Abstract:
:Brain death has been recognized by the scientific community as the person's death, and accepted in the legislation of different countries. Brain death is defined as the irreversible ending of the functions of all the intracranial neurological structure in both the brain and brain stem. This clinical situation appears when intracranial pressure exceeds the patient's systolic blood pressure, leading to brain circulatory arrest. The most frequent are cerebral hemorrhage and cranioencephalic trauma. Clinical diagnostic must be done by doctors with expertise in neurocritical patient treatment. This diagnosis is based on a systematic, complete and extremely rigorous clinical examination that confirms a non-reactive coma, absence of brain stem reflex, and absence of spontaneous breathing. Instrumental tests may be obligatory in some cases, this depending on each country. Electroencephalogram and evoked potentials are the electrophysiological tests used. In patients treated with sedative drugs, cerebral blood flow evaluation tests, such as cerebral angiography, transcranial Doppler or 99Tc-HMPAO scintigraphy, will be used. More than 92% of the transplants performed in Spain are performed with brain death donor organs. Brain death confirmation is a high responsibility act, with medical, ethical and legal significance since it requires removal of all artificial support, or organs extraction for transplant. Extensive knowledge on its diagnostic and correct decision making avoid unnecessary use of resources and improves management of organs for transplant.
journal_name
Med Intensivajournal_title
Medicina intensivaauthors
Escudero Ddoi
10.1016/s0210-5691(09)71215-xsubject
Has Abstractpub_date
2009-05-01 00:00:00pages
185-95issue
4eissn
0210-5691issn
1578-6749pii
S0210-5691(09)71215-Xjournal_volume
33pub_type
杂志文章,评审abstract::Severe acute pancreatitis (SAP) causes local and systemic complications leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. In the last decade, nutritional support has become a key element in the treatment of SAP. Thus, specialized nutrition is indicated from a...
journal_title:Medicina intensiva
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1016/S0210-5691(11)70007-9
更新日期:2011-11-01 00:00:00
abstract::After an introduction that summarizes the new definitions and risk classification of acute kidney injury, along with the consequences on its epidemiology, available evidence in the literature is reviewed in order to compare intermittent and continuous renal replacement therapy in terms of survival, renal function reco...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/s0210-5691(09)70688-6
更新日期:2009-03-01 00:00:00
abstract::Technology and insertion techniques for cardiac temporary internal pacing have experienced a remarkable development over the last few years. Despite this fact, the procedure continues to have potentially fatal associated complications. Temporary internal pacing is indicated for the treatment of bradyarrhythmias or tac...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2014.02.006
更新日期:2014-12-01 00:00:00
abstract::The utility of using quality indicators as a tool to measure the common practice and evaluate efficacy of measures established to improve quality has been demonstrated, making it possible to identify and make known the improvements carried out. The project "Quality indicators in the critical patient" has been conducte...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(08)70899-4
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Before deciding increases in the number or capacitance of Intensive Care Units (ICUs), or the regionalization of Units, it is essential to know their present effectiveness. OBJECTIVE:To analyze the daily occupancy rate of ICUs in Catalonia (Spain) and the frequency of denied admission due to lack of capacit...
journal_title:Medicina intensiva
pub_type: 杂志文章,多中心研究
doi:10.1016/j.medin.2014.11.002
更新日期:2015-12-01 00:00:00
abstract::These recommendations are designed to be of assistance to doctors in ICUs when making first evaluations of these patients. They are mainly intended to assist with early diagnosis, risk stratification and initial treatment. The need for individualised treatment is at present one of the main objectives in the management...
journal_title:Medicina intensiva
pub_type: 共识发展会议,杂志文章,实务指引,评审
doi:10.1016/j.medin.2009.07.010
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To analyze the profile, incidence of life support therapy limitation (LSTL) and donation potential in neurocritical patients. STUDY DESIGN:A multicenter prospective study was carried out. SETTING:Nine hospitals authorized for organ harvesting for transplantation. PATIENTS:All patients consecutively admitte...
journal_title:Medicina intensiva
pub_type: 杂志文章,多中心研究
doi:10.1016/j.medin.2014.07.010
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:Hemodynamic resuscitation is considered a cornerstone of the initial treatment of septic shock. However, there is growing concern about its side effects. Our objective was to assess the relationship between fluid administration and norepinephrine infusion and the development of lung injury. DESIGN:Randomized...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2020.05.011
更新日期:2020-07-24 00:00:00
abstract::In 2004 was published the first edition of the "Surviving sepsis campaign" guidelines for the management of severe sepsis and septic shock, opening a new era in the treatment of this syndrome. The paradox is that guidelines application have produced positive results despite including in some cases treatments proven in...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2013.07.008
更新日期:2013-12-01 00:00:00
abstract::Maintaining organ viability from extraction to transplantation is crucial to ensure the function and survival of the graft. In recent years, maintaining organ viability has become more challenging because the shortage of donors has led to broader criteria for donor acceptability and consequently to organs with greater...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/S0210-5691(09)72196-5
更新日期:2009-08-01 00:00:00
abstract::Thoracic surgery has undergone significant advances in recent years related to anesthetic and surgical techniques and the prevention and management of complications related to the procedure. This has allowed improvements in patient clinical outcomes in surgeries of this kind. Despite the above, thoracic surgery, espec...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2019.10.012
更新日期:2020-04-01 00:00:00
abstract::Immunosuppression in transplantation has experienced changes in recent years as a result of the introduction of new drugs that act upon the different pathways of the host immune response with the purpose of securing more individualized immune suppression, with fewer side effects. Although following in the steps of oth...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2012.05.011
更新日期:2013-01-01 00:00:00
abstract::We maintain a dynamic position on extracorporeal blood purification therapies (EBPT). Continuous therapies are of choice in the hemodynamically unstable patient. We recommend their early introduction in the course of the disease, and starting with a dose of 30-35mL/kg/h. Above all, however, daily re-evaluation is requ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2016.05.009
更新日期:2016-10-01 00:00:00
abstract::Electrical impedance tomography has been described as a new method of monitoring critically ill patients on mechanical ventilation. It has recently gained special interest because of its applicability for monitoring ventilation and pulmonary perfusion. Its bedside and continuous implementation, and the fact that it is...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2011.05.005
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To determine the results of the implementation of a protocol in an intensive care unit (ICU) referred to critically ill patients requiring a prolonged artificial airway. DESIGN:A prospective, observational cohort study was carried out. INTERVENTION:Management strategies were established on the airway by end...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2012.07.003
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:The optimal blood management after cardiac surgery remains controversial. Moreover, blood transfusions may have an impact on long-term outcomes. OBJECTIVE:The aim of this study is to characterize the impact of liberal red blood cell transfusions on Health-Related Quality of life (HRQoL) after cardiac surger...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2018.01.014
更新日期:2019-04-01 00:00:00
abstract:AIM:To determine the risk of microbiological contamination with hospital use high- and low-flow bubbling humidifiers. METHODS:A systematic literature review was carried out in 6 databases. Observational or experimental studies published between 1990 and 2016 were selected, written in English or Spanish, and in which m...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2017.11.003
更新日期:2019-01-01 00:00:00
abstract::Posttraumatic carotid-cavernous fistula (PtCCF) is an uncommon complication after cranioencephalic trauma. It is usually diagnosed with a cerebral arteriography when the clinical symptoms have already appeared. The transcranial color-coded duplex sonography (TCDS) is a non-invasive technique at the patient's bedside t...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(07)74769-1
更新日期:2007-01-01 00:00:00
abstract::Second level therapeutic maneuvres for controlling intracranial hypertension (ICH) proposed by the European Brain Injury Consortium and the American Association of Neurological Surgeons include barbiturates, moderate hypothermia and more recently the decompressive craniectomy (DC).In most patients, ICP can be maintain...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2010.09.011
更新日期:2011-04-01 00:00:00
abstract::The current COVID-19 pandemic has rendered up to 15% of patients under mechanical ventilation. Because the subsequent tracheotomy is a frequent procedure, the three societies mostly involved (SEMICYUC, SEDAR and SEORL-CCC) have setup a consensus paper that offers an overview about indications and contraindications of ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2020.05.002
更新日期:2020-11-01 00:00:00
abstract::Sepsis is a major public health problem and a leading cause of death in the world, where delay in the beginning of treatment, along with clinical guidelines non-adherence have been proved to be associated with higher mortality. Machine Learning is increasingly being adopted in developing innovative Clinical Decision S...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2020.04.003
更新日期:2020-05-29 00:00:00
abstract::Most patients who require mechanical ventilation for longer than 24 hours, and who improve the condition leading to the indication of ventilatory support, can be weaned after passing a first spontaneous breathing test. The challenge is to improve the weaning of patients who fail that first test. We have methods that c...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2012.08.008
更新日期:2013-12-01 00:00:00
abstract::Massive hemorrhage is the main cause of mortality and morbidity in trauma patients, and is one of the most important causes in any patient following major surgery. Conventional treatment consists of volume replacement, including the transfusion of blood products, so that tissue perfusion and oxygenation may be maintai...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2011.11.010
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:Analyze the utility and safety of MARS therapy applied with the CRRT monitor. DESIGN:Prospective study of cohorts. SCOPE:Polyvalent ICU in tertiary university hospital with hepatic transplantation program. PATIENTS:Thirty one patients: 9 (22.6%) with acute liver failure (ALF) (1 hepatic surgery, 1 primary ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(07)74841-6
更新日期:2007-10-01 00:00:00
abstract::The intensive care units must be prepared for a possible disaster, whether internal or external, in case it becomes necessary to evacuate the in-patients. They must have an Emergency and Self-protection Plan that includes the patient evacuation criteria and this must be known by all the personnel who work in the servi...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2009.05.005
更新日期:2010-04-01 00:00:00
abstract::Invasive aspergillosis is a common condition in patients with hematologic malignancies. Symptoms are extremely non-specific, and therefore it is necessary to be familiar with the diagnostic tests for early diagnosis. This review has attempted to clarify the current evidence regarding the following areas: clinical pres...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2009.11.010
更新日期:2010-10-01 00:00:00
abstract:PURPOSE:Streptococcus pneumoniae and Neisseria meningitidis are major causes of severe invasive bacterial infections in some individuals. Apparently the genetic is a major susceptibility determinant to these infectious diseases. We study if the functional polymorphisms within genes of the innate immune system (TLR2-TLR...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2013.08.006
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To design a probability model for prolonged mechanical ventilation (PMV) using variables obtained during the first 24 hours of the start of MV. DESIGN:An observational, prospective, multicenter cohort study. SCOPE:Thirteen Spanish medical-surgical intensive care units. PATIENTS:Adult patients requiring mec...
journal_title:Medicina intensiva
pub_type: 杂志文章,多中心研究
doi:10.1016/j.medin.2012.01.003
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:Apply a sedoanalgesic (SA) protocol for invasive procedures (PI) in pediatric patients and evaluate its effectiveness and safety. DESIGN:Prospective observational study. SCOPE:Pediatric Intensive Care Unit (PICU) of third level hospital. PATIENTS:A total of 110 children subjected to invasive procedures und...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(07)74851-9
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVES:To assess Southern European intensive care unit nurses' knowledge about evidence-based guidelines for the prevention of ventilator-associated pneumonia and to compare these findings with a pan-European perspective. DESIGN:A sub-analysis from an observational study performed using a 9-questions, multiple-cho...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2010.07.012
更新日期:2011-01-01 00:00:00