Abstract:
:Most of transplanted organs are obtained from brain death (BD) donors. In neurocritical patients with catastrophic injuries and decompressive craniectomy (DC), which show a dreadful development in spite of this treatment, DC could be a futile tool to avoid natural progress to BD. We propose if cranial compressive bandage (cranioplasty with bandage) could be an ethically correct practice, similar to other life-sustaining treatment limitation (LSTL) common methods. Based on a clinical case, we contacted with the Assistance Ethics Committee and some bioethics professionals asking them two questions: 1) Is ethically correct to perform a cranioplasty with bandage in those patients with LSTL indication? 2) Thinking in organ donation possibility, is this option preferable? Conclusions 1) Cranioplasty with bandage could be considered an ethically acceptable LSTL practice, similar to other procedures. 2) It facilitates organ donation for transplant, which provides value-added because of its own social good. 3) In these cases, it is necessary to know previous patient's will or, in absentia, to obtain family consent after a detailed procedure report.
journal_name
Med Intensivajournal_title
Medicina intensivaauthors
Escudero D,Cofiño L,Gracia D,Palacios M,Casares M,Cabré L,Simón P,Miranda P,Martínez K,Iribarren S,Saralegui I,Simó RM,de León B,Español Vdoi
10.1016/j.medin.2012.12.008subject
Has Abstractpub_date
2013-04-01 00:00:00pages
180-4issue
3eissn
0210-5691issn
1578-6749pii
S0210-5691(12)00379-8journal_volume
37pub_type
杂志文章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: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::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:OBJECTIVE:To analyze the current evidence on glycemic control with insulin therapy in the critically ill. RECENT FINDINGS:Stress hyperglycemia in critically ill patients has been associated with increased morbidity and mortality. Furthermore, current evidence suggests that glucose variability has a predictive value fo...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2009.10.003
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:1) To assess the prevalence of pain during nursing care procedures, and 2) to evaluate the usefulness of certain vital signs and the bispectral index (BIS) in detecting pain. METHODS:A prospective, observational analytical study was made of procedures (endotracheal aspiration and mobilization with turning) ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2015.03.004
更新日期:2016-03-01 00:00:00
abstract::Cerebrovascular accident in young adults is not rare and the most common causes are: cardiac embolism, arterial dissection and migraine. The unknown etiology, in spite of extensive studies, is described in the literature in about one third of patients under 45 years of age. The mitochondrial encephalomyopathy, lactic ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(08)70925-2
更新日期:2008-04-01 00:00:00
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::Tuberculosis miliar is a very rare complication of bacillus Calmette-Guérin (BCG) immunotherapy that is associated to high mortality. Thus, early diagnosis and treatment is essential. At present, there is a polymerase chain reaction technique (PCR) which is a rapid diagnostic method with elevated sensitivity. Treatmen...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(06)74485-0
更新日期:2006-04-01 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: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:OBJECTIVE:To identify factors related to mortality in adult trauma patients, analyzing the clinical, epidemiological and therapeutic characteristics at the pre-hospital levels, in the Emergency Care Department and in Intensive Care. DESIGN:A retrospective, longitudinal descriptive study was carried out. Statistical an...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2014.06.004
更新日期:2015-10-01 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::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::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:OBJECTIVES:To identify the organs most susceptible to develop multiorgan dysfunction syndrome (MODS) in patients with sepsis due to secondary peritonitis, and to determine the outcome and mortality predicting utility of the SOFA (Sequential Organ Failure Assessment) system. DESIGN:A prospective, observational cohort s...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2012.07.010
更新日期:2013-10-01 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::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:OBJECTIVE:To describe the incidence and main clinical characteristics of barotrauma during open lung ventilation (OLV). DESIGN:A retrospective, observational, descriptive study was made of 100 patients with acute respiratory failure and bilateral pulmonary infiltrates. INTERVENTIONS:1) A lung recruitment maneuver (LR...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2011.10.011
更新日期:2012-06-01 00:00:00
abstract::With the aim of analyzing the current state of the educational objectives in the training of medical residents in solid organ transplantation (SOT), we conducted a review of the status of the official programs of the specialities involved in SOT, focusing particularly on lung transplantation. A survey of medical resid...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2012.03.012
更新日期:2012-11-01 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::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: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:PURPOSE:Chemokines are a large superfamily of small proteins that function not only in leukocyte trafficking, but are also necessary for linkage between innate and adaptive immunity. Little is known about their role in septic shock. We hypothesized that serum levels of the most important chemokines are related to organ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2012.09.008
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:To analyze the incidents related to patient safety (IRSP) and their risk factors during in-hospital transfer (IHT) of critical patients after the application of a protocol, and to evaluate safety during transfer using quality indicators. DESIGN:A prospective, observational and non-intervention cohort study w...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2020.05.022
更新日期:2020-07-15 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 detect donor characteristics related to graft function after orthotopic liver transplantation (OLT). DESIGN:Retrospective cohort study. CONTEXT:Polyvalent intensive care unit. PATIENTS:145 liver transplant recipients and their respective donors. INTERVENTIONS:None. MAIN VARIABLES OF INTEREST:In donors...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(08)75708-5
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To compare the results of quality monitoring after the implementation of improvement strategies in the respiratory intensive care unit (RICU). DESIGN:A prospective, comparative, longitudinal and interventional study was carried out. SETTING:The RICU of Hospital General de México (Mexico). PATIENTS:All pati...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2014.01.006
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:to document possible complications related to the location of central venous catheter (CVC) tip in the right atrium (RA) in two medical-surgical intensive care units (ICU). DESIGN:An observational, retrospective study of critically ill patients. SETTING:two medical-surgical ICUs. PATIENTS:adult patients in...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2010.07.003
更新日期:2010-12-01 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::The benefit of enteral nutrition in critically ill patients has been demonstrated by several studies, especially when it is started early, in the first 24-48h of stay in the Intensive Care Unit, and this practice is currently advised by the main clinical guidelines. The start of enteral nutrition is controversial in p...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2014.04.002
更新日期:2015-01-01 00:00:00