Abstract:
:Recently, the work group made up of the National Transplant Organization (Organización Nacional de Trasplantes, ONT), Spanish Society of Intensive, Critical Medicine and Coronary Units (Sociedad Española de Medicina Intensiva, Crítica y de Unidades Coronarias, SEMICYUC) and other Scientific Societies have recommended using 15 mg/kg of methyl prednisolone during the management of lung donors after brain death. This recommendation is based on descriptive and retrospective studies. However, the review of different experimental and clinical studies also suggests a potential benefit of using steroids in either thoracic or abdominal organ donors during management strategies. In brain death management, early steroid administration may decrease cytokine production and also may prevent alterations induced by proinflammatoy mediators, stabilize cell membranes, reduce expression of cell surface adhesion molecules and avoid lipid peroxidation after the ischemic period. This could be beneficial in increasing number and quality of organs harvested and in decreasing rejection episodes after transplant. It would be very recommendable to carry out prospective and comparative studies to demonstrate these potential utilities. Meanwhile and knowing the deleterious effects of inflammatory activity arising during and after brain death, we recommend using 15 mg/kg of methyl prednisolone in the organ donor management, as soon as possible. The potential benefit of its immunomodulation effects, its low cost and the absence of major side effects can justify this recommendation.
journal_name
Med Intensivajournal_title
Medicina intensivaauthors
Michelena JC,Chamorro C,Falcón JA,Garcés Sdoi
10.1016/s0210-5691(09)71760-7subject
Has Abstractpub_date
2009-06-01 00:00:00pages
251-5issue
5eissn
0210-5691issn
1578-6749pii
13139698journal_volume
33pub_type
杂志文章,评审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: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
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 evaluate different characteristics of patients with acute coronary syndrome (ACS) without ST-segment elevation compared with transient St-segment elevation. DESIGN:An observational, prospective study. SETTING:A 12-bed coronary care unit. PATIENTS:Consecutive patients of ACS without persistent ST-segment...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2011.01.007
更新日期:2011-06-01 00:00:00
abstract::Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the mana...
journal_title:Medicina intensiva
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1016/j.medin.2020.03.005
更新日期:2020-10-01 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:OBJECTIVES:To gather all published information about the stability of drugs commonly used in Intensive Care Units (ICU); evaluate the methodology of published data; and generate a compatibility table. DESIGN:i) A systematic review was conducted searching the following databases: Medline, Stabilis, Handbook of Injectab...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2018.08.004
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:To assess the incidence and prognostic value of acute renal function deterioration (ARFD) in patients with acute heart disease. SETTING:Coronary Care Unit in a tertiary university hospital. DESIGN:Retrospective study. PARTICIPANTS:One hundred consecutive patients admitted during 2004. INTERVENTIONS:No ran...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(08)70932-x
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To assess the impact of gender upon the prognosis and medical care in a regional acute ST-elevation myocardial infarction management network. DESIGN:An observational study was made of consecutive patients entered in a prospective database. SCOPE:The Catalan acute ST-elevation myocardial infarction managemen...
journal_title:Medicina intensiva
pub_type: 杂志文章,多中心研究
doi:10.1016/j.medin.2016.06.008
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To analyze the efficacy of negative fluid balance in hypoxemic patients with an elevated extravascular lung water index (EVLWI). DESIGN:A retrospective observational study was made. SETTING:Intensive Care Unit of Virgen de las Nieves Hospital (Spain). PARTICIPANTS:Forty-four patients participated in the st...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2014.07.008
更新日期:2015-08-01 00:00:00
abstract::In 1994, an American-European Consensus Conference (AECC) formalized the criteria for the diagnosis of the acute respiratory distress syndrome (ARDS). Although that definition is simple to apply in the clinical setting, it has been challenged over the years in several studies since the assessment of the oxygenation de...
journal_title:Medicina intensiva
pub_type: 共识发展会议,杂志文章
doi:10.1016/j.medin.2012.08.010
更新日期:2012-11-01 00:00:00
abstract::The specialty of Intensive Care Medicine was established over twenty years ago in Spain as part of the MIR (Resident training) system. The European Union allows for free circulation of its workers and the multilateral recognition of their university degrees as well as their postgraduate training. Unfortunately, our sp...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2010.11.002
更新日期:2011-01-01 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::Pain is a problem in critically ill patients. The diagnosis of the intensity of is more simple when the patient is conscious (using ad hoc scales) than in unconscious or sedated patients. In these cases the study of the physiological responses to pain can be the best way of pain monitoring. The pain management in ICU ...
journal_title:Medicina intensiva
pub_type: 杂志文章,实务指引
doi:
更新日期:2008-02-01 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::This syndrome was described in 1990. It is characterized by chest pain that simulates an acute coronary syndrome (ACS), with alterations in the ECG, but with normal coronary arteries. We present 16 patients admitted in our ICU, who met the criteria of transient left ventricular dysfunction syndrome (TLVDS). All but 1 ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2010.09.010
更新日期:2011-06-01 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::Cancer patients are a vulnerable group exposed to numerous and serious risks beyond cancer itself. In recent years, the prognosis of these individuals has improved substantially thanks to several advances such as immunotherapy, targeted molecular therapies, surgical techniques, or developments in support treatment. Th...
journal_title:Medicina intensiva
pub_type: 杂志文章,实务指引
doi:10.1016/j.medin.2018.01.008
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Multicenter study oriented at establishing the incidence and prognosis of acute kidney failure (AKF) in the ICU of our country. MATERIAL AND METHODS:Prospective study of adult patients admitted over 8 months in 43 Spanish ICUs to detect AKF defined as creatinine>or=2 mg/dl or diuresis<400 ml/24 hours (in chr...
journal_title:Medicina intensiva
pub_type: 杂志文章,多中心研究
doi:10.1016/s0210-5691(06)74522-3
更新日期:2006-08-01 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:UNLABELLED:The two pillars of the appropriate management of patients with ST-elevation myocardial infarction (STEMI) are immediate access to defibrillation and early reperfusion. The Public Enterprise for Health Emergencies (EPES) and the Andalusian ARIAM (Analysis of the Delay in the Treatment of Acute Myocardial Infa...
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(07)74857-x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To analyze the management and progression of the critical trauma patient. DESIGN:A retrospective, descriptive analysis. SETTING:The ICU in the province of Toledo. PATIENTS:All patients with traumatic injury admitted during the 2001-2007 period (7 years). MAIN VARIABLES OF INTEREST:These include the variab...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2010.02.002
更新日期:2010-08-01 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::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::This article is based on the strategic reflection and discussion that took place on occasion of the first conference on innovation and technology transfer in the health sciences organized by the REGIC-ENS-FENIN-SEMICYUC and held in Madrid in the Instituto de Salud Carlos III on May 7th, 2013, with the aim of promoting...
journal_title:Medicina intensiva
pub_type:
doi:10.1016/j.medin.2014.04.012
更新日期:2014-11-01 00:00:00
abstract:INTRODUCTION:Hemodynamic parameters such as the global end-diastolic volume index (GEDVI) and extravascular lung water index (EVLWI), derived by transpulmonary thermodilution, have gained increasing interest for guiding fluid therapy in critically ill patients. The proposed normal values (680-800ml/m(2) for GEDVI and 3...
journal_title:Medicina intensiva
pub_type: 杂志文章,meta分析
doi:10.1016/j.medin.2011.11.014
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To determine whether extension to holidays and weekends of the protocol for the early proactive detection of severity in hospital ("ICU without walls" project) results in decreased mortality among patients admitted to the ICU during those days. DESIGN:A quasi-experimental before-after study was carried out. ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2015.09.001
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:No data are available on blood caspase-8 concentrations (the initiator caspase in the extrinsic apoptosis pathway) in septic patients. The present study thus describes the blood caspase-8 concentrations in survivors and non-survivors, and examines the possible association between blood caspase-8 concentration...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2020.06.016
更新日期:2020-08-22 00:00:00
abstract:OBJECTIVE:To determine the clinical characteristics and prognostic factors of patients with severe sepsis/septic shock admitted to the Intensive Care Unit of Donostia University Hospital (Guipuzcoa, Spain). DESIGN:A prospective, observational study was carried out during a consecutive 6-year period (1st February 2008-...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2015.01.006
更新日期:2016-01-01 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