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medicine critica

Fernando Chaves, José Garnacho-Montero, José Luis Del Pozo, Emilio Bouza, José Antonio Capdevila, Marina de Cueto, M Ángeles Domínguez, Jaime Esteban, Nuria Fernández-Hidalgo, Marta Fernández Sampedro, Jesús Fortún, María Guembe, Leonardo Lorente, Jose Ramón Paño, Paula Ramírez, Miguel Salavert, Miguel Sánchez, Jordi Vallés
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias)...
February 2018: Enfermedades Infecciosas y Microbiología Clínica
V López Camps, M A García García, M C Martín Delgado, J M Añón Elizalde, N Masnou Burrallo, O Rubio Sanchiz, A Estella García, J L Monzón Marín
INTRODUCTION: Multiple interventions are performed in critical patients admitted to Intensive Care Units (ICUs). This study explores the presence in the daily practice of ICUs of elements related to the 6 bioethics quality indicators of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units, and the participation of their members in the hospital ethics committees. MATERIALS AND METHODS: A multicenter observational study was carried out, using a survey exploring descriptive aspects of the ICUs, with 25 questions related to bioethics quality indicators, and assessing the participation of ICU members in the hospital ethics committees...
December 2017: Medicina Intensiva
Costantino Roberto Frack Costantini, Jose Antonio Ramires, Costantino Ortiz Costantini, Marcos Antonio Denk, Sergio Gustavo Tarbine, Marcelo de Freitas Santos, Daniel Aníbal Zanuttini, Carmen Weigert Silveira, Admar Moraes de Souza, Rafael Michel de Macedo
BACKGROUND: Functional assessment of coronary artery obstruction is used in cardiology practice to correlate anatomic obstructions with flow decrease. Among such assessments, the study of the coronary fractional flow reserve (FFR) has become the most widely used. OBJECTIVE: To evaluate the correlation between FFR and findings of ischemia obtained by noninvasive methods including stress echocardiography and nuclear medicine and the presence of critical coronary artery obstruction...
January 2017: Arquivos Brasileiros de Cardiologia
Sharon Batt
A much-debated series of articles in the New England Journal of Medicine in May 2015 labeled the pharmaceutical industry's critics "pharmascolds." Having followed the debate for two decades, I count myself among the scolds. The weight of the evidence overwhelmingly supports the claim that pharmaceutical policy no longer serves the public interest; the central questions now are how this happened and what to do about it. I approached three of the most recent books on the industry with these questions in mind...
July 2016: Hastings Center Report
R Fernandez
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 capacity. DESIGN: A prospective, observational multicenter study was carried out. PARTICIPANTS: A total of 35 out of 40 ICUs of Catalonia (87%)...
December 2015: Medicina Intensiva
Christian Richard, Laurent Argaud, Alice Blet, Thierry Boulain, Laetitia Contentin, Agnès Dechartres, Jean-Marc Dejode, Laurence Donetti, Muriel Fartoukh, Dominique Fletcher, Khaldoun Kuteifan, Sigismond Lasocki, Jean-Michel Liet, Anne-Claire Lukaszewicz, Hervé Mal, Eric Maury, David Osman, Hervé Outin, Jean-Christophe Richard, Francis Schneider, Fabienne Tamion
The influenza H1N1 epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain. Organized by the Société de Réanimation de Langue Française (SRLF) in conjunction with the Société Française d'Anesthésie et de Réanimation (SFAR), the Société de Pneumologie de Langue Française (SPLF), the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP), the Société Française de Perfusion (SOFRAPERF), the Société Française de Chirurgie Thoracique et Cardiovasculaire (SFCTV) et the Sociedad Española de Medecina Intensiva Critica y Unidades Coronarias (SEMICYUC), a Consensus Conference was held in December 2013 and a jury of 13 members wrote 65 recommendations to answer the five following questions regarding the place of extracorporeal life support for patients with acute respiratory distress syndrome: 1) What are the available techniques?; 2) Which patients could benefit from extracorporeal life support?; 3) How to perform extracorporeal life support?; 4) How and when to stop extracorporeal life support?; 5) Which organization should be recommended? To write the recommendations, evidence-based medicine (GRADE method), expert panel opinions, and shared decisions taken by all the thirteen members of the jury of the Consensus Conference were taken into account...
2014: Annals of Intensive Care
E Celis-Rodríguez, C Birchenall, M Á de la Cal, G Castorena Arellano, A Hernández, D Ceraso, J C Díaz Cortés, C Dueñas Castell, E J Jimenez, J C Meza, T Muñoz Martínez, J O Sosa García, C Pacheco Tovar, F Pálizas, J M Pardo Oviedo, D I Pinilla, F Raffán-Sanabria, N Raimondi, C Righy Shinotsuka, M Suárez, S Ugarte, S Rubiano
INTRODUCTION: Optimal management of sedation, analgesia and delirium offers comfort and security for the critical care patient, allows support measures to be applied more easily and enables an integral approach of medical care, at the same time that lowers the incidence of complications, wich translates in better patient outcomes. OBJECTIVE: To update the Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo published in Medicina Intensiva in 2007, and give recommendations for the management of sedation, analgesia, and delirium...
November 2013: Medicina Intensiva
V Gómez Tello, J Alvarez Rodríguez, A Núñez Reiz, J A González Sánchez, A Hernández Abadía de Barbará, M Martínez Fresneda, P Morrondo Valdeolmillos, J M Nicolás Arfelis, I Pujol Varela, M Calvete Chicharro
INTRODUCTION: Clinical Information Systems (CIS) are becoming a useful tool for managing patients and data in the ICU. However, the existing CIS differ in their capabilities and technical requirements. It is therefore essential for intensivists, as the end clients of these applications, to define the suitable minimum specifications required in order to be operative and helpful. OBJECTIVES: The Spanish Society of Intensive Care Medicine and Coronary Units, through its Organization and Management Workgroup, has designated a group of clinical and software experts to draft a document with the recommendable technical and operating requirements of these systems...
November 2011: Medicina Intensiva
(no author information available yet)
Intensive care medicine is a medical specialty that was officially established in our country in 1978, with a 5-year training program including two years of common core training followed by three years of specific training in an intensive care unit accredited for training. During this 32-year period, intensive care medicine has carried out an intense and varied activity, which has allowed its positioning as an attractive and with future specialty in the hospital setting. This document summarizes the history of the specialty, its current situation, the key role played in the programs of organ donation and transplantation of the National Transplant Organization (after more than 20 years of mutual collaboration), its training activities with the development of the National Plan of Cardiopulmonary Resuscitation, with a trajectory of more than 25 years, its interest in providing care based on quality and safety programs for the severely ill patient...
March 2011: Medicina Intensiva
Juna C Michelena, Carlos Chamorro, Juan A Falcón, Sandra Garcés
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...
June 2009: Medicina Intensiva
Pedro M Olaechea, Francisco Alvarez-Lerma, Miguel Sánchez, Antonio Torres, Mercedes Palomar, Pedro Fernández, José M Miró, José Miguel Cisneros, Manuel Torres, et al.
Recent studies have shown that early attention in patients with serious infections is associated with a better outcome. Assistance in intensive care units (ICU) can effectively provide this attention; hence patients should be admitted to the ICU as soon as possible, before clinical deterioration becomes irreversible. The objective of this article is to compile the recommendations for evaluating disease severity in patients with infections and describe the criteria for ICU admission, updating the criteria published 10 years ago...
June 2009: Enfermedades Infecciosas y Microbiología Clínica
M C Martín, Ll Cabré, J Ruiz, Ll Blanch, J Blanco, F Castillo, P Galdós, J Roca, R M Saura
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 conducted by the Spanish Society of Intensive and Critical Medicine (SEMICYUC) under the methodological management of the Foundation Avedis Donabedian (FAD) of Barcelona. Its objective was to develop key indicators in the care of the critical patient, considering the following as added values: reaching an agreement on the quality criteria in these patients and providing the professionals with a potent and reliable instrument for clinical evaluation and management, introducing common evaluation methods that make it possible to unify the measure, making a comparative evaluation (benchmarking), having information that makes it possible to develop quality plans (quantitative, objective, reliable and valid data) and having a system that assures total quality of care to the critical patient...
January 2008: Medicina Intensiva
E Celis-Rodríguez, J Besso, C Birchenall, M A de la Cal, R Carrillo, G Castorena, D Ceraso, C Dueñas, F Gil, E Jiménez, J C Meza, M Muñoz, C Pacheco, F Pálizas, D Pinilla, F Raffán, N Raimondi, S Rubiano, M Suárez, S Ugarte
No abstract text is available yet for this article.
November 2007: Medicina Intensiva
R Jordà Marcos, A Torres Martí, F J Ariza Cardenal, F Alvarez Lerma, F Barcenilla Gaite
INTRODUCTION: Given the sanitary repercussion of serious intrahospital pneumonia (SIP), representatives of three scientific societies (SEMICYUC; SEPAR and SEIMC) have developed during 2002 and 2003 a practical guide for its treatment. METHOD: A task force was constituted to value five clinical situations related with the treatment of SIP: 1) critical revision of the existent guidelines and groups of risk definition; 2) entry criteria in ICU for SIP; 3) SIP treatment in function of the groups of risk; 4) special situations in SIP treatment, and 5) control treatment...
October 2004: Enfermedades Infecciosas y Microbiología Clínica
No abstract text is available yet for this article.
September 1957: Revista Española de Obstetricia y Ginecología
(no author information available yet)
OBJECTIVE: To draw a picture of the different practices adopted for the diagnosis, specific treatment and general care of critical leg ischaemia (CLI) in the light of the recommendations of the recent Consensus Document. DESIGN: Prospective observational study. SETTING: A representative sample of vascular and general surgery, angiology, general medicine departments of the Italian National Health Service. SUBJECTS: Patients with leg ischaemia considered as chronic and critical according to the definition and diagnostic criteria adopted in each centre...
January 1996: European Journal of Vascular and Endovascular Surgery
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