{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T12:30:09Z","timestamp":1781181009383,"version":"3.54.1"},"reference-count":0,"publisher":"SEMES (Sociedad Espanola de Medicina de Urgencias y Emergencias)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emergencias"],"abstract":"<jats:p>Objetivo. El ensayo cl\u00ednico MIMO demostr\u00f3 que los pacientes con edema agudo de pulm\u00f3n (EAP) tratados con midazolam ten\u00edan menos eventos adversos graves (EAG) que los tratados con morfina. Muchos pacientes con EAP tienen fracci\u00f3n de eyecci\u00f3n del ventr\u00edculo izquierdo (FEVI) preservada ($ 50%). El objetivo fue conocer si la disfunci\u00f3n sist\u00f3lica ventricular izquierda (DSVI) (fracci\u00f3n eyecci\u00f3n ventr\u00edculo izquierdo &lt; 50%) modifica el efecto protector del midazolam frente a la morfina. M\u00e9todo. El estudio MIMO asign\u00f3 al azar 111 pacientes con EAP a tratamiento con midazolam (dosis de 1 mg intravenosa, hasta una dosis m\u00e1xima de 3 mg, n = 55) o morfina (dosis de 2-4 mg, hasta una dosis m\u00e1xima de 8 mg, n = 56). Se calcul\u00f3 el riesgo relativo (RR) de padecer un EAG en pacientes con y sin DSVI. Resultado. La FEVI preservada estuvo presente en 84 (75,7%) pacientes con EAP. En el grupo con DSVI, 4 pacientes (26,9%) en el brazo midazolam frente a 6 (50%) en el brazo morfina presentaron EAG (RR = 0,53; IC 95: 0,2-1,4). En el grupo sin DSVI 6 pacientes (15%) del brazo midazolam frente a 18 (40,9%) del brazo morfina presentaron EAG (RR = 0,37; IC 95: 0,16-0,83). La DSVI no modific\u00f3 el efecto protector del midazolam en la aparici\u00f3n de EAG con respecto a la morfina (p = 0,57). Conclusiones. En pacientes con EAP el efecto protector del midazolam sobre la morfina en la aparici\u00f3n de EAG y EAG o muerte fue similar en pacientes con y sin DSVI.<\/jats:p>","DOI":"10.55633\/s3me\/e095.2023","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T13:05:47Z","timestamp":1719925547000},"source":"Crossref","is-referenced-by-count":1,"title":["Effects of midazolam vs morphine in patients with acute pulmonary edema with left ventricular systolic dysfunction: a secondary analysis of data from the MIMO trial"],"prefix":"10.55633","author":[{"given":"Alberto","family":"Dom\u00ednguez-Rodr\u00edguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hern\u00e1ndez-Vaquero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coral","family":"Suero-M\u00e9ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Burillo-Putze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor","family":"Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Calvo-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascual","family":"Pi\u00f1era-Salmer\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Llorens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco J.","family":"Mart\u00edn-S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Abreu-Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Formica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d2scar","family":"Mir\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33356","published-online":{"date-parts":[[2024,7,2]]},"container-title":["Emergencias"],"original-title":["Efectos del midazolam frente a la morfina en pacientes con edema agudo de pulm\u00f3n con disfunci\u00f3n sist\u00f3lica ventricular izquierda: un an\u00e1lisis secundario del ensayo MIMO"],"deposited":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T13:05:47Z","timestamp":1719925547000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistaemergencias.org\/numeros-anteriores\/volumen-35\/numero-1\/efectos-del-midazolam-frente-a-la-morfina-en-pacientes-con-edema-agudo-de-pulmon-con-disfuncion-sistolica-ventricular-izquierda-un-analisis-secundario-del-ensayo-mimo\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,2]]},"references-count":0,"URL":"https:\/\/doi.org\/10.55633\/s3me\/e095.2023","relation":{},"ISSN":["1137-6821","2386-5857"],"issn-type":[{"value":"1137-6821","type":"print"},{"value":"2386-5857","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,2]]}}}