Resuscitation and Initial Management After Moderate-to-Severe Traumatic Brain Injury: Questions for the On-Call Shift.

Traumatic brain injury (TBI) is a leading cause of disability and mortality globally, stemming from both primary mechanical injuries and subsequent secondary responses. Effective early management of moderate-to-severe TBI is essential to prevent secondary damage and improve patient outcomes. This review provides a comprehensive guide for the resuscitation and stabilization of TBI patients, combining clinical experience with current evidence-based guidelines.

Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients-Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC).

Adequate medical nutrition therapy for critically ill patients has an impact on their prognoses. However, it requires an individualized approach that takes into account the activity (phases of metabolic stress) and particularity of these patients. We propose a comprehensive strategy considering the patients' nutritional status and the set of modifiable circumstances in these patients, in order to optimize/support nutritional efficiency: (1) A detailed anamnesis and an adequate initial nutritional assessment must be performed in order to implement medical nutrition therapy that is in line with the needs and characteristics of each patient.

Parenteral Nutrition: Current Use, Complications, and Nutrition Delivery in Critically Ill Patients.

Background: Parenteral nutrition (PN) is needed to avoid the development of malnutrition when enteral nutrition (EN) is not possible. Our main aim was to assess the current use, complications, and nutrition delivery associated with PN administration in adult critically ill patients, especially when used early and as the initial route. We also assessed the differences between patients who received only PN and those in whom EN was initiated after PN (PN-EN).

Factors associated with the need of parenteral nutrition in critically ill patients after the initiation of enteral nutrition therapy.

Background And Aims: Despite enteral nutrition (EN) is the preferred route of nutrition in patients with critical illness, EN is not always able to provide optimal nutrient provision and parenteral nutrition (PN) is needed. This is strongly associated with gastrointestinal (GI) complications, a feature of gastrointestinal dysfunction and disease severity. The aim of the present study was to investigate factors associated with the need of PN after start of EN, together with the use and complications associated with EN.

External validation of the Glasgow Coma Scale-Pupils in patients with severe head injury.

Objectives: To compare the ability of the Glasgow Coma Scale (GCS) score, the GCS Pupils (GCS-P) score, and the Pupil Reactivity Score (PRS) to predict mortality in patients with severe head injury.

Material And Methods: Retrospective analysis of all patients with severe head injury and initial GCS scores of 8 or lower on initial evaluation for whom records included pupil dilation information and clinical course after admission to intensive care units of participating hospitals. We assessed the ability of each of the 3 scores (GCS, GCS-P, and PRS) to predict mortality using discrimination analysis.

Traumatic Brain Injury and Acute Kidney Injury-Outcomes and Associated Risk Factors.

Our objective was to analyze the contribution of acute kidney injury (AKI) to the mortality of isolated TBI patients and its associated risk factors. Observational, prospective and multicenter registry (RETRAUCI) methods were used, from March 2015 to December 2019. Isolated TBI was defined as abbreviated injury scale (AIS) ≥ 3 head with no additional score ≥ 3.

Implementation of a major trauma team. Analysis of activation and care times in patients admitted to the ICU.

Objective: To analyze the factors associated with the activation of the severe trauma care team (STAT) in patients admitted to the ICU, to measure its impact on care times, and to analyze the groups of patients according to activation and level of anatomical involvement.

Design: Prospective cohort study of severe trauma admitted to the ICU. From June 2017 to May 2019.

The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?

Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database.

Chronic critical illness in polytrauma. Results of the Spanish trauma in ICU registry.

Purpose: Chronic critical illness after trauma injury has not been fully evaluated, and there is little evidence in this regard. We aim to describe the prevalence and risk factors of chronic critical illness (CCI) in trauma patients admitted to the intensive care unit.

Material And Methods: Retrospective observational multicenter study (Spanish Registry of Trauma in ICU (RETRAUCI)).

Enteral nutrition in critically ill patients under vasoactive drug therapy: The NUTRIVAD study.

Background: Enteral nutrition (EN) in critically ill patients requiring vasoactive drug (VAD) support is controversial. This study assesses the tolerability and safety of EN in such patients.

Methods: This prospective observational study was conducted in 23 intensive care units (ICUs) over 30 months.

Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study): Does nutrition really affect ICU mortality?

Background & Aims: The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients.

Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018.

Risk Factors Associated with Mortality in Severe Chest Trauma Patients Admitted to the ICU.

Our objective was to determine outcomes of severe chest trauma admitted to the ICU and the risk factors associated with mortality. An observational, prospective, and multicenter registry of trauma patients admitted to the participating ICUs (March 2015-December 2019) was utilized to collect the patient data that were analyzed. Severe chest trauma was defined as an Abbreviated Injury Scale (AIS) value of ≥3 in the thoracic area.

Factors associated with death due to trauma in patients with a Glasgow Coma Scale score of 3 and bilateral fixed dilated pupils.

Objectives: To compare patients with a Glasgow Coma Scale (GCS) score of 3 stratified according to pupillary reaction and to explore factors associated with in-hospital death in those with bilateral fixed dilated pupils.

Material And Methods: Prospective, observational, multicenter study. We included all patients with trauma and GCS scores of 3 admitted to the intensive care unit from March 2015 to December 2019.

Concomitant Traumatic Brain Injury and Hemorrhagic Shock: Outcomes Using the Spanish Trauma ICU Registry (RETRAUCI).

Background: To compare the main outcomes of trauma patients with and without traumatic brain injury (TBI), hemorrhagic shock, and the combination of both using data from the Spanish trauma intensive care unit (ICU) registry (RETRAUCI).

Methods: Patients admitted to the participating ICUs from March 2015 to May 2019 were included in the study. The main outcomes were analyzed according to the presence of TBI, hemorrhagic shock, and/or both.

[Evaluation of the degree of adherence to the nutritional recommendations of the critical care patient].

Background: the application of specialized nutritional support (SNE) is difficult at the organizational level due to the complexity of clinical practice guidelines and we do not know the degree of adherence to the published nutritional recommendations. The aim of this study was to assess the degree of adherence to the recommendations of high impact and "do not do" within our environment, in order to show areas for improvement. Methods: survey of nine questions agreed by experts and carried out in different ICUs of our environment, which reflected the recommendations in SNE.

Current practice in continuous renal replacement therapy: An epidemiological multicenter study.

Objective: The aim of the study is to ascertain the most relevant aspects of the current management of renal replacement therapy (RRT) in critically ill patients, and to analyze renal function recovery and mortality in patients undergoing RRT.

Methods: A non-interventional three-month observational study was made in 2012, with a follow-up period of 90 days, in 21 centers in Catalonia (Spain). Demographic information, severity scores and clinical data were obtained, as well as RRT parameters.

Scoring severity in trauma: comparison of prehospital scoring systems in trauma ICU patients.

Purpose: We evaluated the predictive ability of mechanism, Glasgow coma scale, age and arterial pressure (MGAP), Glasgow coma scale, age and systolic blood pressure (GAP), and triage-revised trauma Score (T-RTS) scores in patients from the Spanish trauma ICU registry using the trauma and injury severity score (TRISS) as a reference standard.

Methods: Patients admitted for traumatic disease in the participating ICU were included. Quantitative data were reported as median [interquartile range (IQR), categorical data as number (percentage)].

Mortality prediction using TRISS methodology in the Spanish ICU Trauma Registry (RETRAUCI).

Objectives: To validate Trauma and Injury Severity Score (TRISS) methodology as an auditing tool in the Spanish ICU Trauma Registry (RETRAUCI).

Design: A prospective, multicenter registry evaluation was carried out.

Setting: Thirteen Spanish Intensive Care Units (ICUs).

Epidemiology of severe trauma in Spain. Registry of trauma in the ICU (RETRAUCI). Pilot phase.

Objective: To describe the characteristics and management of severe trauma disease in Spanish Intensive Care Units (ICUs). Registry of trauma in the ICU (RETRAUCI). Pilot phase.

[Risk factors for the deterioration of quality of life in critical trauma patients. Assessment at 6 and 12 months after discharge from the intensive care unit].

Objective: To evaluate factors influencing the deterioration of health-related quality of life (HRQoL) in trauma patients admitted to an ICU.

Design: A prospective observational study was carried out.

Setting: The combined medical/surgical ICU in a university secondary hospital with 24-hour neurosurgery service.

Occult donor metastatic adenocarcinoma. Contribution of the forensic autopsy. A case report.

Background: The transmission of malignancies from the organ donor to the recipients is an uncommon complication, but it can be fatal. Older donors may increase the risk of tumor transmission. A forensic autopsy will help identify diseases that might be transmitted to the recipient.

[Changes in health-related quality of life after ICU according to diagnostic category. Comparison of two measurement instruments].

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 university hospital with 450 beds.

[Recall and memory after intensive care unit stay. Development of posttraumatic stress disorder].

Background And Objective: The intensive care unit (ICU) confers a stress on patients and may affect the memory. The aim of the study was to examine the memory after critical care and the relationship with therapy and the development of posttraumatic stress disorder.

Patients And Method: Prospectively study conducted between December 2001 and June 2003.