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Technological innovation in critical care and limits of the life.
Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2025.502153
Esteban Fernández-Hinojosa, María Adriaensens Pérez, José Cayetano Naranjo Jarillo
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引用次数: 0
An unexpected foramen ovale 意外的卵圆孔
Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.06.017
Pablo Carrión Montaner, Mario Sutil-Vega, Jordi Sans Roselló
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引用次数: 0
Erratum to “Practical approach to inhaled sedation in the Critically ill patient. Sedation, analgesia and Delirium Working Group (GTSAD) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC)” [Med Intensiva (Engl Ed) (2024) 467-476]
Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.11.008
Sofía Contreras , Carola Giménez-Esparza Vich , Jesús Caballero , en representación del Grupo de Trabajo de Sedación, Analgesia y Delirium (GTSAD) de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)
{"title":"Erratum to “Practical approach to inhaled sedation in the Critically ill patient. Sedation, analgesia and Delirium Working Group (GTSAD) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC)” [Med Intensiva (Engl Ed) (2024) 467-476]","authors":"Sofía Contreras , Carola Giménez-Esparza Vich , Jesús Caballero , en representación del Grupo de Trabajo de Sedación, Analgesia y Delirium (GTSAD) de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)","doi":"10.1016/j.medine.2024.11.008","DOIUrl":"10.1016/j.medine.2024.11.008","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 3","pages":"Page 190"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inhaled sedation in the ICU. Still a long road ahead 重症监护室中的吸入镇静剂。前路依然漫长
Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.11.003
Hernán Aguirre-Bermeo , Pedro D. Wendel-García , Óscar Peñuelas , Ferran Roche-Campo
{"title":"Inhaled sedation in the ICU. Still a long road ahead","authors":"Hernán Aguirre-Bermeo , Pedro D. Wendel-García , Óscar Peñuelas , Ferran Roche-Campo","doi":"10.1016/j.medine.2024.11.003","DOIUrl":"10.1016/j.medine.2024.11.003","url":null,"abstract":"","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":"49 3","pages":"Pages 184-185"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Videolaryngoscopy vs. direct laryngoscopy in orotracheal intubation in obese critical patients: Systematic review and meta-analysis.
Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2025.502168
Samuel David Gil-Bazán, Gustavo Adolfo Vásquez-Tirado, Edward Chávez-Cruzado, Edinson Dante Meregildo-Rodríguez, Claudia Vanessa Quispe-Castañeda, Wilson Marcial Guzmán-Aguilar, Leslie Jacqueline Liñán-Díaz

Objective: To determine whether the use of videolaryngoscopy (VL) is more effective than direct laryngoscopy (DL) for orotracheal intubation in obese patients.

Design: This is a systematic review and meta-analysis.

Setting: A comprehensive search was conducted in five databases for studies published up to December 26, 2023, using a PICO strategy. Fifteen studies were identified for quantitative analysis and included in our meta-analysis.

Participants: The participants of the included primary studies (obese patients).

Interventions: Orotracheal intubation with videolaryngoscopy or direct laryngoscopy.

Main variables of interest: Videolaryngoscopy, direct laryngoscopy, intubation time, first--pass success rate, minor complications.

Results: No significant differences were found in intubation time between VL and DL in obese patients (MD: -4.84; 95% CI: -13.49 to 3.80; I2: 90%). In the subgroup analysis, the Airtaq technique showed a significant difference in intubation time compared to the Macintosh technique (MD: -25.29; 95% CI: -49.17 to -1.38; I2: 95%). However, no significant differences were observed in the first--pass success rate (OR: 1.58; 95% CI: 0.77-3.23; I2: 33%) or in complications such as pain (OR: 1.15; 95% CI: 0.75-1.75; I2: 0%) and voice changes (OR: 0.76; 95% CI: 0.46-1.26; I2: 0%) between the two methods.

Conclusion: There are no significant differences in intubation time, first--pass success rate, or complications between VL and DL in obese critical patients.

{"title":"Videolaryngoscopy vs. direct laryngoscopy in orotracheal intubation in obese critical patients: Systematic review and meta-analysis.","authors":"Samuel David Gil-Bazán, Gustavo Adolfo Vásquez-Tirado, Edward Chávez-Cruzado, Edinson Dante Meregildo-Rodríguez, Claudia Vanessa Quispe-Castañeda, Wilson Marcial Guzmán-Aguilar, Leslie Jacqueline Liñán-Díaz","doi":"10.1016/j.medine.2025.502168","DOIUrl":"https://doi.org/10.1016/j.medine.2025.502168","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the use of videolaryngoscopy (VL) is more effective than direct laryngoscopy (DL) for orotracheal intubation in obese patients.</p><p><strong>Design: </strong>This is a systematic review and meta-analysis.</p><p><strong>Setting: </strong>A comprehensive search was conducted in five databases for studies published up to December 26, 2023, using a PICO strategy. Fifteen studies were identified for quantitative analysis and included in our meta-analysis.</p><p><strong>Participants: </strong>The participants of the included primary studies (obese patients).</p><p><strong>Interventions: </strong>Orotracheal intubation with videolaryngoscopy or direct laryngoscopy.</p><p><strong>Main variables of interest: </strong>Videolaryngoscopy, direct laryngoscopy, intubation time, first--pass success rate, minor complications.</p><p><strong>Results: </strong>No significant differences were found in intubation time between VL and DL in obese patients (MD: -4.84; 95% CI: -13.49 to 3.80; I<sup>2</sup>: 90%). In the subgroup analysis, the Airtaq technique showed a significant difference in intubation time compared to the Macintosh technique (MD: -25.29; 95% CI: -49.17 to -1.38; I<sup>2</sup>: 95%). However, no significant differences were observed in the first--pass success rate (OR: 1.58; 95% CI: 0.77-3.23; I<sup>2</sup>: 33%) or in complications such as pain (OR: 1.15; 95% CI: 0.75-1.75; I<sup>2</sup>: 0%) and voice changes (OR: 0.76; 95% CI: 0.46-1.26; I<sup>2</sup>: 0%) between the two methods.</p><p><strong>Conclusion: </strong>There are no significant differences in intubation time, first--pass success rate, or complications between VL and DL in obese critical patients.</p>","PeriodicalId":94139,"journal":{"name":"Medicina intensiva","volume":" ","pages":"502168"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between fluid overload and mortality and morbidity in pediatric intensive care unit 儿科重症监护室液体超负荷与死亡率和发病率之间的关系。
Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.09.001
Hilmi Bayirli , Nazan Ulgen Tekerek , Alper Koker , Oguz Dursun

Objective

The relationship between fluid overload and clinical outcomes was investigated.

Design

This study is an observational and analytic study of a retrospective cohort.

Settings

Pediatric intensive care units.

Patients or participants

Between 2019 and 2021 children who needed intensive care were included in the study.

Interventions

No intervention.

Main variable of interest

Early, peak and cumulative fluid overload were evaluated.

Results

The mortality rate was 11.7% (68/513). When fluid overloads were examined in terms of mortality, the percentage of early fluid overload was 1.86 and 3.35, the percent of peak fluid overload was 2.87 and 5.54, and the percent of cumulative fluid overload was 3.40 and 8.16, respectively, in the survivor and the non-survivor groups. After adjustment for age, severity of illness, and other potential confounders, peak (aOR = 1.15; 95%CI 1.05−1.26; p: 0.002) and cumulative (aOR = 1.10; 95%CI 1.04−1.16; p < 0.001) fluid overloads were determined as independent risk factors associated with mortality. When the cumulative fluid overload is 10% or more, a 3.9-fold increase mortality rate was calculated. It is found that the peak and cumulative fluid overload, had significant negative correlation with intensive care unit free days and ventilator free days.

Conclusions

It is found that peak and cumulative fluid overload in critically ill children were independently associated with intensive care unit mortality and morbidity.
目的研究液体超负荷与临床结果之间的关系:本研究是一项回顾性队列观察和分析研究:儿科重症监护病房:研究纳入了2019年至2021年间需要重症监护的儿童:主要关注变量评估早期、高峰期和累积性液体超负荷:死亡率为11.7%(68/513)。结果:死亡率为 11.7%(68/513),根据死亡率对体液超负荷进行评估,幸存者组和非幸存者组的早期体液超负荷百分比分别为 1.86 和 3.35,高峰期体液超负荷百分比分别为 2.87 和 5.54,累积性体液超负荷百分比分别为 3.40 和 8.16。在对年龄、病情严重程度和其他潜在混杂因素进行调整后,峰值(aOR = 1.15;95%CI 1.05-1.26;P:0.002)和累积(aOR = 1.10;95%CI 1.04-1.16;P:0.002)和峰值(aOR = 1.15;95%CI 1.05-1.26;P:0.002)均高于非幸存者组:研究发现,危重症儿童的峰值和累积性液体超负荷与重症监护室的死亡率和发病率有独立关联。
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引用次数: 0
Early blood pressure drop predicts renal function deterioration and mortality in ICU patients with liver failure: a retrospective cohort study 早期血压下降可预测重症监护病房肝功能衰竭患者的肾功能恶化和死亡率:一项回顾性队列研究。
Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.10.005
Rubing Guo , Jingjing Tong , Li Wang , Bo Yang , Liang Ma , Yongtong Cao , Wei Zhao

Objective

To investigate the association between early blood pressure drop and worsening renal function (WRF) in ICU patients with liver failure and to evaluate their clinical outcomes.

Design

Retrospective observational study.

Setting

Intensive Care Medicine.

Patients

Patients admitted to the ICU for the first time during their first hospitalization; diagnosed with liver failure according to the International Classification of Diseases, Ninth and Tenth Revision codes; and aged ≥18 years were included. Patients with a peak systolic blood pressure (SBP) drop of <0 mmHg were excluded.

Intervention

We analyzed data of ICU patients with liver failure from the Medical Information Mart for Intensive Care IV version 2.2 database. Descriptive statistics, analysis of variance, Kruskal–Wallis test, and chi-square test were employed for analysis. Multivariate linear regression models were used to assess the determinants of blood pressure decline. Cox proportional hazards and generalized additive models were used to evaluate

Main variables of interest

The relationship between blood pressure decline, WRF, and 60-day in-hospital mortality were evaluated, along with subgroup analyses.

Results

Peak SBP drop was independently associated with higher risks of WRF (P < 0.001) and 60-day in-hospital mortality (P < 0.001), even after adjusting for potential confounders, including baseline SBP. The independent risk relationship observed between peak diastolic blood pressure, mean arterial pressure drop, and the occurrence of WRF and 60-day in-hospital mortality was similar.

Conclusions

In ICU patients with liver failure, a significant early drop in blood pressure was associated with a higher incidence of WRF, increased risk of 60-day in-hospital mortality, and poorer prognoses.
目的研究ICU肝功能衰竭患者早期血压下降与肾功能恶化(WRF)之间的关系,并评估其临床结局:设计:回顾性观察研究:重症医学科:研究对象: 首次住院期间入住重症监护病房的患者;根据《国际疾病分类》第九版和第十版诊断为肝功能衰竭;年龄≥18岁。收缩压(SBP)峰值下降的患者 介入:我们分析了重症监护医学信息市场 IV 版 2.2 数据库中 ICU 肝衰患者的数据。分析采用了描述性统计、方差分析、Kruskal-Wallis 检验和卡方检验。多变量线性回归模型用于评估血压下降的决定因素。采用 Cox 比例危险模型和广义加性模型评估主要相关变量:评估血压下降、WRF 和 60 天院内死亡率之间的关系,并进行亚组分析:结果:SBP 峰值下降与 WRF 风险较高密切相关(P<0.05):在重症监护病房肝衰竭患者中,早期血压显著下降与较高的 WRF 发生率、较高的 60 天院内死亡风险和较差的预后有关。
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引用次数: 0
Analysis of frailty as a prognostic factor independent of age: A prospective observational study.
Pub Date : 2025-02-25 DOI: 10.1016/j.medine.2025.502144
Rosario Molina Lobo, Federico Gordo Vidal, Lola Prieto López, Inés Torrejón Pérez, Antonio Naharro Abellán, Irene Salinas Gabiña, Beatriz Lobo Valbuena

Objective: Analyze the effects of frailty and prefrailty in patients admitted to the ICU without age limits and to determine the factors associated with mortality.

Design: Prospective cohort.

Setting: Intensive Care Unit, Spain.

Patients: 1462 critically ill patients without age limits.

Intervention: None.

Main variables of interest: Hospital mortality and health outcomes.

Results: Patients' ages ranged from 15 to 93 years, median of 66 years. Predisposing factors independently associated with frailty and prefrailty were age older than 65 years, female sex, respiratory and renal comorbidities, longer pre-ICU stays, and weekend admission. There is a greater use of noninvasive mechanical ventilation, greater colonization by multidrug-resistant bacteria, and the development of delirium. The risk of hospital mortality was RR 4.04 (2.11-7.74; P<.001) for prefail and 5.88 (2.45-14.10; P<.001) for frail. Factors associated with in-hospital mortality in prefrail and frail were pre-ICU hospital length of stay (cutpoint 4.5 days [1.6-7.4]), greater severity on admission (SAPS3) (cutpoint 64.5 [63.6-65.4]), Glasgow Coma Scale deterioration (OR 4.14 [1.23-13.98]; P .022) and thrombocytopenia (OR 11.46 [2.21-59.42]; P .004).

Conclusions: Lower levels of frailty are most common in ICU patients and are associated with worse health outcomes. Our data suggest that frailty and pre frailty should be determined in all patients admitted to the ICU, regardless of their age.

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引用次数: 0
Neuroaspergillosis: Diagnostic in immunosuppressed patients illustrated by MRI imaging. 神经疱疹:通过核磁共振成像对免疫抑制患者进行诊断。
Pub Date : 2025-02-24 DOI: 10.1016/j.medine.2025.502151
Almudena Domínguez González, Nuria Medina Cabrera, Alejandro Hueso Mor
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引用次数: 0
Improvement in cerebral hypoperfusion by stellate ganglion block in refractory vasospasm.
Pub Date : 2025-02-24 DOI: 10.1016/j.medine.2025.502121
Luis Patricio Maskin, Federico Rodríguez Lucci
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引用次数: 0
期刊
Medicina intensiva
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