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Introduction: the implementation of renal POCUS in critical care is a valuable tool that complements the physical examination of critically ill patients. It is non-invasive, accessible, harmless, and inexpensive, allowing renal perfusion to be evaluated at the bedside of patients through ultrasound measurements such as the renal resistance index (RRI) and intrarenal venous Doppler (IVD), which are considered early predictors of acute kidney injury (AKI). Objective: to determine the relationship between the renal resistance index (RRI) and the degree of AKI according to KDIGO in neurocritical patients, and to correlate intrarenal venous Doppler (IVD) flow abnormalities with the degree of AKI according to KDIGO. Methods: an observational, analytical, prospective, and longitudinal study was conducted in a neurocritical patient ICU with 43 participants. RRI and IVD measurements were performed at admission, 72 hours, and 7 days. The study evaluated which parameter better predicts AKI according to KDIGO. Results: in the study of 43 critically ill patients, the correlation results between RRI value and AKI according to KDIGO were not significant. On the other hand, the correlation between intrarenal venous Doppler (IVD) at admission, 72 hours, and 7 days with AKI according to KDIGO was significa nt with a value of r: 43=0,95 (P=0,54); 0,49 (P=0,001); 0,58(P=0,000). Analyzing by classification tree, it was determined that the variables that best predict the risk of developing AKI before it occurs are intrarenal venous Doppler (IVD) measurement at 7 days and the cumulative fluid balance value. Conclusions: there is a positive and significant correlation between intrarenal venous Doppler (IVD) and AKI. Intrarenal venous Doppler (IVD) and cumulative fluid balance predict the risk of developing AKI in critically ill patients. On the other hand, renal resistance index was not related to AKI in the studied population. [ABSTRACT FROM AUTHOR]

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Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Brazilian Journal of Transplantation is the property of Brazilian Journal of Transplantation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Portuguesa de Enfermagem de Reabilitação is the property of Associacao Portuguesa dos Enfermeiros de Reabilitacao (APER) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of CES Medicina is the property of Universidad CES and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Patients using extracorporeal membrane oxygenation (ECMO) are at greater risk of developing multiple organ dysfunction, therefore, the construction of protocols and training of professionals become essential to reduce mortality. With that in mind, a hospital trained nurses to act more assertively in the care of this patient. Report how this training took place. This is an experience report at a large private and philanthropic hospital in the city of São Paulo, on the training of nurses to assist patients with ECMO. 52 nurses were trained. The training consisted of theoretical and practical classes, in a realistic simulation environment, in addition to clinical discussion, guided study and debriefing. The training of nurses in ECMO patient care enables improvement in the quality and safety of care provided, preventing complications, ensuring early interventions and better outcomes. [ABSTRACT FROM AUTHOR]

Introdução: A disfagia pós-extubação afeta uma percentagem significativa de doentes. Contudo o seu rastreio não é realizado de forma sistemática, contribuindo para uma reduzida perceção do problema e predispondo à ocorrência de complicações. Metodologia: Revisão Sistemática da Literatura orientada pelos princípios da Cochrane Screening and Diagnostic Test Methods Group e o Preferred Reporting Items for Systematic Reviews and Meta-Analyses, com o objetivo de identificar os instrumentos de rastreio da disfagia em doentes pós-extubação. Consultadas as bases de dados Medline, Cochrane Library, Scielo, Science Direct e CINAHL e efetuada pesquisa na literatura cinzenta. Como critérios de inclusão foram definidos estudos de validação de instrumentos de rastreio para doentes pós-extubação de intubação prolongada (superior a 48 horas). Resultados: Revistos 7043 artigos dos quais foram selecionados sete para leitura integral, sendo que apenas um cumpria os critérios de inclusão. Discussão: Apenas um instrumento de rastreio de disfagia validado foi identificado para esta população específica. O instrumento apresenta boa fiabilidade entre observadores, no entanto, a sensibilidade, sendo de 81%, significa que parte destes doentes não será identificado como disfágico, o que terá repercussões negativas. Este instrumento foi validado contra avaliação clínica, o que se mostra uma limitação à interpretação dos seus resultados. Conclusão: Não existe versão em português deste instrumento, o que dificulta a elaboração de orientações que sistematizem a abordagem terapêutica para doentes pós-extubação. Advoga-se a sua tradução e validação para o contexto nacional e validação com teste de referência. Protocolo registado na Open Science Framework osf.io/q6k7g a 16 de maio de 2022.

Introduction and objectives: The coronavirus disease 2019 (COVID-19) spread quickly around the world. Although mainly a respiratory illness, there is growing interest in non-respiratory manifestations, particularly cardiovascular ones. At our center, mobilization of cardiologists with intensive care training was needed. Our aim is to describe patients with severe COVID-19 admitted to a Portuguese intensive care unit (ICU), the cardiovascular impact of the disease and the experience of cardiologists working in a COVID-19 ICU. Methods: Data from adult patients with COVID-19 admitted to the ICU of Centro Hospitalar de Vila Nova de Gaia/Espinho between 16 March 2020 and 21 April 2020 were analyzed retrospectively. Results: Thirty-five patients were admitted. Mean age was 62.6±6.0 years and 23 (65.7%) were male. Dyslipidemia was the most common cardiovascular risk factor (65.7%, n=23), followed by hypertension (57.1%, n=20). Mean ICU stay time was 15.9±10.0 days. Patients had high rates of mechanical ventilation (88.6%, n=31) and vasopressor support (88.6%, n=31). Low rates of new onset left systolic dysfunction were detected (8.5%, n=2). One patient required venoarterial extra-corporeal membrane oxygenation. Mortality was 25% (n=9). Acute myocardial injury and N-terminal pro-B-type natriuretic peptide (NT-proBNP) elevation was detected in 62.9% (n=22). Patients that died had higher NT-proBNP compared to those discharged alive (p

Objetivo: Identificar las dificultades del personal sanitario de una unidad de cuidados intensivos (UCI) en la interpretación de las presiones del circuito extracorpóreo renal mediante el uso de fotografías. Metodología: Estudio descriptivo-transversal, en dos UCI polivalentes de 20 camas y 82 profesionales sanitarios (médicos/ enfermeras) en noviembre de 2020. Se utilizaron 15 fotografías validadas por dos expertos de la pantalla de Prismaflex®, con cuatro opciones de respuesta: problemas línea entrada, problemas línea retorno, coagulación, filtro y funcionamiento correcto. Una era la correcta. Resultados: Participaron 66 profesionales (80,5% muestra). Se clasificaron correctamente el 71,7% (IC95% 68,8-74,4) de las fotografías. La media de respuestas correctas fue de 9,9 (DE=2,4). Las fotografías interpretadas con más dificultad fueron las de la línea de retorno con porcentajes de aciertos del 50%. Los profesionales con formación obtuvieron una media de aciertos de 10,8 (DE=2,5) frente al 9,1 (DE=2,1) de los sin formación (p

The worldwide incidence of acute kidney injury (AKI) in pregnancy is 1.6 to 6.3 per 10,000 pregnancies. In developing countries, maternal mortality due to secondary complications of acute kidney injury is 4 to 5.8%. As it is well known, most cases of acute kidney injury in obstetrics occur during the puerperium, its presentation has been associated with an increase in fetal morbidity and mortality, compared to normoevolutive pregnancies. [ABSTRACT FROM AUTHOR]

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To characterize myocardial injury and cardiovascular complications and their predictors in severe and critical COVID-19 patients admitted to the intensive care unit. Methods: This was an observational cohort study of severe and critical COVID-19 patients admitted to the intensive care unit. Myocardial injury was defined as blood levels of cardiac troponin above the 99th percentile upper reference limit. Cardiovascular events considered were the composite of deep vein thrombosis, pulmonary embolism, stroke, myocardial infarction, acute limb ischemia, mesenteric ischemia, heart failure and arrhythmia. Univariate and multivariate logistic regression or Cox proportional hazard models were used to determine predictors of myocardial injury. Results: Of 567 patients with severe and critical COVID-19 admitted to the intensive care unit, 273 (48.1%) had myocardial injury. Of the 374 patients with critical COVID-19, 86.1% had myocardial injury, and also showed more organ dysfunction and higher 28-day mortality (56.6% versus 27.1%, p < 0.001). Advanced age, arterial hypertension and immune modulator use were predictors of myocardial injury. Cardiovascular complications occurred in 19.9% of patients with severe and critical COVID-19 admitted to the intensive care unit, with most events occurring in patients with myocardial injury (28.2% versus 12.2%, p < 0.001). The occurrence of an early cardiovascular event during intensive care unit stay was associated with higher 28-day mortality compared with late or no events (57.1% versus 34% versus 41.8%, p = 0.01). Conclusion: Myocardial injury and cardiovascular complications were commonly found in patients with severe and critical forms of COVID-19 admitted to the intensive care unit, and both were associated with increased mortality in these patients. [ABSTRACT FROM AUTHOR]

Objective: To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal. Methods: This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 - 16 and 17 - 34, were defined. Results: Five hundred forty-one adult patients with a median age of 65 [57 - 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39; p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136; p = 0.6), antibiotic therapy (57% versus 64%; p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%; p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 - 3] versus 2 [0 - 5]; p = 0.002) and presented a higher use of vasopressors (47% versus 36%; p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%; p < 0.001) at admission, prone positioning (45% versus 36%; p = 0.04), and hydroxychloroquine (59% versus 10%; p < 0.001) and lopinavir/ritonavir (41% versus 10%; p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%; p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau. Conclusion: There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave. [ABSTRACT FROM AUTHOR]

Goal. To analyze the role of the father in the care of the newborn hospitalized in a neonatal intensive care unit. Methodology. This is a qualitative approach study. The selection of open sampling, convenience saturation, interviewing 10 parents where at the end 4 were analyzed where the interviews were conducted in the Neonatal Intensive Care Units (NICU). The data was analyzed using the Atlas Ti 8.0® program through categories and content analysis. Results. Parents need to face the stressful situation of having their child in an intensive care unit, train and learn about the baby's health condition, constantly carry out introjection and reflective self-analysis, delve into the spiritual component and also focus on the I work as financial manager. Conclusion. The father's skills in the care of the hospitalized newborn were identified, such as patience and passion to perform the role of father. It is evident that man has a fundamental role in the care of the newborn. [ABSTRACT FROM AUTHOR]

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Introduction: The quality of life of critically ill patients who survive treatment in intensive care units is lower than that of the general population. Baseline health status and severity of clinical condition on admission to intensive care are risk factors for quality of life and functionality. Objective: To analyze the level of knowledge on quality of life and functionality of intensive care survivors. Materials and methods: An exploratory review was conducted by searching studies published between January 2010 and May 2020 in Scielo, PubMed, Science Direct, ProQuest, Redalyc, Dialnet, OVID, and Scopus databases. The study was conducted according to the PRISMA statement. Full texts that met the inclusion criteria were reviewed and analyzed in the final selection of articles. Results: Of 1814 articles identified, 65 articles describing the quality of life and functionality in post-intensive care patients were screened. Finally, 16 were included to analyze the article's characteristics, population characteristics, and variables of analysis for assessing the quality of life and functionality of post-intensive care survivors. Conclusions: Studies on quality of life and functionality in intensive care survivors were conducted mainly in Europe between 2010 and 2016. They are primarily prospective observational studies correlating factors determining mental and physical health after intensive care discharge. Multiple scales were applied; the most used were the SF-36 and the EQ-5D to assess the quality of life and the Barthel Index to determine functional status in patients discharged from intensive care. The SF-36 and Barthel index reported impaired quality of life and functionality of the intensive care survivor population. [ABSTRACT FROM AUTHOR]

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Objective: The treatment and prevention of delirium in the intensive care unit (ICU) have gained significant importance in patient care in recent years. Some studies have linked delirium with increased risks of mortality, prolonged hospital stay, and more days of mechanical ventilation. This study aims to analyze the use of psychotropic drugs initiated in the ICU and their continuation upon hospital discharge, as well as to evaluate their contribution to polypharmacy and associated adverse clinical effects., Method: A multicenter prospective observational case study was designed, focusing on patients over 18 years old admitted to the ICU and treated with psychotropic drugs. Data on demographics, variables related to admission and psychotropic drug treatment, as well as clinical outcomes and adverse effects, will be collected. Among other variables, the frequency of psychotropic treatments initiated in the ICU and continued upon discharge from the ICU and the hospital will be measured. Data collection will be performed through review of electronic medical records and prescription programs, and IBM SPSS 20.0 statistical package will be used for analysis., Discussion: Delirium is common in ICU patients and is associated with long-term negative consequences. Although antipsychotics are used to treat delirium, their prolonged use can have adverse effects, and their continuation after ICU discharge contributes to polypharmacy. This study aims to provide information on the use of psychotropic drugs initiated in the ICU and their continuation upon discharge, with the goal of identifying opportunities for intervention and reducing unnecessary use of these medications., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Background and Goal: Vaccination against influenza is widespread worldwide, reducing complications associated with infection. However, the impact of vaccination on mortality/ICU admission in hospitalized patients has been little studied., Material and Methods: A retrospective observational study was conducted on 238 patients hospitalized for influenza from October 2023 to January 2024 to evaluate the vaccine's effectiveness in terms of the combined event of ICU admission/mortality during hospitalization. Additionally, the characteristics of vaccinated patients and the existence of bacterial superinfection were analyzed. Cox regression was performed using the SPSS program and the free «R» software., Results: A total of 238 patients were included. Those vaccinated were older (78.2±8.8 vs 69.97±16.6years; P<.001) and were more likely to have hypertension (82.2% vs 56.2%; P<.001), cardiovascular disease (36.6% vs 24.1%; P=.05), chronic bronchopathy (25.7% vs 8.8%; P=.001), or chronic kidney disease (22.8% vs 8.8%; P=0.005). They had lower levels of CRP (8.39±9.55 vs 11.03±10.75mg/dl; P=.05), procalcitonin (0.62±1.74 vs 1.67±4.57ng/dl; P=.05), and SOFA scores (1.13±0.9 vs 1.39±0.97; P=0.033). 11 patients were admitted to ICU (4.6%) and 11 died (4.6%). Influenza vaccination was associated as a protective factor against ICU admission/mortality in the Cox regression (HR=0.216; 95%CI: 0.062-0.759, P=.017). The presence of bacterial superinfection was similar between vaccinated and unvaccinated patients (63.4% vs 67.9%; P=.556)., Conclusions: Influenza vaccination may reduce the probability of ICU admission or death. This effect is likely due to better control of the immune response. We did not observe any relationship with the risk of presenting bacterial superinfection., (Copyright © 2024 Elsevier España, S.L.U. All rights reserved.)

Extubation failure can result from different complications, mostly well described in the literature such as laryngeal edema. Airway obstruction by foreign bodies is a less frequent and unexpected complication and its detection remains a challenge to healthcare professionals. In this case-report, we describe a patient admitted in an intensive care unit following a motor vehicle accident and who underwent an extubation failure and tracheostomy placement due to a misdiagnosed obstruction of a foreign body in the upper airway. Thus, screening of foreign bodies should be considered with a careful interpretation of medical imagery and clinical evaluation in these patients. Finally, cuff leak test, ultrasonography and videolaryngoscopy can be important adjuvants to the identification of suspected foreign bodies., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Patient safety is a priority for all healthcare systems. Despite this, too many patients still suffer harm as a consequence of healthcare. Furthermore, it has a significant impact on family members, professionals and healthcare institutions, resulting in considerable economic costs. The critically ill patient is particularly vulnerable to adverse events. Numerous safe practices have been implemented, acknowledging the influence of human factors on safety and the significance of the well-being of professionals, as well as the impact of critical episodes at hospital discharge on patients and their families. Training and engagement of professionals, patients and families are of paramount importance. Recently, artificial intelligence has demonstrated its ability to enhance clinical safety. This update on "Patient Safety" reviews all these aspects related to one of the most pivotal dimensions of healthcare quality., (Copyright © 2024 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)

Desde diciembre de 2019 surge en Wuhan un nuevo SARS-Coronavirus-2 (SARS-CoV-2) asociado a la enfermedad de COVID-19, un evento pandémico. Además de causar neumonía y síndrome respiratorio agudo severo, el SARS-CoV-2 es un agente neurotrópico que se une a la enzima convertidora de angiotensina 2 (ECA2) y utilizando los receptores ECA2 que se encuentran dentro del sistema nervioso central, ingresa causando manifestaciones neurológicas. Debido a que es una enfermedad de reciente aparición y su presentación clínica es bastante variable, su fisiopatología no está completamente dilucidada. Las alteraciones hematológicas como los estados procoagulantes se han asociado a peor pronóstico y a un alto riesgo de producción de eventos cardiovasculares y afecciones de tipo neurológicas. En este artículo se presenta un caso de ictus isquémico focal en un paciente con múltiples comorbilidades en el contexto de COVID-19. Se reporta la presencia de focalidad completa del nervio oculomotor derecho en un masculino de 64 años COVID-19 positivo, un hallazgo infrecuente, por lo que sugerimos realizar estudios seriados de neuroimagen en centros hospitalarios durante el manejo de casos graves de COVID-19 con manifestaciones neurológicas. Since December 2019 emerges in Wuhan a novel SARS-Coronavirus-2 (SARS-CoV-2) associated to COVID-19 disease, a pandemic event. In addition to COVID-19 pneumonia and severe acute respiratory syndrome, SARS-CoV-2 is a neurotropic agent that binds to angiotensin converting enzyme 2 (ACE2) and using ACE2 receptors found within the central nervous system, enters causing neurological manifestations. Because it is a recent-onset disease and its clinical presentation is quite variable, its pathophysiology is not fully understood. Hematological alterations such as procoagulant states have been associated with a worse prognosis and a high risk of cardiovascular events and neurological conditions. In this article presents a case of focal ischemic stroke in a patient with multiple comorbidities in the context of COVID-19. It is reported the presence of right nerve oculomotor complete focality in a COVID-19 positive 64-year-old male, an infrequent finding, so, we suggest conducting serial neuroimaging studies in hospital centers during the management of severe cases of COVID-19 with neurological manifestations.

RESUMO Objetivo: Avaliar a capacidade do Teste de Caminhada de 6 Minutos para predizer a melhora do estado funcional físico em longo prazo de pacientes sobreviventes à unidade de terapia intensiva. Métodos: Foram avaliados, de forma prospectiva, entre fevereiro de 2017 e agosto de 2018, em um ambulatório pós-unidade de terapia intensiva, 32 sobreviventes à unidade de terapia intensiva. Foram inscritos consecutivamente os pacientes com permanência na unidade de terapia intensiva acima de 72 horas (para admissões emergenciais) ou acima de 120 horas (para admissões eletivas) que compareceram ao ambulatório pós-unidade de terapia intensiva 4 meses após receberem alta da unidade de terapia intensiva. A associação entre a distância percorrida no Teste de Caminhada de 6 Minutos realizado na avaliação inicial e a evolução do estado funcional físico foi avaliada durante 8 meses, com utilização do Índice de Barthel. Resultados: A distância média percorrida no Teste de Caminhada de 6 Minutos foi significantemente mais baixa nos sobreviventes à unidade de terapia intensiva do que na população geral (405m versus 557m; p < 0,001). A idade (β = -4,0; p < 0,001) e a fraqueza muscular (β = -99,7; p = 0,02) se associaram com a distância percorrida no Teste de Caminhada de 6 Minutos. A distância percorrida no Teste de Caminhada de 6 Minutos se associou com melhora do estado funcional físico no período de 8 meses de acompanhamento desses pacientes (razão de chance para cada 10m: 1,07; IC95% 1,01 - 1,16; p = 0,03). A área sob a curva Característica de Operação do Receptor para predição da melhora funcional física pelo Teste de Caminhada de 6 Minutos foi de 0,72 (IC95% 0,53 - 0,88). Conclusão: O Teste de Caminhada de 6 Minutos, realizado 4 meses após a alta da unidade de terapia intensiva, predisse com precisão moderada a melhora do estado funcional físico de sobreviventes à unidade de terapia intensiva.

• La estancia prolongada en una Unidad de Cuidado Intensivo (UCI) y los días de ventilación mecánica, originan un deterioro en la funcionalidad generando una condición de dependencia temporal o permanente en los sobrevivientes de enfermedades críticas. • Las prácticas clínicas humanizadas en las unidades de cuidado intensivo mejoran la calidad de vida en los sobrevivientes de enfermedades críticas después del alta hospitalaria. • El deterioro en la salud mental después del egreso de cuidado intensivo está asociado a la ausencia de acompañamiento familiar, a la poca atención por el personal de enfermería y a la ausencia de protocolos de sedación durante el periodo de permanencia en cuidado crítico. • La movilización temprana en las unidades de cuidados intensivos (UCI) puede mejorar la calidad de vida y la funcionalidad en los sobrevivientes de enfermedades críticas. Introducción: La calidad de vida en pacientes críticos que sobreviven al tratamiento en unidades de cuidados intensivos es inferior al de la población general. La condición de salud basal y la severidad de la condición clínica al ingreso a terapia intensiva son factores de riesgo para la calidad de vida y la funcionalidad. Objetivo: Analizar el nivel de conocimiento en la calidad de vida y la funcionalidad de los sobrevivientes de cuidados intensivos. Materiales y métodos: Se realizó una revisión exploratoria en las bases de datos: Scielo, PubMed, Science Direct, ProQuest, Redalyc, Dialnet, OVID, Scopus, publicados entre enero del año 2010 y mayo del año 2020. El estudio se desarrolló según la estructura de la Metodología PRISMA. Se revisaron y analizaron los textos completos que cumplían los criterios de inclusión para la selección final de los artículos. Resultados: De 1814 artículo seleccionados, se eligieron 65 artículos que describen la calidad de vida y la funcionalidad en pacientes después de cuidados intensivos, y finalmente, 16 artículos son incluidos, donde se analizaron las características de los artículos, las características de la población estudiada, y las variables de análisis sobre la evaluación de la calidad de vida y la funcionalidad en los sobrevivientes después cuidados intensivos. Conclusión: Los estudios sobre calidad de vida y funcionalidad en sobrevivientes de cuidados intensivos se realizaron en mayor proporción en Europa en los años 2010 a 2016. Con estudios observacionales prospectivos que correlacionan los factores que determinan la salud mental y física después del egreso de cuidados intensivos. Se aplicaron múltiples escalas siendo las más utilizadas SF-36 y el EQ-5D para evaluar la calidad de vida y del índice de Barthel para determinar el estado de funcionalidad en los egresados de cuidados intensivos. El SF-36 y el índice de Barthel reportaron una afectación en la calidad de vida y en la funcionalidad en la población sobreviviente de cuidados intensivos. Como citar este artículo: Mejia Vanegas Dulfary, Arias Díaz Julia Andrea, Leyton Toro Lleraldyn, Ayala Grajales Katherine Yuliet, Becerra Londoño Angie Manuela, Vallejo Ospina Jorge Iván, Rincón Hurtado Ángela María. Calidad de vida y funcionalidad en sobrevivientes de cuidados intensivos: Una revisión exploratoria. Revista Cuidarte. 2022;13(3):e2269. http://dx.doi.org/10.15649/cuidarte.2269

Introducción: La cirugía torácica representa una de las causas de ingreso más frecuentes en la unidad de cuidados intensivos. Objetivo: Describir las variables edad, sexo, diagnóstico preoperatorio, técnica quirúrgica empleada, analgesia, complicaciones y evolución de los pacientes sometidos a cirugía torácica, en una unidad de cuidados intensivos. Métodos: Se realizó un estudio de corte transversal de 42 pacientes de cirugía torácica, ingresados en una unidad de cuidados intensivos. Se estudiaron las variables edad, sexo, diagnóstico, técnica quirúrgica empleada, analgesia, complicaciones y evolución, con las cuales se realizó un análisis de frecuencias. Resultados: El grupo etario predominante fue el de mayores de 60 años (42,9 %). El sexo representativo fue el masculino (78,5 %). El diagnóstico más frecuente para cirugía torácica fue el cáncer de pulmón (47,6 %). La técnica más empleada fue la lobectomía (28,6 %). La dipirona fue la analgesia más utilizada (35,7 %). La mayoría de los pacientes no presentó complicaciones (83,3 %). Prevalecieron los pacientes egresados vivos (97,6 %) sobre los fallecidos (2,4 %). Conclusiones: El cáncer de pulmón representó la causa más frecuente de cirugía torácica en ambos sexos, en consecuencia, la toracotomía con lobectomía fue la técnica más empleada. Este tipo de intervención siempre implica alteraciones funcionales que pueden ser inaparentes y controlables; el manejo postoperatorio en la unidad de cuidados intensivos de estos pacientes determinará en gran medida su evolución.

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

RESUMEN Las lesiones por humedad representan un importante y grave problema en personas encamadas durante periodos de tiempo prolongados. En las unidades de cuidados intensivos, dichas lesiones suponen un importante reto para los profesionales de enfermería. Su prevención y tratamiento temprano con apósitos específicos es una tarea importante para disminuir la morbilidad del enfermo en cuidados intensivos.

RESUMO Objetivo: Identificar a existência de associação entre os valores de driving pressure e mechanical power e do índice de oxigenação no primeiro dia de ventilação mecânica com a mortalidade de pacientes vítimas de trauma sem diagnóstico de síndrome do desconforto respiratório agudo. Métodos: Foram incluídos pacientes ventilados em modo de pressão ou volume controlado, com coleta de dados 24 horas após sua intubação orotraqueal. O acompanhamento do paciente foi realizado por 30 dias para obter o desfecho clínico. Os pacientes estiveram internados em duas unidades de terapia intensiva do Hospital de Pronto Socorro de Porto Alegre, no período de junho a setembro de 2019. Resultados: Foram avaliados 24 pacientes. Os valores de driving pressure, mechanical power e do índice de oxigenação foram similares entre os pacientes que sobreviveram e os que tiveram desfecho de óbito, sem diferença estatisticamente significativa entre os grupos. Conclusão: Os valores de driving pressure, mechanical power e índice de oxigenação obtidos no primeiro dia de ventilação mecânica não demonstraram ter associação com a mortalidade de pacientes vítimas de trauma sem síndrome do desconforto respiratório agudo.

Introdução: A profissão de enfermagem, nomeadamente na área dos cuidados intensivos, acarreta um elevado desgaste físico, e sobretudo psicológico, prejudicando a qualidade e a segurança dos cuidados. Com a finalidade de mapearmos a evidência científica na temática, foi estabelecida a seguinte questão de investigação: “A segurança do doente é influenciada pelo burnout sentido pelos enfermeiros que trabalham em unidades de cuidados intensivos?”. Objetivos: Identificar as causas de burnout em enfermeiros de Unidades de Cuidados Intensivos (UCI); identificar as repercussões do burnout na segurança do doente; identificar estratégias minimizadoras/preventivas do burnout. Materiais e Métodos: Revisão integrativa da literatura com recurso à consulta de bases de dados. A busca dos artigos aconteceu no dia 24 de janeiro de 2021, recorrendo à EBSCOhost Web, B-on e Google Académico. Resultados: Foram selecionadas seis produções científicas que demonstram as causas, implicações do burnout na segurança do doente em UCI e estratégias minimizadoras/preventivas do burnout. Conclusão: A análise dos artigos selecionados revela a existência de diversas causas de burnout e a associação entre o mesmo e a segurança do doente em UCI. É fundamental o planeamento de estratégias e o desenvolvimento de uma cultura de segurança voltada para o doente e para os enfermeiros no sentido de promover cuidados seguros.

El ingreso a la Unidad de Cuidados Intensivos (UCI) de un paciente post operado es para optimizar el estado clínico corrigiendo trastornos relacionados con el estrés quirúrgico y las complicaciones intraoperatorias. El objetivo del estudio fue caracterizar los pacientes post operados que ingresaron a la UCI. Se realizó un estudio observacional, descriptivo, transversal en 163 pacientes post operados de cirugías electivas que ingresaron a UCI. La muestra representó el 4,6% de las cirugías electivas. El 94,5% fueron ingresos previstos y el 5,5% imprevistos. Dentro de los casos previstos (n=154), el 68% ingresaron estables y extubados para monitoreo, el 19% por inestabilidad hemodinámica y el 13% por imposibilidad de extubación. El promedio de días de internación en la UCI fue 4 ± 3 días. 7 pacientes fallecieron (4,3%). En conclusión, se encontró una alta frecuencia de ingresos previstos. La mayoría fueron para un monitoreo postoperatorio por la envergadura de la cirugía o por las comorbilidades del paciente. La mayoría de los pacientes ingresaron hemodinámicamente estables y extubados. Los servicios que más ingresos requirieron fueron Cirugía General y Neurocirugía. El tiempo promedio de internación fue 4 días. La mortalidad fue 4,3%.

Copyright of Revista Científica de Enfermería (2071-5080) is the property of Colegio de Enfermeros del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Despite similar disease severity scores; we found a higher crude death rate in the group of immigrant children compared to the group of native children in a paediatric intensive care unit. Our study aimed to compare descriptive data and standardised mortality ratios (SMR) in order to analyse differences in mortality. Material and Methods: We conducted a retrospective study comparing demographic characteristics, diagnostic data, disease severity scores and mortality in immigrant children of Syrian descent and children of Turkish descent. We included data for the medical and surgical patients admitted in 1 year. The sample included 1283 patients. Results: We compared the age and sex distribution, presence of underlying disease, frequency of community-acquired infectious diseases, length of say, PRISM scores, SMR and crude death rates in the 2 groups.There were 1077 patients in the Turkish group and 206 patients in the immigrant group. The proportion of patients with underlying disease was greater in the Turkish group (42% vs 37.4%). The proportion of patients with a community-acquired infectious disease as the presenting complaint was similar in both groups (52.9% vs 47.4%). The mortality in patients with infectious disease was higher in the immigrant group (19.3% vs 9.8%). There was not significant difference in the mean PRISM score between the 2 groups. We found a higher mortality in the immigrant group (16% vs 11%). The standardised mortality ratio was 0.32 in the total sample, group; 0.4 in the immigrant group and 0.24 in the Turkish group. Conclusions: In our study, we found an association between community-acquired infectious disease and increased mortality in the immigrant group. The underlying mechanism for this increase remains to be explained and further research is required to determine whether parameters related to infection should be added to this severity score for its use in this specific population. Resumen: Introducción: A pesar de tener puntuaciones similares en la escala de gravedad, en una unidad de cuidados intensivos pediátricos se observó una tasa cruda de mortalidad superior en el grupo de niños inmigrantes sirios en comparación con el grupo de niños autóctonos turcos. El objetivo del estudio fue comparar datos descriptivos y la tasa estandarizada de mortalidad (TEM) para analizar diferencias en la mortalidad. Materiales y Métodos: Estudio retrospectivo con comparación de características demográficas, datos diagnósticos, puntuaciones de gravedad y mortalidad en niños inmigrantes de origen sirio y niños de origen turco. Se incluyeron en el análisis datos de pacientes médicos y quirúrgicos ingresados en un período de un año. La muestra incluyó 1283 pacientes. Resultados: Se compararon la edad y sexo de los pacientes, la presencia de enfermedad de base, la frecuencia de infecciones adquiridas en la comunidad, la estancia en la UCIP, las puntuaciones PRISM, la TEM y la tasa cruda de mortalidad en los dos grupos.El grupo turco lo formaron 1077 pacientes y el grupo inmigrante 206 pacientes. La proporción de pacientes con enfermedad subyacente era mayor en el grupo turco (42% vs. 37,4%). La proporción de pacientes en que el motivo de ingreso fue una infección adquirida en la comunidad fue similar en ambos grupos (52,9% vs. 47,4%). La mortalidad en pacientes con enfermedad infecciosa fue mayor en el grupo inmigrante (19,3% vs 9,8%). No se observaron diferencias significativas en las puntuaciones de la escala PRISM entre los dos grupos. La mortalidad fue mayor en el grupo de pacientes inmigrantes (16% vs. 11%). La TEM fue 0,32 en la muestra total, 0,4 en el grupo inmigrante y 0,24 en el grupo turco. Conclusiones: El estudio detectó una asociación entre la presencia de infección adquirida en la comunidad y una mayor mortalidad en el grupo inmigrante. El mecanismo subyacente queda por determinar, y son necesarios estudios adicionales para establecer si deberían añadirse parámetros infecciosos a esta escala de gravedad para su uso en esta población.

RESUMEN Objetivos: Describir la incidencia de lesiones por presión (LPP) en pacientes pediátricos atendidos en unidades de críticos, así como diferentes variables relacionadas con la metodología de su cálculo. Introducción: Las LPP constituyen un serio problema de salud con importantes repercusiones en los pacientes que las sufren. Las UCI pediátricas (UCIP) y neonatales (UCIN) atienden a pacientes en alto riesgo para el desarrollo de LPP. Existen pocos datos sistematizados acerca de la incidencia y variables definitorias de LPP en UCIP y UCIN. Métodos: Revisión sistemática de la literatura científica publicada entre el 1 de enero de 2000 y el 31 de diciembre de 2016, que incluía artículos que reportaban datos sobre incidencia en UCIP o UCIN. Se han incluido trabajos que notifican datos sobre LPP relacionadas con el apoyo, con o sin lesiones relacionadas con dispositivos sanitarios; se han excluido los artículos que incluían exclusivamente datos de lesiones relacionadas con dispositivos sanitarios. Resultados: La revisión sistemática ha permitido identificar 27 artículos con un total de 53 reportes de incidencia con información sobre 15 587 pacientes. En el caso de las UCIP, la mediana de la incidencia de lesiones por presión es del 19,4% en los trabajos prospectivos que no incluyen de manera implícita lesiones por presión relacionadas con dispositivos sanitarios y del 16,97% en los que incluyen a la vez lesiones relacionadas con dispositivos sanitarios y lesiones por presión por apoyo de los pacientes. En el caso de las UCIN encontramos unos valores del 3,9% y del 23,58%. Conclusiones: Los resultados del presente trabajo permiten definir el alcance de la incidencia de las LPP en pacientes críticos pediátricos y resaltan aspectos relacionados con la metodología utilizada para su cálculo.

Based on research from previous pandemics, studies of critical care survivors, and emerging COVID-19 data, we estimate that up to 30% of survivors of severe COVID will develop PTSD. PTSD is frequently undetected across primary and secondary care settings and the psychological needs of survivors may be overshadowed by a focus on physical recovery. Delayed PTSD diagnosis is associated with poor outcomes. There is a clear case for survivors of severe COVID to be systematically screened for PTSD, and those that develop PTSD should receive timely access to evidence-based treatment for PTSD and other mental health problems by multidisciplinary teams. We anticipate that up to 30% of survivors of severe COVID will develop PTSD, yet PTSD is frequently undetected in primary and secondary care settings. There is, therefore, a clear case for establishing systematic screening and ensuring timely access to treatment. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Evidence-based Healthcare is the property of Journal of Evidence-based Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud, Ciencia y Tecnología is the property of Fundacion Salud, Ciencia y Tecnologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The distribution of beds throughout Brazil respects the minimum limit considered adequate, however, the lack of beds is routine, especially in SUS, requiring greater efficiency in these sectors. In this context, mortality prediction scores were created, among them the SAPS. This is a retrospective cohort, with data from patients admitted to a general ICU. To assess SAPS III as a predictor of mortality, TMP, Oddis ratio, ROC curve and goodness of fit test were calculated. It is observed that the score underestimated mortality, however, it has a statistical correlation with the outcome of death. For admission diagnoses of cancer, thoracic surgery, hepatology and sepsis, the data point out a poor distinction between survivors and deaths and, except for the diagnoses of digestive surgery and infectious diseases, there was a good adjustment of the model under study. SAPS III proved to be a good predictor of global mortality, however, when assessed by admission diagnoses, the possibility of weaknesses was observed. [ABSTRACT FROM AUTHOR]