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 study. INTERVENTIONS:We analyzed our database of hypoxemic patients covering a period of 11 consecutive months. We included all hemodynamically stable and hypoxemic patients with EVLWI>9ml/kg. The protocol dictates a negative fluid balance between 500 and 1500ml/day. We analyzed the impact of this negative fluid balance strategy upon pulmonary, hemodynamic, and renal function. MAIN VARIABLES OF INTEREST:Demographic data, severity scores, clinical, hemodynamic, pulmonary, metabolic and renal function data. RESULTS:Thirty-three patients achieved negative fluid balance (NFB group) and 11 had a positive fluid balance (PFB group). In the former group, PaO2/FiO2 improved from 145 (IQR 106, 200) to 210mmHg (IQR 164, 248) (p<0.001), and EVLWI decreased from 14 (11, 18) to 10ml/kg (8, 14) (p<0.001). In the PFB group, EVLWI also decreased from 11 (10, 14) to 10ml/kg (8, 14) at the end of the protocol (p=0.004). For these patients there were no changes in oxygenation, with a PaO2/FiO2 of 216mmHg (IQR 137, 260) at the beginning versus 205mmHg (IQR 99,257) at the end of the study (p=0.08). CONCLUSION:Three out of four hypoxic patients with elevated EVLWI tolerated the NFB protocol. In these subjects, the improvement of various analyzed physiological parameters was greater and faster than in those unable to complete the protocol. Patients who did not tolerate the protocol were usually in more severe condition, though a larger sample would be needed to detect specific characteristics of this group.
journal_name
Med Intensivajournal_title
Medicina intensivaauthors
Díaz-Rubia L,Ramos-Sáez S,Vázquez-Guillamet R,Guerrero-López F,Pino-Sánchez F,García-Delgado M,Gómez-Jiménez FJ,Fernández-Mondéjar Edoi
10.1016/j.medin.2014.07.008subject
Has Abstractpub_date
2015-08-01 00:00:00pages
345-51issue
6eissn
0210-5691issn
1578-6749pii
S0210-5691(14)00206-Xjournal_volume
39pub_type
杂志文章abstract:OBJECTIVES:To analyze the nutritional management practices in Intensive Care (ICU) to detect the need for improvement actions. Re-evaluate the process after implementation of improvement actions. DESIGN:Prospective observational study in 3 phases: 1) observation; 2) analysis, proposal development and dissemination; 3)...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2015.04.010
更新日期:2015-12-01 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::Burned patients may need prolonged admissions in the Intensive Care Service, both for initial care and for the pre and postoperative treatment of the multiple surgeries they require. The initial resuscitation of critically burned patients requires adequate monitoring to calculate the fluid therapy necessary to repleni...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2019.07.005
更新日期:2020-03-01 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::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::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::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:OBJECTIVE:Describe the frequency of high degree atrioventricular block (HDAVB) in patients with unstable angina (UA), analyze the variables associated with their appearance and evaluate whether HDAVB is independently associated with increased mortality or increased length of ICU stay. DESIGN:Retrospective descriptive ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(06)74566-1
更新日期:2006-12-01 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: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::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:OBJECTIVE:Assessment of health related quality of life (HRQOL) before and 12 months after discharge from a mixed intensive care unit (ICU) according to diagnostic category and the relationship between both instruments. DESIGN:Prospective observational study. SETTING:The combined medical/surgical ICU in a secondary un...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(08)70942-2
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To describe the main factors associated with proper recognition and management of patient-ventilator asynchrony (PVA). DESIGN:An analytical cross-sectional study was carried out. SETTING:An international study conducted in 20 countries through an online survey. PARTICIPANTS:Physicians, respiratory therapis...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2019.09.004
更新日期:2019-10-23 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::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: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:AIM:A study is made of the influence of alcohol and/or drug abuse upon traumatismo recurrence, with an analysis of the influence of such abuse upon the time to appearance of first injury in patients without antecedents of trauma. DESIGN:A prospective observational study was made. SETTING:Trauma patients admitted to t...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2012.04.010
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:A comparison was made of the oxidative stress (OS) levels of patients with either viral or bacterial severe community-acquired pneumonia (sCAP) and of patients without infection (healthy volunteers (HV) and patients with acute myocardial infarction (AMI)). DESIGN:A prospective observational study was made. ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2013.01.004
更新日期:2014-03-01 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::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: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: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 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: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: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::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:An evaluation is made of the hospital mortality predicting capacity of the main predictive scoring systems. DESIGN:A 2-year retrospective cohort study was carried out. SETTING:A third level ICU with surgical and medical patients. PATIENTS:All patients with multiorgan failure during the first day in the ICU...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2015.03.005
更新日期:2016-04-01 00:00:00
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 ...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/s0210-5691(09)71215-x
更新日期:2009-05-01 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