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: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::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::The diagnosis of influenza A/H1N1 is mainly clinical, particularly during peak or seasonal flu outbreaks. A diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. The respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be...
journal_title:Medicina intensiva
pub_type: 杂志文章,实务指引
doi:10.1016/j.medin.2011.11.020
更新日期:2012-03-01 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: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: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: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::Acute liver failure with criteria of seriousness and alcoholic etiology is a picture of worldwide distribution, with an elevated mortality, of approximately 50%, that requires admission to the ICU. Acute serious alcoholic hepatitis is defined by a Maddrey score value > 32 and/or spontaneous encephalopathy. Together wi...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(06)74556-9
更新日期:2006-11-01 00:00:00
abstract::Both acute myocardial infarction and pulmonary thromboembolism are responsible for a great number of cardiac arrests. Both present high rates of mortality. Thrombolysis has proved to be an effective treatment for acute myocardial infarction and pulmonary thromboembolism with shock. It would be worth considering whethe...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/s0210-5691(06)74470-9
更新日期:2006-03-01 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: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::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:INTRODUCTION:Real body weight and height are essential data to be obtained in all critically ill patients (CIP), due to their influence in the designing of therapies and monitoring. Visual estimation is a very inaccurate practice. No precise descriptions of anthropometric measurements among CIP are available in the cli...
journal_title:Medicina intensiva
pub_type: 杂志文章,多中心研究
doi:10.1016/j.medin.2017.09.008
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To describe the factors associated to morbidity-mortality in pediatric patients with severe head injury (SHI). MATERIAL AND METHOD:A review was made of the patients admitted to the Pediatric Intensive Care Unit (PICU) with SHI between July 1983 and December 2009. RESULTS:Of the 389 patients with head injuri...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2011.02.006
更新日期:2011-08-01 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::BD was diagnosed by clinical examination, electroencephalogram (EEG), Transcranial Doppler (TCD) and multislice CT of 64 detectors. Initially, a brain perfusion study was performed. This was followed by supra-aortic trunk and brain artery angiography with acquisition of images using 0.5 mm slices, from the origin of t...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(07)74833-7
更新日期:2007-08-01 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::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::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::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::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: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::The use of neuromuscular blockers (NMB) is a frequent practice in Intensive Care Units. However most of the experience with the use of these agents come from the operating room used to deal with patients with different characteristics from those admitted in the ICU. Recent advances on neuromonitoring and the commercia...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:
更新日期:2008-02-01 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::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::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: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::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: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: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