Medicina intensiva最新文献

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Guided reversal of dabigatran in massive hemorrhagic shock 大面积失血性休克患者在达比加群引导下逆转治疗：病例报告。

Medicina intensiva

Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.10.002

Manuel Fernández Caro , Manuel Casado Méndez , Francisco Javier Rodríguez Martorell , Antonio Manuel Puppo Moreno

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Removal of giant bronchial clot with cryoadhesion probe 用低温粘附探针移除巨大的支气管血栓。

Medicina intensiva

Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.07.012

Mónica García Simón, Cristina Sanchís Piqueras, Georgia García Fernández

引用次数: 0

Current perspectives on the use of artificial intelligence in critical patient safety 人工智能在危重病人安全中的应用现状。

Medicina intensiva

Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.04.002

Jesús Abelardo Barea Mendoza , Marcos Valiente Fernandez , Alex Pardo Fernandez , Josep Gómez Álvarez

Intensive Care Units (ICUs) have undergone enhancements in patient safety, and artificial intelligence (AI) emerges as a disruptive technology offering novel opportunities. While the published evidence is limited and presents methodological issues, certain areas show promise, such as decision support systems, detection of adverse events, and prescription error identification. The application of AI in safety may pursue predictive or diagnostic objectives. Implementing AI-based systems necessitates procedures to ensure secure assistance, addressing challenges including trust in such systems, biases, data quality, scalability, and ethical and confidentiality considerations.

The development and application of AI demand thorough testing, encompassing retrospective data assessments, real-time validation with prospective cohorts, and efficacy demonstration in clinical trials. Algorithmic transparency and explainability are essential, with active involvement of clinical professionals being crucial in the implementation process.

重症监护病房（ICU）的患者安全得到了加强，而人工智能（AI）作为一种颠覆性技术的出现则提供了新的机遇。虽然已发表的证据有限，且存在方法论问题，但某些领域仍大有可为，如决策支持系统、不良事件检测和处方错误识别。人工智能在安全领域的应用可以实现预测或诊断目标。要实施基于人工智能的系统，就必须制定确保安全协助的程序，应对包括对此类系统的信任、偏差、数据质量、可扩展性以及道德和保密考虑在内的挑战。人工智能的开发和应用需要全面的测试，包括回顾性数据评估、前瞻性队列的实时验证以及临床试验中的疗效展示。算法的透明度和可解释性至关重要，临床专业人员的积极参与对实施过程至关重要。

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引用次数: 0

Correlation and concordance of HACOR and IROX scales in patients with COVID-19 pneumonia who received non-invasive ventilation in two intensive care units 在两个重症监护病房接受无创通气治疗的 COVID-19 肺炎患者的 HACOR 和 IROX 量表的相关性和一致性。

Medicina intensiva

Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.11.007

Alberto Belenguer-Muncharaz , Irina Hermosilla-Semikina , Francisco Bernal-Julián , Héctor Hernández-Garcés , Lluís Tormo-Rodriguez , Estefanía Granero-Gasamans

引用次数: 0

Technological innovation in critical care and limits of the life.

Medicina intensiva

Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2025.502153

Esteban Fernández-Hinojosa, María Adriaensens Pérez, José Cayetano Naranjo Jarillo

引用次数: 0

An unexpected foramen ovale 意外的卵圆孔

Medicina intensiva

Pub Date : 2025-03-01 DOI: 10.1016/j.medine.2024.06.017

Pablo Carrión Montaner, Mario Sutil-Vega, Jordi Sans Roselló

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]

Medicina intensiva

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)

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

Medicina intensiva

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

引用次数: 0

Videolaryngoscopy vs. direct laryngoscopy in orotracheal intubation in obese critical patients: Systematic review and meta-analysis.

Medicina intensiva

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.

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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。

Medicina intensiva

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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