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 admitted to the hospital with GCS < 8 during a 6-month period were followed-up until discharge or day 30 of hospital stay. STUDY VARIABLES:Demographic data, cause of coma, clinical status upon admission and outcome were analyzed. LSTL, brain death (BD) and organ donation incidence were recorded. RESULTS:A total of 549 patients were included, with a mean age of 59.0 ± 14.5 years. The cause of coma was cerebral hemorrhage in 27.0% of the cases.LSTL was applied in 176 patients (32.1%). In 78 cases LSTL consisted of avoiding ICU admission. Age, the presence of contraindications, and specific causes of coma were associated to LSTL. A total of 58.1% of the patients died (n=319). One-hundred and thirty-three developed BD (24.2%), and 56.4% of these became organ donors (n=75). The presence of edema and mid-line shift on the CT scan, and transplant coordinator evaluation were associated to BD. LSTL was associated to a no-BD outcome. Early LSTL (first 4 days) was applied in 9 patients under 80 years of age, with no medical contraindications for donation and a GCS ≤ 4 who finally died in asystole. CONCLUSIONS:LSTL is a frequent practice in neurocritical patients. In almost one-half of the cases, LSTL consisted of avoiding admission to the ICU, and on several occasions the donation potential was not evaluated by the transplant coordinator.
journal_name
Med Intensivajournal_title
Medicina intensivaauthors
Bodí MA,Pont T,Sandiumenge A,Oliver E,Gener J,Badía M,Mestre J,Muñoz E,Esquirol X,Llauradó M,Twose J,Quintana Sdoi
10.1016/j.medin.2014.07.010subject
Has Abstractpub_date
2015-08-01 00:00:00pages
337-44issue
6eissn
0210-5691issn
1578-6749pii
S0210-5691(14)00209-5journal_volume
39pub_type
杂志文章,多中心研究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 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：: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：: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：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
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abstract：:Patients with cardiac disease can develop two types of malnutrition: cardiac cachexia, which appears in chronic congestive heart failure, and malnutrition due to the complications of cardiac surgery or any other type of surgery in patients with heart disease. Early enteral nutrition should be attempted if the oral rou...
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)70017-1
更新日期：2011-11-01 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：: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: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：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：OBJECTIVE:To assess the efficacy and safety of a treatment with clopidogrel when associated or not to the treatment with tirofiban and aspirin for high-risk non-ST segment elevation myocardial infarction (non-STEMI), without early angioplasty. SETTING:Intensive Care and Coronary Unit (ICCU), in a center with no Hemody...
journal_title：Medicina intensiva
pub_type： 临床试验,杂志文章
doi：10.1016/s0210-5691(07)74801-5
更新日期：2007-05-01 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 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：: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
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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
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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：:There is a direct correlation between the development of the multiple organ dysfunction syndrome (MODS) and the elevated mortality associated with sepsis. The mechanisms responsible for MODS development are being studied, however, the main efforts regarding MODS evaluation have focused on oxygen delivery optimization ...
journal_title：Medicina intensiva
pub_type： 杂志文章,评审
doi：10.1016/j.medin.2008.10.002
更新日期：2009-11-01 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：: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
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journal_title：Medicina intensiva
pub_type： 杂志文章
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更新日期：2019-04-01 00:00:00
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journal_title：Medicina intensiva
pub_type： 杂志文章,多中心研究
doi：10.1016/j.medin.2017.09.007
更新日期：2018-01-01 00:00:00
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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
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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
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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：:Extracorporeal membrane oxygenation (ECMO) support is indicated in patients who are refractory to treatment, those with cardiogenic shock or respiratory failure and those with exacerbations eligible for heart and lung transplantation. Physician experience and quantity of necessary resources are reasons why regionaliza...
journal_title：Medicina intensiva
pub_type： 杂志文章,评审
doi：10.1016/j.medin.2018.01.004
更新日期：2019-03-01 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
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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：: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 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
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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
