Pub Date : 2025-09-01DOI: 10.1016/j.medin.2025.502253
Juan-Jose Beunza
{"title":"El intensivista debe dirigir la implementación de la inteligencia artificial en la UCI","authors":"Juan-Jose Beunza","doi":"10.1016/j.medin.2025.502253","DOIUrl":"10.1016/j.medin.2025.502253","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502253"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921128","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 : 2025-09-01DOI: 10.1016/j.medin.2025.502142
Laura Del Campo-Albendea , Ana García De La Santa Viñuela , Óscar Peñuelas , José Ignacio Pijoan Zubizarreta , Khalid Saeed Khan , Alfonso Muriel , Javier Zamora
Intensive care units (ICUs) rely in many instances on observational research and often encounter difficulties in establishing cause-and-effect relationships. After conducting a thorough search focused on ICU observational studies, this review analysed the causal language and evaluated the quality of reporting of the methodologies employed. The causal was assessed by analysing the words linking exposure to outcomes in the title and main objective. The quality of the reporting of the key methodological aspects related to causal inference was based on STROBE and ROBINS-I tools. We identified 139 articles, with 87 (63%) and 82 (59%) studies having non-causal language in their title and main objective, respectively. Among the total, 49 (35%) articles directly addressed causality. The review found vague causal language in observational ICU research and highlighted the need for better adherence to reporting guidelines for improved causal analysis and inference.
{"title":"Quality of causality assessment among observational studies in intensive care: A methodological review","authors":"Laura Del Campo-Albendea , Ana García De La Santa Viñuela , Óscar Peñuelas , José Ignacio Pijoan Zubizarreta , Khalid Saeed Khan , Alfonso Muriel , Javier Zamora","doi":"10.1016/j.medin.2025.502142","DOIUrl":"10.1016/j.medin.2025.502142","url":null,"abstract":"<div><div>Intensive care units (ICUs) rely in many instances on observational research and often encounter difficulties in establishing cause-and-effect relationships. After conducting a thorough search focused on ICU observational studies, this review analysed the causal language and evaluated the quality of reporting of the methodologies employed. The causal was assessed by analysing the words linking exposure to outcomes in the title and main objective. The quality of the reporting of the key methodological aspects related to causal inference was based on STROBE and ROBINS-I tools. We identified 139 articles, with 87 (63%) and 82 (59%) studies having non-causal language in their title and main objective, respectively. Among the total, 49 (35%) articles directly addressed causality. The review found vague causal language in observational ICU research and highlighted the need for better adherence to reporting guidelines for improved causal analysis and inference.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502142"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921204","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 : 2025-09-01DOI: 10.1016/j.medin.2025.502149
Gustavo Adolfo Vásquez-Tirado , Edinson Dante Meregildo-Rodríguez , Claudia Vanessa Quispe-Castañeda , María Cuadra-Campos , Wilson Marcial Guzmán-Aguilar , Percy Hernán Abanto-Montalván , Hugo Alva-Guarniz , Leslie Jacqueline Liñán-Díaz , Luis Ángel Rodríguez-Chávez
Objective
To determine whether the Reverse Shock Index multiplied by the Glasgow Coma Scale (rSIG) is a predictor of in-hospital mortality in patients with traumatic brain injury (TBI).
Design
This is a systematic review and meta-analysis.
Setting
A comprehensive search was conducted in five databases for studies published up to May 22, 2024, using a PECO strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis.
Participants
The participants of the included primary studies.
Interventions
Patients with a low rSIG as a predictor of in-hospital mortality in TBI.
Main variables of interest
rSIG, in-hospital mortality, TBI.
Results
Our meta-analysis evaluated a total of eight observational studies encompassing 430,000 patients with TBI, observing 6,417 deaths (15%). After performing a sensitivity analysis, we found that patients with TBI and a low value of the reverse shock index multiplied by the Glasgow Coma Scale (rSIG) had a 24% higher risk of death (OR 1.24; 95% CI 1.12–1.38; I²: 96%). Furthermore, rSIG values were significantly higher in survivors compared to those who died (MD 7.72; 95% CI 1.86–13.58; I²: 99%).
目的探讨逆休克指数乘以格拉斯哥昏迷量表（rSIG）是否可以预测外伤性脑损伤（TBI）患者的住院死亡率。这是一项系统回顾和荟萃分析。使用PECO策略，在5个数据库中对截至2024年5月22日发表的研究进行了全面检索。8项研究被确定用于定量分析，并纳入我们的荟萃分析。参与者纳入的主要研究的参与者。干预措施：低rSIG患者作为TBI住院死亡率的预测因子。感兴趣的主要变量：sig，住院死亡率，TBI。我们的荟萃分析共评估了8项观察性研究，包括430,000例TBI患者，观察到6,417例死亡（15%）。在进行敏感性分析后，我们发现，与格拉斯哥昏迷量表（rSIG）相比，逆行休克指数较低的TBI患者的死亡风险高出24% （OR 1.24; 95% CI 1.12-1.38; I²：96%）。此外，幸存者的rSIG值明显高于死亡患者（MD 7.72; 95% CI 1.86-13.58; I²：99%）。
{"title":"Reverse shock index multiplied by Glasgow coma scale (rSIG) to predict mortality in traumatic brain injury: systematic review and meta-analysis","authors":"Gustavo Adolfo Vásquez-Tirado , Edinson Dante Meregildo-Rodríguez , Claudia Vanessa Quispe-Castañeda , María Cuadra-Campos , Wilson Marcial Guzmán-Aguilar , Percy Hernán Abanto-Montalván , Hugo Alva-Guarniz , Leslie Jacqueline Liñán-Díaz , Luis Ángel Rodríguez-Chávez","doi":"10.1016/j.medin.2025.502149","DOIUrl":"10.1016/j.medin.2025.502149","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether the Reverse Shock Index multiplied by the Glasgow Coma Scale (rSIG) is a predictor of in-hospital mortality in patients with traumatic brain injury (TBI).</div></div><div><h3>Design</h3><div>This is a systematic review and meta-analysis.</div></div><div><h3>Setting</h3><div>A comprehensive search was conducted in five databases for studies published up to May 22, 2024, using a PECO strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis.</div></div><div><h3>Participants</h3><div>The participants of the included primary studies.</div></div><div><h3>Interventions</h3><div>Patients with a low rSIG as a predictor of in-hospital mortality in TBI.</div></div><div><h3>Main variables of interest</h3><div>rSIG, in-hospital mortality, TBI.</div></div><div><h3>Results</h3><div>Our meta-analysis evaluated a total of eight observational studies encompassing 430,000 patients with TBI, observing 6,417 deaths (15%). After performing a sensitivity analysis, we found that patients with TBI and a low value of the reverse shock index multiplied by the Glasgow Coma Scale (rSIG) had a 24% higher risk of death (OR 1.24; 95% CI 1.12–1.38; I²: 96%). Furthermore, rSIG values were significantly higher in survivors compared to those who died (MD 7.72; 95% CI 1.86–13.58; I²: 99%).</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502149"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922221","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 : 2025-09-01DOI: 10.1016/j.medin.2025.502155
Gabriel Appendino, Fernando Paziencia, Carlos Lovesio
{"title":"Monitoreo a través de tomografía por impedancia eléctrica en ECMO pediátrico","authors":"Gabriel Appendino, Fernando Paziencia, Carlos Lovesio","doi":"10.1016/j.medin.2025.502155","DOIUrl":"10.1016/j.medin.2025.502155","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 9","pages":"Article 502155"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921129","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 : 2025-08-01DOI: 10.1016/j.medin.2025.502166
Guillem Navarra-Ventura , Marta Godoy-González , Lluís Blanch , Josefina López-Aguilar , Sol Fernández-Gonzalo
{"title":"Changes in the stress hormone cortisol during intensive care unit stay as a predictor of objective cognition at discharge","authors":"Guillem Navarra-Ventura , Marta Godoy-González , Lluís Blanch , Josefina López-Aguilar , Sol Fernández-Gonzalo","doi":"10.1016/j.medin.2025.502166","DOIUrl":"10.1016/j.medin.2025.502166","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502166"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749483","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 : 2025-08-01DOI: 10.1016/j.medin.2025.502207
José María Arribas-Leal , José Miguel Rivera-Caravaca , Claudia Vicente-Andreu , Alicia Verdú-Verdú , Ángel Sornichero , Daniel Pérez-Martínez , Juan Blanco-Morillo , Francisco Gutiérrez , Marina Simón-Páez , Rubén Jara , Sergio J. Canovas-Lopez , Carlos Albacete-Moreno
Objective
To analyze our experience with extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory distress syndrome (ARDS) treatment during the COVID-19 pandemic.
Design
Retrospective, observational, single center study.
Setting
Third-level hospital in Spain.
Patients
Adult patients with COVID-19 ARDS treated with an ECMO system in our center between March 2020 and March 2023.
Interventions
Retrospective collection of variables during hospital admission and follow-up.
Main Variables of Interest
Demographic variables, clinical history, variables related to ECMO therapy, COVID-19 wave number, in-hospital mortality, adverse events, ICU and hospital length of stay, and functional status at follow-up were collected.
Results
Eighty-one patients were included. Of these, 61 patients (75%) died during hospitalization. Patients who died were older and had more comorbidities. During the second, third, and sixth waves, mortality was higher. In the multivariate analysis, the only independent predictor of mortality was age (OR 1.24 95% CI (1.027–1.5, P = 0.025). After discharge, 40% of patients had difficulties returning to normal life due to respiratory failure requiring oxygen and arthropathies.
Conclusion
In-hospital mortality increased during the pandemic. Older age was the only independent predictor of mortality. After discharge, no deaths were recorded during the first 18 months of follow-up, although 40% of surviving patients had respiratory and motor sequelae making it difficult for them to return to a normal life.
目的分析2019冠状病毒病疫情期间体外膜氧合（ECMO）治疗急性呼吸窘迫综合征（ARDS）的经验。设计回顾性、观察性、单中心研究。西班牙三级医院。2020年3月至2023年3月期间，我们中心接受ECMO系统治疗的成年COVID-19 ARDS患者。干预措施：回顾性收集住院和随访期间的变量。收集人口学变量、临床病史、ECMO治疗相关变量、COVID-19波数、住院死亡率、不良事件、ICU和住院时间、随访时功能状态。结果共纳入81例患者。其中，61例（75%）患者在住院期间死亡。死亡的患者年龄较大，有更多的合并症。在第二次、第三次和第六次浪潮中，死亡率更高。在多变量分析中，死亡率的唯一独立预测因子是年龄(OR 1.24, 95% CI （1.027-1.5, P = 0.025）。出院后，40%的患者由于呼吸衰竭需要氧气和关节病变而难以恢复正常生活。结论流感大流行期间住院死亡率上升。年龄较大是死亡率的唯一独立预测因子。出院后，在前18个月的随访中没有死亡记录，尽管40%的存活患者有呼吸和运动后遗症，使他们难以恢复正常生活。
{"title":"Experience with ECMO therapy for acute respiratory distress syndrome treatment throughout the COVID-19 pandemic","authors":"José María Arribas-Leal , José Miguel Rivera-Caravaca , Claudia Vicente-Andreu , Alicia Verdú-Verdú , Ángel Sornichero , Daniel Pérez-Martínez , Juan Blanco-Morillo , Francisco Gutiérrez , Marina Simón-Páez , Rubén Jara , Sergio J. Canovas-Lopez , Carlos Albacete-Moreno","doi":"10.1016/j.medin.2025.502207","DOIUrl":"10.1016/j.medin.2025.502207","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze our experience with extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory distress syndrome (ARDS) treatment during the COVID-19 pandemic.</div></div><div><h3>Design</h3><div>Retrospective, observational, single center study.</div></div><div><h3>Setting</h3><div>Third-level hospital in Spain.</div></div><div><h3>Patients</h3><div>Adult patients with COVID-19 ARDS treated with an ECMO system in our center between March 2020 and March 2023.</div></div><div><h3>Interventions</h3><div>Retrospective collection of variables during hospital admission and follow-up.</div></div><div><h3>Main Variables of Interest</h3><div>Demographic variables, clinical history, variables related to ECMO therapy, COVID-19 wave number, in-hospital mortality, adverse events, ICU and hospital length of stay, and functional status at follow-up were collected.</div></div><div><h3>Results</h3><div>Eighty-one patients were included. Of these, 61 patients (75%) died during hospitalization. Patients who died were older and had more comorbidities. During the second, third, and sixth waves, mortality was higher. In the multivariate analysis, the only independent predictor of mortality was age (OR 1.24 95% CI (1.027–1.5, <em>P</em> = 0.025). After discharge, 40% of patients had difficulties returning to normal life due to respiratory failure requiring oxygen and arthropathies.</div></div><div><h3>Conclusion</h3><div>In-hospital mortality increased during the pandemic. Older age was the only independent predictor of mortality. After discharge, no deaths were recorded during the first 18 months of follow-up, although 40% of surviving patients had respiratory and motor sequelae making it difficult for them to return to a normal life.</div></div>","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502207"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749976","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 : 2025-08-01DOI: 10.1016/j.medin.2025.502163
Elena Cuenca Fito , Inés Gómez-Acebo , Alejandro González Castro
{"title":"Desarrollo y validación de modelos predictivos de mortalidad en pacientes oncológicos críticos en la UCI: una necesidad urgente","authors":"Elena Cuenca Fito , Inés Gómez-Acebo , Alejandro González Castro","doi":"10.1016/j.medin.2025.502163","DOIUrl":"10.1016/j.medin.2025.502163","url":null,"abstract":"","PeriodicalId":49268,"journal":{"name":"Medicina Intensiva","volume":"49 8","pages":"Article 502163"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749973","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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