Enfermeria Intensiva最新文献

{"title":"Hyperpolypharmacy in intensive care: Medicines interactions between centrally acting drugs","authors":"Ana Paula Possebon Carda,&nbsp;Adriana Inocenti Miasso PhD,&nbsp;Assis do Carmo Pereira Júnior PhD,&nbsp;Carlos Renato Tirapelli PhD","doi":"10.1016/j.enfi.2026.500616","DOIUrl":"10.1016/j.enfi.2026.500616","url":null,"abstract":"<div><h3>Introduction</h3><div>The prescription of multiple drugs increases the likelihood of drug interactions, making the use of drugs in intensive care unit patients challenging.</div></div><div><h3>Aim</h3><div>To analyze the occurrence of hyperpolypharmacy and potential drug interactions between centrally-acting drugs and drugs from other pharmacological classes on the first and last day of admission to an intensive care unit.</div></div><div><h3>Methods</h3><div>Descriptive study with patients in a hospital in the state of São Paulo, Brazil. The study included patients of both sexes over the age of 18. The patients included had been in the ICU for three days or more, had multiple diagnoses and were taking centrally-acting drugs. Data was collected using the Philips Tasy health management software, that provides information on age, gender, marital status, outcome, polypharmacy, hyperpolypharmacy and results of laboratory blood tests. Data was also collected on prescribed medication. Micromedex® software was used to analyze the occurrence of potential drug interactions and a logistic regression model was used to analyze the data.</div></div><div><h3>Results</h3><div>A higher risk of death was identified in patients aged 40–59 years (OR<!--> <!-->=<!--> <!-->7.36; <em>p</em> <!-->=<!--> <!-->0.010; CI 1.39–38.80) and in those taking cardiovascular medications that interact with other medications (OR<!--> <!-->=<!--> <!-->4.41; <em>p</em> <!-->=<!--> <!-->0.007; CI 1.48–13.08). Severe drug interactions were associated with regular documentation (OR<!--> <!-->=<!--> <!-->3.54; <em>p</em> <!-->=<!--> <!-->0.014; CI 1.32–9.46) and an unspecified time of onset (OR<!--> <!-->=<!--> <!-->27.76; <em>p</em> <!-->&lt;<!--> <!-->0.001; CI 7.53–102.2). Moderate drug interactions were associated with the time of onset: a nonspecific onset increased the incidence by 13.13 times (<em>p</em> <!-->&lt;<!--> <!-->0.001; CI 3.24–53.17), while a delayed onset increased this probability by 24.85 times (<em>p</em> <!-->&lt;<!--> <!-->0.001; CI 5.32–115.9).</div></div><div><h3>Conclusion</h3><div>The results reveal the need to invest in educational strategies to reduce drug interactions in the intensive care unit, with a view to identifying potential drug interactions at an early stage.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 3","pages":"Article 500616"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-intensive care syndrome in cardiac patients: Cognitive, psychological, and functional implications – A cross-sectional study","authors":"Anastasios Tzenalis PhD, MSc, RN,&nbsp;Efrosini Petropoulou MSc, RN,&nbsp;George Kipourgos PhD(c), MSc, RN,&nbsp;Evangelia Andreopoulou MSc, RN,&nbsp;Angeliki Gkotsi PhD(c), MSc, RN,&nbsp;Eleni Albani PhD, MSc, RN","doi":"10.1016/j.enfi.2026.500602","DOIUrl":"10.1016/j.enfi.2026.500602","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-intensive care syndrome (PICS) involves cognitive, psychological, and physical impairments after ICU hospitalization. While extensively studied in general ICU populations, its impact on cardiac patients remains underexplored.</div></div><div><h3>Objectives</h3><div>This study examined the prevalence and severity of PICS-related symptoms among cardiac patients 2–4 weeks after ICU discharge and explored correlations with selected demographic and clinical factors.</div></div><div><h3>Method</h3><div>A cross-sectional correlational study was conducted with 100 post-ICU cardiac patients, assessed 2–4 weeks after ICU discharge, at a Critical Care Recovery Center (May–June 2024). Data were collected using a structured questionnaire and the Greek-adapted Healthy Aging Brain Care Monitor – Self Report (HABC-M SR). Non-parametric tests and Spearman correlations were applied (<em>p</em> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>Clinically relevant PICS symptoms were identified in 68% of participants. The mean total HABC-M SR score was 41.4<!--> <!-->±<!--> <!-->23.9, indicating moderate to severe symptom burden. Functional and psychological impairments were more prominent than cognitive deficits. Greater symptom burden correlated with older age, lower educational level, and male sex.</div></div><div><h3>Discussion</h3><div>PICS significantly influences the recovery of cardiac patients, affecting their physical, cognitive, and emotional well-being. Early identification of vulnerable groups is essential.</div></div><div><h3>Conclusions</h3><div>Post-intensive care syndrome was highly prevalent among cardiac patients within the first month following ICU discharge, with functional and psychological impairments more pronounced than cognitive deficits. Older age, lower educational level, and male sex were correlated with greater symptom burden across PICS domains. These findings highlight the multidimensional impact of PICS in cardiac populations and underscore the need for early, structured screening and multidisciplinary follow-up during early recovery to support functional recovery and psychological well-being.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 3","pages":"Article 500602"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisión sistemática de aerosolterapia en ventilación mecánica invasiva: ubicación eficaz y rol de la enfermera","authors":"Carmen Carrera Castro RN","doi":"10.1016/j.enfi.2026.500613","DOIUrl":"10.1016/j.enfi.2026.500613","url":null,"abstract":"<div><h3>Introduction</h3><div>Aerosol therapy during invasive mechanical ventilation is a common practice in intensive care units, however, its effectiveness is highly dependent on technical factors. Variability in device positioning and nursing technique produces substantial differences between the nominal dose and the fraction of drug that reaches the lungs, underscoring the need for standardized placement to enhance both safety and therapeutic efficiency.</div></div><div><h3>Objective</h3><div>To examine recent scientific evidence to determine the optimal positioning of aerosol delivery devices within the ventilator circuit, thereby guiding nursing practice toward standardized, evidence-informed procedures.</div></div><div><h3>Methodology</h3><div>Systematized review (2018-2025) conducted in PubMed, BVSalud, and complementary academic search engines. MeSH, DeCS, and free-text terms related to aerosol therapy and mechanical ventilation were used. The PIO framework was applied following PRISMA guidelines and GRADE assessment. From 165 initial records, eight original studies were included.</div></div><div><h3>Results</h3><div>Vibrating mesh nebulizers demonstrated greater efficiency when positioned on the inspiratory limb, either near the Y-piece (10-15<!--> <!-->cm) or at the humidifier inlet. Jet nebulizers showed optimal placement varying according to the device type (continuous, breath-actuated, or synchronized), although their overall performance was inferior to that of vibrating mesh nebulizers. Metered-dose inhalers were most effective when positioned on the inspiratory limb before the Y-piece, particularly when used with a spacer.</div></div><div><h3>Conclusions</h3><div>The available evidence suggests that device positioning influences the efficiency of aerosol therapy during invasive mechanical ventilation. Vibrating mesh nebulizers and properly positioned inhalers may improve pulmonary drug delivery; however, the overall certainty of the evidence remains low.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 3","pages":"Article 500613"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conciliación de la medicación en el paciente crítico: innovación digital para la seguridad del paciente","authors":"María Martín Cerezuela BPharm,&nbsp;Luis Pérez de Amezaga Tomás BPharm,&nbsp;Jesús Ruiz Ramos BPharm, PhD,&nbsp;Ana de Lorenzo Pinto BPharm, PhD,&nbsp;Esther Domingo Chiva BPharm, PhD,&nbsp;Marta Valera Rubio BPharm,&nbsp;Irene Aquerreta González BPharm, PhD,&nbsp;Carla Bastida Fernández BPharm, PhD,&nbsp;Laura Doménech Moral BPharm, PhD,&nbsp;Amaia Egüés Lugea BPharm, PhD,&nbsp;Miguel Ángel Amor García BPharm, PhD,&nbsp;Tatiana Betancor García BPharm,&nbsp;Sara Cobo Sacristán BPharm,&nbsp;Marta Albanell Fernández BPharm,&nbsp;Sara Ortiz Pérez BPharm,&nbsp;Fernando Becerril Moreno BPharm, PhD","doi":"10.1016/j.enfi.2026.500615","DOIUrl":"10.1016/j.enfi.2026.500615","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 3","pages":"Article 500615"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfil competencial de la enfermera de cuidados críticos, urgencias y emergencias en España: fundamentos para una especialidad propia","authors":"Maria del Carmen Duque del Río MSc, RN ,&nbsp;Begoña Fernández Rodriguez MSc, RN ,&nbsp;Juan Francisco Velarde-García PhD, RN ,&nbsp;Elena Gómez Oliva PhD, RN ,&nbsp;Miguel Ángel Robledo Uceda MSc, RN ,&nbsp;Diego Villalobos Buitrago MSc, RN ,&nbsp;Cecilia Cuzco Cabellos PhD, RN ,&nbsp;Miguel Ángel Giménez-Lajara PhD, Rn","doi":"10.1016/j.enfi.2026.500605","DOIUrl":"10.1016/j.enfi.2026.500605","url":null,"abstract":"<div><h3>Introduction</h3><div>Critical care, emergency, and urgent care nursing is practiced within a highly specialized clinical setting that requires advanced competencies extending beyond generalist nursing education and that are not currently formally delineated through a state-recognized residency-based specialty within the nursing specialties of the Spanish National Health System. The national regulatory framework allows for the justification of new specialties based on healthcare needs, clinical complexity, and the existence of clearly differentiated professional competencies.</div></div><div><h3>Objective</h3><div>To identify the specific competencies of nurses in critical care, emergency, and urgent care, by analyzing their differences in relation to existing nursing specialties, as a basis for justifying their establishment as a distinct specialty.</div></div><div><h3>Method</h3><div>A sequential mixed-methods, descriptive and comparative study was conducted in three phases: 1) a competency questionnaire based on the Nursing Interventions Classification, the Therapeutic Intervention Scoring System–28, and the National Aeronautics and Space Administration–Task Load Index; 2) an eDelphi consensus process; and 3) an association analysis between nursing interventions and NANDA-I diagnoses. Data were analyzed using descriptive statistics and concordance measures, yielding high levels of reliability.</div></div><div><h3>Results</h3><div>The first phase of the study was completed by 3,476 nurses, and 302 experts participated in the second phase. In the third phase, 72.72% of the interventions reached a high frequency level (4–5), with a predominance of generalist activities such as nutrition, mobility, hygiene, safety, and comfort. In contrast, specific interventions; including oxygenation, advanced therapies, diagnostics, and critical communication; showed a high frequency exclusively in intensive care units, post-anesthesia care units, in-hospital and out-of-hospital emergency services, and advanced life support and nurse-led advanced life support teams (85.6%). Concordance in nursing interventions was 67.10%, and the intervention–nursing diagnosis association reached 53.65%, with only 31.46% shared with existing nursing specialties.</div></div><div><h3>Discussion</h3><div>The findings identify an advanced and homogeneous competency core in critical care, emergency, and urgent care nursing, clearly differentiated from generalist practice and aligned with international advanced practice frameworks.</div></div><div><h3>Conclusions</h3><div>Establishing a dedicated specialty would standardize training and competencies, leading to improvements in patient safety, quality of care, and healthcare system efficiency.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500605"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147746624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SIMUPICS: curso basado en simulación para la prevención del síndrome post-UCI","authors":"Marta Raurell-Torredà RN, PhD ,&nbsp;Ignacio Zaragoza-García RN, PhD ,&nbsp;Francisco Javier Sánchez-Chillón RN, MSN ,&nbsp;Martin Torralba-Melero RN, MSN ,&nbsp;Oscar Arrogante RN, PhD ,&nbsp;María Jesús Frade Mera RN, PhD ,&nbsp;Elena Maestre RN, MSN ,&nbsp;Mariona Farrés-Tarafa RN, PhD","doi":"10.1016/j.enfi.2025.500588","DOIUrl":"10.1016/j.enfi.2025.500588","url":null,"abstract":"<div><h3>Introduction</h3><div>Post Intensive Care Syndrome (PICS) can be prevented by applying the components of the ABCDE bundle (mainly pain management, sedation, delirium and early mobilization).</div></div><div><h3>Objective</h3><div>To design and validate the simulation-based SIMUPICS course to train knowledge and skills related to the application of the ABCDE bundle.</div></div><div><h3>Methods</h3><div>Descriptive study of metric characteristics. Analysis of the face and content validity of the course with experts from the working groups of the Spanish Society of Intensive Care Nurses and Coronary Units (SEEIUC). Pilot test with at least 30 intensive care unit (ICU) nurses to assess applicability of the course in ICUs.</div></div><div><h3>Results</h3><div>Two Delphi rounds were carried out until 85% of the items were agreed as optimal and an Aiken V between 0.82 and 1. The nurses who participated in the pilot test (n<!--> <!-->=<!--> <!-->38) considered that the simulation received had helped them to identify key actions in the prevention of post-ICU syndrome (5 [4-5]) with a Likert scale from 1 totally disagree to 5 totally agree, and that the structure of the course (stations, duration, dynamics) facilitated practical learning (5 [4-5]).</div></div><div><h3>Conclusions</h3><div>The SIMUPICS course, validated by nursing experts in analgesia, delirium and mobilization practices, is useful for training skills and knowledge related to the ABCDE bundle. Its design based on clinical simulation makes it a suitable strategy for the continuing education of health professionals, both in situ in the ICU itself and in simulation centers.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500588"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceso vascular intraóseo en transporte pediátrico y neonatal especializado. Estudio descriptivo","authors":"Marta Rodríguez-Navarro MD,&nbsp;Montserrat Pujol-Jover MD,&nbsp;Maria Lourdes Ausin-Garcia MD,&nbsp;Beatriz Soria-Navarro MD,&nbsp;Roser Riera-Mas RN","doi":"10.1016/j.enfi.2025.500586","DOIUrl":"10.1016/j.enfi.2025.500586","url":null,"abstract":"<div><h3>Aims</h3><div>The primary objective was to identify the factors associated with the success rate of intraosseous (IO) access placement in patients attended by a Pediatric and Neonatal Transport (PNT) unit.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive study between January 2021 and September 2025, including all pediatric and neonatal patients (0-16 years) who required intraosseous (IO) access during care provided by the TPN team. Demographic, clinical, and procedural data were collected. Descriptive statistics were used, and associations with the primary outcome (successful IO access placement) were assessed using the Chi-square test for categorical variables (age group, operator, needle type, and anatomical site) and the Mann–Whitney U test for numerical variables (weight and age).</div></div><div><h3>Results</h3><div>Sixty IO access attempts were analyzed in 45 patients. The overall success rate was 88.3% (n<!--> <!-->=<!--> <!-->53). Anatomical site was significantly associated with successful placement (<em>P</em>=.01), with the proximal tibia being the most frequently used and effective site, followed by femur and humerus. No association was found with patient age, needle size, or the provider performing the procedure. Complications occurred in 15.1% of cases, all due to extravasation, with a higher incidence in younger and lower-weight patients.</div></div><div><h3>Conclusions</h3><div>The IO access is an effective alternative to vascular access in critically ill pediatric and neonatal patients. Placement success is significantly influenced by anatomical site. Neonates show a tendency toward lower success rates and higher incidence of extravasation.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500586"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated and structured care in lung transplantation for a Jehovah's Witness patient","authors":"Thayanne Chaves RN ,&nbsp;Ariel Pereira da Silva ,&nbsp;Isabella Rosmino ,&nbsp;João Paulo Victorino RN, CCNS, PhD ,&nbsp;Talita Rodrigues PT ,&nbsp;Daniel Santos PhD ,&nbsp;Vagner Pires de Campos Junior PT","doi":"10.1016/j.enfi.2026.500590","DOIUrl":"10.1016/j.enfi.2026.500590","url":null,"abstract":"<div><h3>Evaluation</h3><div>A 63-year-old female Jehovah's Witness with familial idiopathic pulmonary fibrosis underwent elective bilateral lung transplantation at a private quaternary hospital in southeastern Brazil. Intraoperatively, Cell Saver technology was used to minimize blood loss. Postoperatively, she developed severe anemia (Hb &lt;7<!--> <!-->g/dL), primary graft dysfunction (grade 2), and septic shock. Due to her religious beliefs, she refused allogeneic blood transfusion, creating unique challenges for the intensive care team.</div></div><div><h3>Diagnosis</h3><div>Nursing diagnoses included risk of ineffective tissue perfusion related to severe anemia and transfusion refusal; impaired gas exchange secondary to graft dysfunction; risk of infection and sepsis due to immunosuppression; and potential spiritual distress associated with religious restrictions in the context of critical illness.</div></div><div><h3>Planning</h3><div>The care plan focused on pharmacological stimulation of erythropoiesis, continuous hemodynamic and respiratory monitoring, renal replacement therapy, infection control, and individualized rehabilitation strategies. Ethical principles – particularly autonomy – guided all shared decision-making and documentation.</div></div><div><h3>Discussion</h3><div>Despite comprehensive interdisciplinary interventions, the patient developed progressive clinical deterioration and died. This case emphasizes the importance of structured nursing care, integration of bioethical principles, and institutional preparedness in managing complex postoperative scenarios when transfusion is not an option. It highlights the nurse's central role in coordinating technical, psychosocial, and spiritual care needs, ensuring that patient-centered values remain at the core of critical care.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500590"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inteligencia emocional en la UCI: de lo invisible a lo imprescindible","authors":"Mónica Vázquez-Calatayud PhD ,&nbsp;Rosana Goñi-Viguria MSN","doi":"10.1016/j.enfi.2026.500603","DOIUrl":"10.1016/j.enfi.2026.500603","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500603"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147706781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital early warning scores for predicting clinical deterioration of COVID-19 patients: An integrative review","authors":"Elena Moreta-Gil RN ,&nbsp;Cristina Rivera-Picón PhD ,&nbsp;Rosa Conty-Serrano PhD ,&nbsp;Begoña Polonio-López PhD ,&nbsp;José L. Martín-Conty PhD ,&nbsp;Francisco Martín-Rodríguez PhD ,&nbsp;Ancor Sanz-García PhD","doi":"10.1016/j.enfi.2025.500584","DOIUrl":"10.1016/j.enfi.2025.500584","url":null,"abstract":"<div><h3>Introduction</h3><div>Triage, and in particular scales, are a tool that allows patients with clinical risk to be managed for early, effective and efficient care.</div></div><div><h3>Objective</h3><div>To identify the most precise and specific prehospital score for the detection of clinical worsening risk in COVID-19 patients.</div></div><div><h3>Methods</h3><div>The protocol followed for the integrative review was the PRISMA method 2020. A literature search was performed in five databases: Scopus, Cochrane Library, Pubmed, Embase, Prospero and Lit-covid-NIH-NLM. Based on 19 keywords, 5 inclusion and 5 exclusion points. Finally, 22 articles were selected.</div></div><div><h3>Results</h3><div>Twenty-two studies were identified that addressed effective outcomes for early measures such as telephone triage, web, protocols or tools such as scales. We compared the functionality of 12 scales in patients with COVID-19, showing that the most important variables for this early assessment of clinical worsening were systolic blood pressure, temperature, oxygen saturation and the need for oxygen supplementation. The best predictive value for clinical deterioration and mortality was obtained by NEWS score, with sensitivities and specificities ranging from 77 to 88%.</div></div><div><h3>Conclusions</h3><div>Prehospital scales are still under development, with few research studies and a relative confidence in their statistical values. Nonetheless, it has been observed that the scale that best fit the COVID-19 was NEWS with an optimal prediction for patients. This could pave the way for its use under other relevant clinical scenarios, such as acute respiratory infections, exacerbations of chronic diseases or future health emergencies.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"37 2","pages":"Article 500584"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}