Enfermeria Intensiva最新文献

{"title":"Valve in valve mitral: a propósito de un caso","authors":"M. Parellada-Vendrell RN, MSc ,&nbsp;M. Prat-Masana RN ,&nbsp;S. Pérez-Ortega RN, Ph candidate","doi":"10.1016/j.enfi.2021.07.002","DOIUrl":"https://doi.org/10.1016/j.enfi.2021.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Mitral valve-in-valve implantation is a new therapeutic tool in the field of structural interventional cardiology for patients with bioprosthetic dysfunction due to severe mitral valve regurgitation and high surgical risk. The objective was to develop an individualised nursing care plan for a patient undergoing this procedure; the first case in our centre.</p></div><div><h3>Case description</h3><p>A 75-year-old woman, independent for activities of daily living, with a history of chronic renal failure and biological mitral valve replacement due to rheumatic valve disease. She was admitted to the acute cardiac care unit for severe symptomatic mitral valve regurgitations secondary to mitral bioprosthesis dysfunction. Heart surgery was ruled out due to comorbidities and high surgical risk, and the patient underwent percutaneous mitral valve-in-valve implantation. The implantation was successful.</p></div><div><h3>Assessment</h3><p>The nursing assessment followed Marjory Gordon's conceptual model identifying the following impaired patterns: pattern<!--> <!-->2: bilateral malleolar oedema without pitting; pattern<!--> <!-->3: urinary catheter and intravenous diuretic use; pattern<!--> <!-->4: dyspnoea on moderate exertion, dry nocturnal cough, orthopnoea and respiratory disturbances, and activity intolerance; pattern<!--> <!-->5: need for pharmacological assistance for a good night's rest.</p></div><div><h3>Diagnoses</h3><p>The following nursing diagnoses were established using the NANDA taxonomy: Excess fluid volume; Ineffective breathing pattern; Activity intolerance and problem collaborating; Hypotension and anaemia secondary to deep thigh haematoma.</p></div><div><h3>Planning</h3><p>The following objectives were set based on the NOC taxonomy: Fluid balance; Respiratory status: ventilation; Cardiopulmonary status, and the following NIC interventions: Hypervolaemia management; Respiratory monitoring and oxygen therapy; Vital sign monitoring and heart care.</p></div><div><h3>Discussion</h3><p>Nursing interventions aimed at monitoring haemodynamic status, fluid restriction together with the efficacy of diuretic treatment achieved a negative water balance which contributed to fluid depletion improving respiratory symptoms, enabling implantation under better conditions.</p></div><div><h3>Conclusions</h3><p>Technological progress in the health sciences, and in the field of acute cardiology in particular, directly calls for training, revision and updating of critical care nursing. Given this dynamic and continually evolving process, the specialist intensive care nurse, the inclusion of the cardiovascular nurse specialist in multidisciplinary teams such as the heart team, and expanding the consultation of the haemodynamic nurse are urgently required to ensure optimal nursing care, safety, and care quality.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 1","pages":"Pages 43-52"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49794665","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":"La disfagia en cuidados intensivos, un problema real: análisis de factores de riesgo","authors":"L.P. Armas-Navarro, Y. G. Santana-Padilla, L. Mendoza-Segura, M. Ramos-Diaz, B. Santana-López, J.A. Alcaraz-Jiménez, J. Rico-Rodríguez, L. Santana-Cabrera","doi":"10.1016/j.enfi.2022.08.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2022.08.001","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"1 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54301932","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":"The effect of oral care using honey as an additional topical agent on oral health status of intubated patients in the intensive care unit","authors":"D.T. Anggraeni MN ,&nbsp;A.T. Hayati DMD ,&nbsp;A. Nur’aeni MN","doi":"10.1016/j.enfi.2021.12.003","DOIUrl":"10.1016/j.enfi.2021.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Patients using endotracheal tubes are at high risk of oral health status dysfunction due to impaired natural airway defence, oral flora composition changes and protective substances of the teeth, medication causing xerostomia. Oral care has not been enough to manage oral mucosal dryness, so an additional topical agent is needed to protect oral mucosa to maintain oral health. Honey is one of the recommended topical agents.</p></div><div><h3>Objective</h3><p>This study aims to identify the effect of oral care with honey as topical agents on the oral health status of patients using endotracheal tube in the Intensive Care Unit.</p></div><div><h3>Methods</h3><p>This was an experimental study with a randomized pretest and posttest design. The sample was adult intubated patients, consisting of 36 patients. The data were analysed using the parametric test, and dependent and independent <em>t</em>-test.</p></div><div><h3>Results</h3><p>The oral health score in the control group was found to be pre &amp; post mean score11.94 and 13.28 (<em>p</em> <!-->=<!--> <!-->.004) respectively, while in the intervention group 11.89 and 8.33 (<em>p</em> <!-->&lt;<!--> <!-->.001). Mean differences in both groups were 4.95 (<em>p</em> <!-->&lt;<!--> <!-->.001) and the BOAS subscale differences were seen on the lips, gums &amp; mucosa, and tongue (<em>p</em> <!-->&lt;<!--> <!-->.05).</p></div><div><h3>Conclusion</h3><p>Oral care with honey as a topical agent can improve the oral health status of intubated patients on the lips, gum, mucosa, and tongue subscale. Therefore, honey as an additional topical agent can be a moisturizer to maintain the oral mucosa for intubated patients in the Intensive Care Unit. Furthermore, good mucosal health will help prevent the infection and colonization of microorganisms.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"33 4","pages":"Pages 225-232"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43092426","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":"Conceptos fundamentales para el manejo de las terapias de tratamiento sustitutivo continuo","authors":"A. Mateos-Dávila RN, MSN ,&nbsp;A.J. Betbesé MD, PhD ,&nbsp;E.M. Guix-Comellas RN, PhD","doi":"10.1016/j.enfi.2021.06.003","DOIUrl":"10.1016/j.enfi.2021.06.003","url":null,"abstract":"<div><p>This training article provides the basic concepts in continuous renal purification treatments. A diagram of the size of the molecules that are usually involved in these treatments is shown. This allows a better understanding of why certain substances need a specific type of physical process to be removed. From the knowledge of these processes, the therapies to be programmed in each machine can be classified. Simple line diagrams are provided, representing the filter, the membranes, and the molecules, which are explained.</p><p>It is also necessary to understand each part of the circuit, regardless of the distribution company. For this reason, a general circuit is shown, also drawn using simple lines. Finally, some of the management problems that can present for the ICU nurse are specified.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"33 ","pages":"Pages S1-S9"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39289114","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":"Valoración de la cultura de seguridad del paciente en la UCI de un hospital de segundo nivel al finalizar la tercera oleada de COVID-19","authors":"A. Gil-Aucejo RN ,&nbsp;S. Martínez-Martín RN ,&nbsp;P. Flores-Sánchez ,&nbsp;C. Moyano-Hernández RN ,&nbsp;P. Sánchez-Morales RN ,&nbsp;M. Andrés-Martínez RN ,&nbsp;E. Calvo-Doñate RN ,&nbsp;M. Bataller-Guerrero RN ,&nbsp;M.A. García-García PhD","doi":"10.1016/j.enfi.2021.09.006","DOIUrl":"10.1016/j.enfi.2021.09.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Current healthcare settings and ICUs especially are complex, highly technical, and multidisciplinary, with interactions between healthcare professionals and users, in which there may be errors at different levels. Our objective was to assess the perception of patient safety in our unit at the end of the third wave of the COVID pandemic, with the intention of conducting subsequent improvement actions.</p></div><div><h3>Methods</h3><p>Observational, cross-sectional, and descriptive study. The perception of Safety Culture was estimated using the HSOPS questionnaire translated into Spanish. Some questions were posed in a positive sense, and others in a negative sense. The response was also rated as positive, negative, or neutral. Our findings were compared visually, not mathematically, with those found in the previous national study «Analysis of the culture on patient safety in the hospital setting of the Spanish National Health System» published in 2009. A subgroup analysis was performed according to professional group and seniority as a health worker. The Student's t, χ^? and ANOVA tests were used.</p></div><div><h3>Results</h3><p>Sixty-two professionals responded to the questionnaire, 73.90% of the total. The median time working in ICU 2 years (interquartile range 2-4.5 years). The rating for the degree of safety was 8.06 (SD 1.16). The majority (91.20%) had not reported any adverse event in the last year. A total of 30.90% had recently received patient safety training. The dimensions considered as weaknesses were 9 («Staffing», with 27.57% of positive responses) and 10 (“Support of the hospital management in safety”, with 17.64% of positive responses). The dimensions considered as strengths were 3 («Expectation of actions by management / supervision of the service») with 85.29% of positive responses, and 5 («Teamwork») with 95.58% of positive responses. The Cronbach's alpha index values suggest that the questionnaire has adequate internal consistency. In general, our data are more positive than those collected in the 2011 national survey, although the 2 dimensions considered weaknesses were already considered such in the previous work.</p></div><div><h3>Conclusions</h3><p>The perception of patient safety in the ICU of our hospital after the end of the third wave of the COVID pandemic is adequate, with a more positive rating than that of the national study on safety culture at the hospital level carried out in 2009. The constant quest for patient safety should prioritize activity in the 2 dimensions considered weaknesses: staffing, and support from hospital management in everything related to patient safety.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"33 4","pages":"Pages 185-196"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39718298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Membranas en terapias depurativas continuas","authors":"A. Mateos-Dávila RN, MsN, PhDc ,&nbsp;M.E. Prieto-Arriba RN, MsN ,&nbsp;S. Juárez-Zapata RN ,&nbsp;E.M. Guix-Comellas RN, MsN, PhD","doi":"10.1016/j.enfi.2022.07.004","DOIUrl":"10.1016/j.enfi.2022.07.004","url":null,"abstract":"<div><p>The possibility of filtering water and solutes from the blood is conditioned by the nature of the filter membranes in purification techniques. Some important characteristics such as its surface, its hydrophilicity, its adsorptive capacity, among others, are described here.</p><p>Not all patients respond equally to all types of membrane, and it is necessary to know why. Perhaps a specific pathology needs a specific membrane. The Sieving coefficient help to know the depuration of the molecules. The calculation of the membrane permeability in convective treatments helps to assess how much surface is left free for the depuration.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"33 ","pages":"Pages S65-S69"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127020986","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":"Las terapias adsortivas como coadyuvante al soporte vital en el paciente crítico","authors":"Y.G. Santana-Padilla RN, MSN, PhD ,&nbsp;F.J. Berrocal-Tomé RN ,&nbsp;B.N. Santana-López RN, MSN, PhDc","doi":"10.1016/j.enfi.2022.06.005","DOIUrl":"10.1016/j.enfi.2022.06.005","url":null,"abstract":"<div><p>Renal depurative therapies in acute situations are commonly used in intensive care units (ICU). The principles used for the replacement of renal function are convection, diffusion, and adsorption. Adsorption has been described as an effective principle for removing toxic substances from the blood using membranes and sorbents added to extracorporeal circuits. The regulation of pro-inflammatory mediators (“cytokine storm”) in the septic patient or protein-bound uraemic toxins is under investigation using these adsorptive depurative techniques. The potential of these therapies to eliminate endotoxins and cytokines in patients with or without acute kidney injury make them complementary interventions to be considered in the life support of critically ill patients. Currently, the following adsorptive therapies have been developed: MARS, Cytosorb®, CPFA, OXIRIS® and Seraph®. Critical care nurses are responsible for starting, monitoring, and managing the complete purification procedure, so their training and knowledge are essential for the success of these therapies.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"33 ","pages":"Pages S46-S55"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123057802","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":"Asociación entre el vínculo madre-hijo y los síntomas depresivos en madres de la Unidad de Cuidados Intensivos Neonatales: estudio caso-control","authors":"A. Karamanou CNM, MSc ,&nbsp;P. Varela CNM, MSc, PhD(c) ,&nbsp;C. Nanou RN, RM, MSc, MPH, PhD ,&nbsp;A. Deltsidou RN, RM, MSc, MPH, PhD","doi":"10.1016/j.enfi.2021.07.003","DOIUrl":"10.1016/j.enfi.2021.07.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Maternal perinatal depression has been associated with impaired mother-infant bonding. The adverse effect of this impaired bonding has been reported. This study aimed to investigate and compare the posnatal depressive symptoms and the mother-infant bonding in a Neonatal Intensive Care Unit (NICU) and of mothers with healthy newborns respectively. Secondly, was to explore the association between depressive symptomatology and bonding in both groups.</p></div><div><h3>Methods</h3><p>In this case study, mothers in the early pospartum period who gave birth in the same perinatal center of Greece were recruited to participate. The cases consisted of 88 mothers of neonates who were hospitalized in the NICU and controls were 100 mothers of full-term healthy neonates. For the collection of the data questionnaires including demographics and perinatal variables were used. For the bonding and posnatal assessment, the Mother to Infant Bonding Scale, the Postpartum Bonding Questionnaire, and the Hospital Anxiety and Depression Scale were used.</p></div><div><h3>Results</h3><p>There was a significant difference between the mean of bonding scores of NICU mothers and the control group (t<!--> <!-->=<!--> <!-->-2.696, <em>P</em>=.008). NICU mothers presented lower scores in bonding with the newborn compared to the control group and presented higher depression scores compared to those of controls (χ² <!-->=<!--> <!-->28.588, <em>P</em>=.000). The depression scores were correlated with bonding scores in both groups.</p></div><div><h3>Discussion</h3><p>A NICU admission has an impact on bonding and in some way interacts with maternal pospartum mental health, therefore more research is needed.</p></div><div><h3>Conclusions</h3><p>NICU mothers have been presented as more vulnerable than mothers of healthy infants since they expressed a lower mother-infant bonding and higher depression scores. The support of these vulnerable mothers and the facilitation of mother-infant bonding by the NICU staff is of utmost importance.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"33 4","pages":"Pages 165-172"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123536895","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":"La clasificación de la lesión renal aguda: una herramienta para las enfermeras de críticos","authors":"Y.G. Santana-Padilla RN, MSN, PhD ,&nbsp;J.A. Fernández-Castillo RN, MSN ,&nbsp;A. Mateos-Dávila RN, MSN, PhDc","doi":"10.1016/j.enfi.2022.05.007","DOIUrl":"10.1016/j.enfi.2022.05.007","url":null,"abstract":"<div><p>In acute illnesses, patients may present associations between several pathologies. Kidney failure is one of the most common in critically ill patients.</p><p>Urea, creatinine and potassium blood levels, among others, are indicative of renal function and the health professionals need to be acted upon to maintain the patients’ internal functions without vital risk. Addressing these elements become a central element in the management and treatment of critically ill patients.</p><p>The assessment of this disorder in early stages is complicated. Therefore, continuous monitoring is a key element in the prevention of worsening due to various clinical situations such as, for example, renal dysfunction secondary to nephrotoxic drugs in frail patients. This clinical assessment, carried out correctly, enables health professionals to perform early intervention. This text will provide an approach to the classification of acute kidney injury as a tool to promote the prevention and to detect the incidence. For critical care staff, these concepts are essential to ensure high quality healthcare.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"33 ","pages":"Pages S35-S41"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133494807","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":"Seguridad en el manejo de los sensores de presión en terapia renal depurativa continua","authors":"F.J. Berrocal-Tomé RN ,&nbsp;E.M. Guix-Comellas RN, MSN, PhD ,&nbsp;A. Mateos-Dávila RN, MSN, PhDc","doi":"10.1016/j.enfi.2022.01.001","DOIUrl":"10.1016/j.enfi.2022.01.001","url":null,"abstract":"<div><p>Continuous evaluation of treatment pressures on extracorporeal therapy monitors is very useful in critically ill patients. All the monitors on the market offer five pressure tapings distributed appropriately along the circuits, also calculating the transmembrane pressure. The importance of each of these sensors and the interpretation of the data offered by the monitor are described in this review. Arriving on time for its correct analysis offers a lot of security in the therapy and the patient is treated more effectively and efficiently.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"33 ","pages":"Pages S10-S16"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121553423","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}