Medicina intensiva最新文献

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Medicina intensiva

Pub Date : 2026-01-01

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Medicina intensiva

Pub Date : 2026-01-01

引用次数: 0

Medicina intensiva

Pub Date : 2026-01-01

引用次数: 0

Medicina intensiva

Pub Date : 2026-01-01

引用次数: 0

Medicina intensiva

Pub Date : 2026-01-01

引用次数: 0

Medicina intensiva

Pub Date : 2026-01-01

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Accidental cannulation of the aortic arch with a central venous catheter. 中心静脉导管意外插入主动脉弓。

Medicina intensiva

Pub Date : 2025-12-26 DOI: 10.1016/j.medine.2025.502352

Antonio Padilla-Serrano, José Miguel Pérez Villares, Antonio Cárdenas Cruz

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Coma due to tension pneumocephalus in the posterior fossae. 后窝紧张性脑气致昏迷。

Medicina intensiva

Pub Date : 2025-12-26 DOI: 10.1016/j.medine.2025.502348

Luis Patricio Maskin, Florencia A Cabañuz, Federico Rodriguez Lucci

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Association between time to weaning from mechanical ventilation and presence of physical and mental health disabilities in survivors of critical illness: a multicenter prospective cohort study. 危重疾病幸存者机械通气时间与身心健康障碍之间的关系：一项多中心前瞻性队列研究

Medicina intensiva

Pub Date : 2025-12-24 DOI: 10.1016/j.medine.2025.502360

Bruna Bampi Valer, Cassiano Teixeira, Regis Goulart Rosa, Daniel Sganzerla, Gilberto Friedman

Objective: To evaluate the association between weaning time from invasive mechanical ventilation (IMV) and occurrence of physical and mental health disabilities in ICU survivors.

Design: Prospective, multicenter cohort study.

Setting: 10 Brazilian ICUs (May 2014-December 2018).

Patients or participants: Adult survivors with an ICU stay >72 h for emergency medical and surgical admissions or >120 h for elective surgical admissions and who used IMV. Classification into 3 groups: simple, difficult, and prolonged weaning.

Interventions: Follow-up through structured telephone interviews MAIN VARIABLES OF INTEREST: Outcomes included moderate to severe functional physical dependence (Barthel Index score ≤75) at 3 months post-ICU discharge, symptoms of anxiety and depression (Hospital Anxiety and Depression Symptom Scale scores >7 in the anxiety or depression subdomains) and post-traumatic stress (Impact Event Scale-6 > 9) at 6 months post-ICU discharge and all-cause post-ICU mortality (categorized as early [0-30 days] and late [>30 days]).

Results: Of the 804 patients, 492 (61.2%) presented simple weaning, 60 (7.5%) difficult weaning and 252 (31.3%) prolonged weaning. In total, 670 (83.3%) and 630 (78.3%) patients were alive at 3 and 6 months. Early post-ICU mortality (13.1% vs. 7.1%; p = 0.01) and 3-month physical dependence (55.9% vs. 37.6%; p < 0.001) were both higher in the prolonged weaning group than in the simple weaning group. At 6 months, difficult weaning patients were more anxious (55% vs 23.6% vs 21.4%; p = 0.02) and depressed (50% vs 24.7% vs 17.1%; p = 0.04) compared to simple and prolonged weaning groups, respectively, with no differences regarding post-traumatic stress.

Conclusion: ICU survivors who experienced prolonged weaning had higher early post-ICU mortality and greater rates of moderate to severe physical functional dependence at three months after discharge, whereas those with difficult weaning showed higher rates of anxiety and depression at six months.

目的：探讨ICU患者有创机械通气（IMV）脱机时间与身心健康障碍发生的关系。设计：前瞻性、多中心队列研究。设置：10个巴西icu（2014年5月- 2018年12月）。患者或参与者：使用IMV的ICU成年幸存者，急诊内科和外科住院患者住院时间为>72小时，择期外科住院患者住院时间为>120小时。分为简单断奶、困难断奶和延长断奶3组。干预措施：通过结构化电话访谈进行随访结果包括icu出院后3个月中度至重度功能性身体依赖（Barthel指数评分≤75），icu出院后6个月出现焦虑和抑郁症状（医院焦虑和抑郁症状量表在焦虑或抑郁子域评分为bbb7）和创伤后应激（影响事件量表评分为bbb9），以及全因icu后死亡率（分为早期[0-30天]和晚期[>30天]）。结果：804例患者中，简单脱机492例（61.2%），困难脱机60例（7.5%），延长脱机252例（31.3%）。总共670例（83.3%）和630例（78.3%）患者在3个月和6个月时存活。延长脱机组icu后早期死亡率（13.1%比7.1%,p = 0.01）和3个月身体依赖（55.9%比37.6%,p < 0.001）均高于简单脱机组。在6个月时，与简单断奶组和延长断奶组相比，困难断奶组患者分别更焦虑（55% vs 23.6% vs 21.4%, p = 0.02）和抑郁（50% vs 24.7% vs 17.1%, p = 0.04），在创伤后应激方面没有差异。结论：在出院后3个月，经历过长时间脱机的ICU幸存者有更高的早期ICU后死亡率和更高的中度至重度身体功能依赖率，而脱机困难的患者在6个月时表现出更高的焦虑和抑郁率。

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Disseminated nocardiosis caused by Nocardia asteroides resistant to trimethoprim-sulfamethoxazole. 由耐甲氧苄啶-磺胺甲恶唑诺卡菌引起的播散性诺卡菌病。

Medicina intensiva

Pub Date : 2025-12-24 DOI: 10.1016/j.medine.2025.502315

Irene Barrero García, Cristina León Moya, Nerissa Álvarez Chicote, José Garnacho Montero, José López Barba, María Luisa Cantón Bulnes

引用次数: 0

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