Usefulness of mid-regional proadrenomedullin levels in the resuscitation phase of severely burned patients and its utility in early sepsis detection.

Introduction: Mid-regional proadrenomedullin (MR-proADM) reflects the adrenomedullin level, which has vasodilatory activity, decreases endothelial permeability, and downregulates proinflammatory cytokines. Sepsis diagnosis in these patients is difficult, and MR-proADM is a widely studied sepsis biomarker. This study evaluates MR-proADM levels during the resuscitation phase, considering the potential influence of haemodynamic changes and its usefulness for the early sepsis detection in burn patients.

Design, validation and piloting of clinical vignettes to analyze critical care clinical decision processes during the COVID-19 pandemic in three different countries (Spain, Chile and United States).

Background: The use of heuristics in clinical decision-making processes increases in contexts of high uncertainty, such as those in Intensive Care Units (ICU. Given the impossibility of empirically studying their impact on real-world conditions, clinical vignettes were developed with the goal of identifying the use of heuristics in the care of critically ill patients during the COVID-19 pandemic in different clinical contexts.

Methodology: Vignettes were designed by critical care physicians in Spain to assess the use of representativeness, availability, and status quo heuristics in the care of critically ill patients during the COVID-19 pandemic.

Clinical Applications of Ultrasonography in Neurocritically Ill Patients.

Ultrasonography is part of the multimodal monitoring of the neurocritical patient. Through transcranial color Doppler ultrasound, carotid-color Doppler ultrasound, and ocular ultrasound it is possible to diagnose and monitor a multitude of pathological conditions, such as cerebrovascular events, vasospasm, Terson syndrome, carotid atheromatosis, and brain death. Furthermore, these techniques enable the monitoring of the intracranial pressure, the cerebral perfusion pressure, and the midline deviation, which allows us to understand the patient's neurocritical pathology at their bedside, in a noninvasive way.