in CPR duration were found, nor in immediate survival or at hospital discharge, between both groups or between COVID+ and COVID− patients.</div></div><div><h3>Conclusions</h3><div>Changes in CPR care protocols due to the COVID-19 pandemia did not seem to affect response times from IHCA team neither immediate nor discharge survival.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502137"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189642","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 : 2025-10-01DOI: 10.1016/j.medin.2025.502145
Yusong Ye , Shu Huang , Xiaohong Wang , Wensen Ren , Xiaomin Shi , Sha Liu , Wei Zhang , Lei Shi , Muhan Lü , Xiaowei Tang
Objective
This study evaluates the predictive value of the lactate/albumin ratio (LAR) for all-cause mortality in cirrhosis patients.
Design
Retrospective observational study.
Setting
Intensive care unit (ICU).
Patients or participants
626 first-time ICU-admitted cirrhosis patients in the USA (MIMIC-IV v2.2).
Interventions
None.
Main variables of interest
LAR index, 28-day, and 90-day all-cause mortality.
Results
Of 626 patients (60.86% male), 27.80% and 39.14% died within 28 and 90 days, respectively. Multivariate Cox analysis showed a significant association between higher LAR and mortality. Adjusted for confounders, elevated LAR increased the 28-day mortality risk [HR: 1.31 (1.21–1.42), P < 0.001]. A restricted cubic spline analysis revealed non-linear relationships between LAR and mortality. For 28-day mortality, the inflection point was 1.583: below this, HR was 2.29 (95% CI: 1.61–3.27, P < 0.001); above, HR was 1.16 (95% CI: 1.02–1.31, P = 0.021; P = 0.002). For 90-day mortality, the inflection point was 1.423: below, HR was 1.60 (95% CI: 1.04–2.47, P = 0.033); above, HR was 0.94 (95% CI: 0.75–1.16, P = 0.542; P = 0.012).
Conclusions
LAR predicts 28-day and 90-day mortality with a segmented effect. An LAR ≥1.583 signals high 28-day mortality risk, necessitating intensified monitoring and potential ICU admission. For 90-day mortality, LAR near 1.423 serves as an early warning for high-risk patients and guides interventions. Continuous LAR monitoring aids management, but prospective studies are needed to confirm clinical utility.
目的探讨乳酸/白蛋白比值（LAR）对肝硬化患者全因死亡率的预测价值。设计回顾性观察性研究。重症监护病房（ICU）。患者或参与者：美国626例首次入住icu的肝硬化患者（MIMIC-IV v2.2）。主要变量为interestLAR指数、28天全因死亡率、90天全因死亡率。结果626例患者（男性60.86%）中，28天内死亡占27.80%，90天内死亡占39.14%。多变量Cox分析显示，较高的LAR与死亡率之间存在显著关联。调整混杂因素后，LAR升高增加了28天死亡风险[HR: 1.31 (1.21-1.42), P <； 0.001]。限制三次样条分析显示LAR与死亡率之间存在非线性关系。28天死亡率的拐点为1.583，低于该拐点的死亡率为2.29 (95% CI: 1.61-3.27, P <； 0.001)；以上,人力资源是1.16(95%置信区间:1.02—-1.31,P = 0.021;P = 0.002)。90天死亡率的拐点为1.423，小于90天的死亡率为1.60 (95% CI: 1.04 ~ 2.47, P = 0.033)；以上,人力资源是0.94(95%置信区间:0.75—-1.16,P = 0.542;P = 0.012)。结论slar预测28天和90天死亡率具有分段效应。LAR≥1.583表明28天死亡风险高，需要加强监测并可能进入ICU。对于90天死亡率，接近1.423的LAR可作为高危患者的早期预警并指导干预措施。持续的LAR监测有助于管理，但需要前瞻性研究来证实临床应用。
{"title":"Association between lactate-to-albumin ratio and all-cause mortality in cirrhosis patients: Analysis of the MIMIC-IV database","authors":"Yusong Ye , Shu Huang , Xiaohong Wang , Wensen Ren , Xiaomin Shi , Sha Liu , Wei Zhang , Lei Shi , Muhan Lü , Xiaowei Tang","doi":"10.1016/j.medin.2025.502145","DOIUrl":"10.1016/j.medin.2025.502145","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the predictive value of the lactate/albumin ratio (LAR) for all-cause mortality in cirrhosis 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>626 first-time ICU-admitted cirrhosis patients in the USA (MIMIC-IV v2.2).</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main variables of interest</h3><div>LAR index, 28-day, and 90-day all-cause mortality.</div></div><div><h3>Results</h3><div>Of 626 patients (60.86% male), 27.80% and 39.14% died within 28 and 90 days, respectively. Multivariate Cox analysis showed a significant association between higher LAR and mortality. Adjusted for confounders, elevated LAR increased the 28-day mortality risk [HR: 1.31 (1.21–1.42), P < 0.001]. A restricted cubic spline analysis revealed non-linear relationships between LAR and mortality. For 28-day mortality, the inflection point was 1.583: below this, HR was 2.29 (95% CI: 1.61–3.27, P < 0.001); above, HR was 1.16 (95% CI: 1.02–1.31, P = 0.021; P = 0.002). For 90-day mortality, the inflection point was 1.423: below, HR was 1.60 (95% CI: 1.04–2.47, P = 0.033); above, HR was 0.94 (95% CI: 0.75–1.16, P = 0.542; P = 0.012).</div></div><div><h3>Conclusions</h3><div>LAR predicts 28-day and 90-day mortality with a segmented effect. An LAR ≥1.583 signals high 28-day mortality risk, necessitating intensified monitoring and potential ICU admission. For 90-day mortality, LAR near 1.423 serves as an early warning for high-risk patients and guides interventions. Continuous LAR monitoring aids management, but prospective studies are needed to confirm clinical utility.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502145"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189643","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 : 2025-10-01DOI: 10.1016/j.medin.2025.502256
Amilcar Tinoco-Solórzano , Adrian Avila-Hilari , Manuel Luis Avellanas-Chavala , Felipe de Jesús Montelongo , Jorge Vélez-Páez , Víctor Nieto Estrada , Antonio Viruez Soto , Daniel Molano Franco , Eduardo Castelo Tamayo , Ignacio Granda Luna , Alfonso Salazar Mendoza , Luis Mamani Cruz , Jonathan Galindo Ayala , Pablo Vásquez-Hoyos , Fausto Maldonado Coronel , Roger Huanca Payehuanca , Jorge Rosendo Sánchez Medina
The Expert Committee on Critical Care Medicine at altitude of the Pan American and Iberian Federation of Critical Care Medicine and Intensive Care detected a lack of terms defining this critical care medicine, as well as a lack of standardization in the approach to these patients. These shortcomings can lead to errors in management, for example, in critically ill patients at risk of death who require oxygen therapy, whether invasive or non-invasively.
The objective of the expert committee was to develop an international consensus that would standardize terminology and establish key definitions and recommendations for the care of critically ill patients at altitude. This document includes five important definitions, four recommendations related to the management of acute respiratory failure at altitude, and a series of considerations for future research. It also establishes specific criteria that differentiate it from the traditional approach used at sea level.
{"title":"Definiciones y recomendaciones de consenso sobre la medicina crítica en la altitud del Comité de Expertos de Medicina Crítica en la altitud de la Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva","authors":"Amilcar Tinoco-Solórzano , Adrian Avila-Hilari , Manuel Luis Avellanas-Chavala , Felipe de Jesús Montelongo , Jorge Vélez-Páez , Víctor Nieto Estrada , Antonio Viruez Soto , Daniel Molano Franco , Eduardo Castelo Tamayo , Ignacio Granda Luna , Alfonso Salazar Mendoza , Luis Mamani Cruz , Jonathan Galindo Ayala , Pablo Vásquez-Hoyos , Fausto Maldonado Coronel , Roger Huanca Payehuanca , Jorge Rosendo Sánchez Medina","doi":"10.1016/j.medin.2025.502256","DOIUrl":"10.1016/j.medin.2025.502256","url":null,"abstract":"<div><div>The Expert Committee on Critical Care Medicine at altitude of the Pan American and Iberian Federation of Critical Care Medicine and Intensive Care detected a lack of terms defining this critical care medicine, as well as a lack of standardization in the approach to these patients. These shortcomings can lead to errors in management, for example, in critically ill patients at risk of death who require oxygen therapy, whether invasive or non-invasively.</div><div>The objective of the expert committee was to develop an international consensus that would standardize terminology and establish key definitions and recommendations for the care of critically ill patients at altitude. This document includes five important definitions, four recommendations related to the management of acute respiratory failure at altitude, and a series of considerations for future research. It also establishes specific criteria that differentiate it from the traditional approach used at sea level.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502256"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189703","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 : 2025-10-01DOI: 10.1016/j.medin.2025.502215
Marta Bauça Socias , Dolly Andrea Caicedo , Eva Benveniste-Pérez , Georgina de la Rosa Loppacher , Eva Montané
{"title":"Hypernatremia and renal dysfunction after sevoflurane sedation in the intensive care unit: Three case reports","authors":"Marta Bauça Socias , Dolly Andrea Caicedo , Eva Benveniste-Pérez , Georgina de la Rosa Loppacher , Eva Montané","doi":"10.1016/j.medin.2025.502215","DOIUrl":"10.1016/j.medin.2025.502215","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502215"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189706","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 : 2025-10-01DOI: 10.1016/j.medin.2025.502177
Ruben Martín-Latorre, Laura de Rivas-Alcover, Àngela Poquet-Poquet
{"title":"Ventilación con liberación de presión en la vía aérea y membrana de oxigenación extracorpórea (ECMO) con configuración veno-venosa","authors":"Ruben Martín-Latorre, Laura de Rivas-Alcover, Àngela Poquet-Poquet","doi":"10.1016/j.medin.2025.502177","DOIUrl":"10.1016/j.medin.2025.502177","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502177"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189707","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 : 2025-10-01DOI: 10.1016/j.medin.2025.502146
Andrés Carrillo-Alcaraz , Miguel Guia , Laura Lopez-Gomez , Pablo Bayoumy , Aurea Higon-Cañigral , Elena Carrasco González , Pilar Tornero Yepez , Juan Miguel Sánchez-Nieto
Objective
The purpose of this study was to analyze the differences in the effectiveness and complications of CPAP versus non-invasive ventilation on bilevel positive airway pressure (BiPAP) in the treatment of COVID-19 associated acute respiratory failure (ARF).
Design
Retrospective observational study.
Setting
ICU.
Patients
All COVID-19 patients, admitted to an ICU between March 2020 and February 2023, who required CPAP or BiPAP were analyzed.
429 patients were analyzed, of whom 328 (76.5%) initially received CPAP and 101 (23.5%) BiPAP. Initial respiratory rate was 30 ± 8 in the CPAP group and 34 ± 9 in BiPAP (p < 0.001), while PaO2/FiO2 was 120 ± 26 and 111 ± 24 mmHg (p = 0.001), respectively. The most frequent complication related to the device was claustrophobia/discomfort, 23.2% in CPAP and 25.7% in BiPAP (p = 0.596), while the most frequent complications not related to the device were severe ARDS, 58.6% and 70.1% (p = 0.044), and hyperglycemia, 44.5% and 37.6%, respectively (p = 0.221). After adjusting by propensity score matched analysis, neither failure of the device (OR 1.37, CI 95% 0.72–2.62) nor in-hospital mortality (OR 1.57, CI 95% 0.73–3.42) differed between both groups.
Conclusions
Either non-invasive ventilatory device failure or mortality rate differed in patients initially treated with CPAP versus BiPAP.
{"title":"Comparison of non-invasive ventilation on bilevel pressure mode and CPAP in the treatment of COVID-19 related acute respiratory failure. A propensity score–matched analysis","authors":"Andrés Carrillo-Alcaraz , Miguel Guia , Laura Lopez-Gomez , Pablo Bayoumy , Aurea Higon-Cañigral , Elena Carrasco González , Pilar Tornero Yepez , Juan Miguel Sánchez-Nieto","doi":"10.1016/j.medin.2025.502146","DOIUrl":"10.1016/j.medin.2025.502146","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to analyze the differences in the effectiveness and complications of CPAP versus non-invasive ventilation on bilevel positive airway pressure (BiPAP) in the treatment of COVID-19 associated acute respiratory failure (ARF).</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Setting</h3><div>ICU.</div></div><div><h3>Patients</h3><div>All COVID-19 patients, admitted to an ICU between March 2020 and February 2023, who required CPAP or BiPAP were analyzed.</div></div><div><h3>Interventions</h3><div>Use of CPAP or BiPAP in COVID-19 associated ARF.</div></div><div><h3>Main variables of interest</h3><div>Initial clinical variables, CPAP and BiPAP failure rate, complications, in-hospital mortality.</div></div><div><h3>Results</h3><div>429 patients were analyzed, of whom 328 (76.5%) initially received CPAP and 101 (23.5%) BiPAP. Initial respiratory rate was 30 ± 8 in the CPAP group and 34 ± 9 in BiPAP (p < 0.001), while PaO<sub>2</sub>/FiO<sub>2</sub> was 120 ± 26 and 111 ± 24 mmHg (p = 0.001), respectively. The most frequent complication related to the device was claustrophobia/discomfort, 23.2% in CPAP and 25.7% in BiPAP (p = 0.596), while the most frequent complications not related to the device were severe ARDS, 58.6% and 70.1% (p = 0.044), and hyperglycemia, 44.5% and 37.6%, respectively (p = 0.221). After adjusting by propensity score matched analysis, neither failure of the device (OR 1.37, CI 95% 0.72–2.62) nor in-hospital mortality (OR 1.57, CI 95% 0.73–3.42) differed between both groups.</div></div><div><h3>Conclusions</h3><div>Either non-invasive ventilatory device failure or mortality rate differed in patients initially treated with CPAP versus BiPAP.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 10","pages":"Article 502146"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189700","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 : 2025-10-01DOI: 10.1016/j.medin.2025.502201
Marina Busico, Fernando Villarejo
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