Enfermeria Intensiva最新文献

{"title":"Validez predictiva de la escala de fragilidad Clinical Frailty Scale-España sobre el incremento de la dependencia tras el alta hospitalaria","authors":"S. Arias-Rivera PhDc, MsN, RN ,&nbsp;M.M. Sánchez-Sánchez MsN, RN ,&nbsp;E. Romero de-San-Pío MsN, RN ,&nbsp;Y. Gabriel Santana-Padilla PhD, RN ,&nbsp;M. Juncos-Gozalo RN ,&nbsp;G. Via-Clavero PhD, RN ,&nbsp;M.N. Moro-Tejedor PhD, RN ,&nbsp;M. Raurell-Torredà PhD, RN ,&nbsp;C. Andreu-Vázquez PhD, MsC, MvD ,&nbsp;Grupo Fragil-Es-UCI","doi":"10.1016/j.enfi.2023.07.003","DOIUrl":"10.1016/j.enfi.2023.07.003","url":null,"abstract":"<div><h3>Introduction</h3><p>The frailty present at hospital admission and the stressors to which patients are subjected during their stay may increase dependency at hospital discharge.</p></div><div><h3>Objectives</h3><p>To assess the predictive validity of the Clinical Frailty Scale-Spain (CFS-Spain) on increased dependency at 3 and 12 months (m) after hospital discharge.</p></div><div><h3>Methodology</h3><p>Multicentre cohort study in 2020-2022. Including patients with &gt;<!--> <!-->48<!--> <!-->h stay in intensive care units (ICU) and non-COVID-19. Variables: pre-admission frailty (CFS-Spain). Sex, age, days of stay (ICU and hospital), dependency on admission and at 3<!--> <!-->m and 12m after discharge (Barthel Index), muscle weakness (Medical Research Council Scale sum score &lt;<!--> <!-->48), hospital readmissions. Statistics: descriptive and multivariate analysis.</p></div><div><h3>Results</h3><p>254 cases were included. Thirty-nine per cent were women and the median [Q1-Q3] age was 67 [56-77] years. SAPS 3 on admission (median [Q1-Q3]): 62 [51-71] points.</p><p>Frail patients on admission (CFS-SAPS 5-9): 58 (23%). Dependency on admission (n<!--> <!-->=<!--> <!-->254) vs. 3<!--> <!-->m after hospital discharge (n<!--> <!-->=<!--> <!-->171) vs. 12m after hospital discharge (n<!--> <!-->=<!--> <!-->118): 1) Barthel 90-100: 82% vs. 68% vs. 65%. 2) Barthel 60-85: 15% vs. 15% vs. 20%. 3) Barthel 0-55: 3% vs. 17% vs 15%.</p><p>In the multivariate analysis, adjusted for the variables recorded, we observed that frail patients on admission (CFS-Spain 5-9) are 2.8 times (95%CI: 1.03-7.58; p<!--> <!-->=<!--> <!-->0.043) more likely to increase dependency (Barthel 90-100 to &lt;<!--> <!-->90 or Barthel 85-60 to &lt;<!--> <!-->60) at 3<!--> <!-->m post-discharge (with respect to admission) and 3.5 times (95%CI: 1.18-10.30; p<!--> <!-->=<!--> <!-->0.024) more likely to increase dependency at 12m post-discharge. Furthermore, for each additional CFS-Spain point there is a 1.6-fold (95%CI: 1.01-2.23; p<!--> <!-->=<!--> <!-->0.016) greater chance of increased dependency in the 12m following discharge.</p></div><div><h3>Conclusions</h3><p>CFS-Spain at admission can predict increased dependency at 3<!--> <!-->m and 12m after hospital discharge.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 2","pages":"Pages 79-88"},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130239923000731/pdfft?md5=0687d6270925d033ff6aa2c0551aa778&pid=1-s2.0-S1130239923000731-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136128079","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":"Intervenciones no farmacológicas para reducir el uso de contenciones mecánicas en las unidades de críticos","authors":"G. Via-Clavero RN, MSc, PhD ,&nbsp;M. Acevedo Nuevo RN, MSc, PhD ,&nbsp;D. Gil-Castillejos RN, MSc, PhD ,&nbsp;J.J. Rodríguez Mondéjar RN, MSc, PhD ,&nbsp;D. Alonso Crespo RN, MSc","doi":"10.1016/j.enfi.2023.11.002","DOIUrl":"https://doi.org/10.1016/j.enfi.2023.11.002","url":null,"abstract":"<div><p>Physical restraint use in critical care units is a frequent low-value care practice influenced by numerous factors creating a local culture. The translation of evidence-based recommendations into clinical practice is scarce so, the analysis of interventions to de-adopt this practice is needed. This update aims to describe and identify nonpharmacological interventions that contribute to minimizing the use of physical restraints in adult critically ill patients. Interventions are classified into 2 groups: those that include education alone and those that combine training with one or more components (multicomponent interventions). These components include less restrictive restraint alternatives, use of physical and cognitive stimulation, decision support tools, institutional multidisciplinary committees, and team involvement. The heterogeneity in the design of the programs and the low quality of the evidence of the interventions do not allow us to establish recommendations on their effectiveness. However, multicomponent interventions including training, physical and cognitive stimulation of the patient and a culture change of professionals and the organizations towards making restraints visible might be the most effective. The implementation of these programs should underpin on a prior analysis of each local context to design the most effective-tailored combination of interventions to help reduce or eliminate them from clinical practice.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 2","pages":"Pages e8-e16"},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140822107","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":"Cuidados enfermeros en el postoperatorio de la cirugía de Glenn. A propósito de un caso","authors":"Ester Álvaro-Sánchez RN","doi":"10.1016/j.enfi.2023.05.003","DOIUrl":"10.1016/j.enfi.2023.05.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Glenn surgery is used as a palliative procedure in children with Hypoplastic Left Heart Syndrome (HLHS) and its objective is to partially redirect the systemic venous return.</p><p>An individualized care plan is presented for a 7-month-old infant, admitted to the Pediatric Intensive Care Unit, after undergoing Glenn procedure. And is shown her evolution during admission.</p></div><div><h3>Assessment</h3><p>Marjorie Gordon's 11 functional health patterns are used for the nursing assessment, highlighting among the altered patterns, the nutritional-metabolic and the activity-exercise, due to their implication in hemodynamic changes derived from the surgery.</p></div><div><h3>Diagnoses and planning</h3><p>Due to their association with the most common postoperative complications in this type of surgery, 8 diagnoses were prioritised according to NANDA-I taxonomy: risk for infection, excess fluid volume, risk for shock, risk for bleeding, risk for decreased cardiac output, impaired gas exchange, ineffective airway clearance and risk for ineffective cerebral tissue perfusion.</p><p>In each of them, expected patient outcomes and nursing interventions, were selected using the NOC and NIC taxonomies, respectively.</p><p>Outcome criteria scores showed a favourable evolution after 7 days from admission, only 3 of the diagnoses selected at the beginning remain active.</p></div><div><h3>Discussion</h3><p>The development and reassessment of the nursing care plan has made it possible to make an effective monitoring of patient's postoperative evolution and to standardize nursing care, ensuring safe and quality health care.</p><p>The lack of similar case reports in available bibliography has prevented us from comparing actions, therefore it has been necessary to disclose these scientific articles to guarantee best evidence-based practice.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 2","pages":"Pages 146-158"},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588111","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":"Adecuación de las escalas conductuales en la monitorización del dolor en el paciente crítico incapaz de autoinformar","authors":"G. Robleda-Font RN, MSc, PhD ,&nbsp;C. López-López RN, MSc, PhD ,&nbsp;I. Latorre-Marco RN ,&nbsp;J. Pozas-Peña RN, MSc, PhDcandidate ,&nbsp;D. Alonso-Crespo RN, MSc ,&nbsp;O. Vallés-Fructuoso RN, MSc, PhDcandidate ,&nbsp;A. Castanera-Duro RN, MsC, PhD","doi":"10.1016/j.enfi.2023.12.004","DOIUrl":"10.1016/j.enfi.2023.12.004","url":null,"abstract":"<div><p>Appropriateness is a dimension of quality that evaluates the effective use of technologies, resources or interventions in specific situations or populations, assessing whether our interventions do more benefit than harm.</p><p>The evidence regarding pain monitoring in the critically ill patient points to the periodic assessment of pain using appropriate tools, with the aim of improving pain management and more efficient use of analgesics in the intensive care unit. The first step would be to assess the patient's ability to communicate or self-report and, based on this, to select the most appropriate pain assessment tool. In patients who are unable to self-report, behavioral pain assessment tools are recommended.</p><p>When we talk about the suitability of behavioral scales for pain monitoring in critically ill patients unable to self-report, we refer to their use with a clear clinical benefit, i.e. using the right tool for pain assessment to be effective, efficient and consistent with bioethical principles.</p><p>To our knowledge, there are no published data on the suitability of pain assessment tools in unable to self-report critically ill patients, so, in the framework of continuous quality improvement in pain care, new research should incorporate this approach by integrating the best scientific evidence with current clinical practice.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 2","pages":"Pages e17-e22"},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402454","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":"Efectividad de los sistemas de retorno de sangre en pacientes de cuidados intensivos: una revisión de alcance","authors":"M. Raurell-Torredà PhD, MSN, RN ,&nbsp;S. Arias-Rivera PhDc, MSN, RN ,&nbsp;M.E. Rodríguez-Delgado RN, MsC ,&nbsp;C. Campos-Asensio BPharm, MLS ,&nbsp;R.J. Fernández-Castillo PhDc, MSN, RN","doi":"10.1016/j.enfi.2023.02.002","DOIUrl":"10.1016/j.enfi.2023.02.002","url":null,"abstract":"<div><h3>Background</h3><p>Anemia associated with blood extraction for diagnostic purposes is a highly prevalent entity in intensive care units (ICU) for adults. The evidence recommends its prevention through different strategies, among which we can find the use of closed blood sampling systems (CBSS). Different experimental studies support the use of these devices.</p></div><div><h3>Objective</h3><p>To identify knowledge gaps regarding the effectiveness of CBSS in ICU patients.</p></div><div><h3>Methods</h3><p>Scoping review with search in PubMed, CINAHL, Embase, Cochrane Library and Joanna Briggs Institute databases, between September 2021 and September 2022. No time, language, or other limits were applied to ensure the recovery of all relevant studies. Gray literature sources: DART-Europe, OpenGrey and Google Scholar. Two researchers independently reviewed titles and abstracts and assessed full texts against the inclusion criteria. The following data was extracted for each study: design and sample, inclusion and exclusion criteria, variables, type of CBSS, results and conclusions.</p></div><div><h3>Results</h3><p>18 articles were included in the final review, 11 clinical trials (RCTs) published between 1992 and 2014. Three systematic reviews were found, but they only analyzed the effect of CBSS in reducing blood loss, hemoglobin stabilization, and the need for transfusion. Five of the RCTs analyzed the risk of infection, one catheter complications, and two alterations in blood pressure readings.</p></div><div><h3>Conclusions</h3><p>The use of CBSS is recommended to reduce blood loss in ICUs. However, there are discrepancies about their ability to prevent anemia and/or the need for blood transfusion. Its use does not increase catheter-related infection rates or alter the measurement of mean arterial pressure.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 2","pages":"Pages 133-145"},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128065622","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":"Clasificación de gravedad y variables de influencia del síndrome poscuidado intensivo","authors":"M.A. Narváez-Martínez RN, MSN ,&nbsp;Á.M. Henao-Castaño RN, PhD","doi":"10.1016/j.enfi.2023.04.005","DOIUrl":"10.1016/j.enfi.2023.04.005","url":null,"abstract":"<div><h3>Objective</h3><p>The study aims to characterize postintensive care syndrome by classifying the severity of the disease and identifying the variables of influence in 2 highly complex intensive care units for adults in Colombia.</p></div><div><h3>Method</h3><p>A descriptive, cross-sectional, prospective study was carried out to characterize survivors of critical illness using the Healthy Aging Brain Care–Monitor in a sample of 135 patients. Postintensive care syndrome severity was classified using Gaussian mixture models for clustering, and the most influencing variables were identified through ordinal logistic regression.</p></div><div><h3>Results</h3><p>Clustering based on Gaussian mixture models allowed the classification of postintensive care syndrome severity into mild, moderate, and severe classes, with an Akaike information criterion of 308 and an area under the curve of 0.80, which indicates a good fit; thus, the mild class was characterized by a score on the HABC-M Total scale<!--> <!-->≤<!--> <!-->9; the moderate class for a HABC-M Total score<!--> <!-->≥<!--> <!-->10 and<!--> <!-->≤<!--> <!-->42 and the severe class for a HABC-M Total score<!--> <!-->≥<!--> <!-->43. Regarding the most influencing variables, the probability of belonging to the moderate or severe classes was related to male sex (91%), APACHE II score (22.5%), age (13%), intensive care units days of stay (10.6%), the use of sedation, analgesia and neuromuscular blockers.</p></div><div><h3>Conclusion</h3><p>Intensive care units survivors were characterized using the HABC-M scale, which made it possible to classify postintensive care syndrome through Gaussian mixture models clustering into mild, moderate, and severe, and to identify variables that had the major influence on the presentation of postintensive care syndrome.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 2","pages":"Pages 89-96"},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588605","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":"Réplica a «¿Movilizamos de forma activa y temprana durante la ventilación mecánica a los pacientes ingresados en una unidad de cuidados intensivos?»","authors":"G. Ballesteros-Reviriego PT MSc ,&nbsp;J. Daniel Martí PT PhD ,&nbsp;B. Planas-Pascual PT MSc","doi":"10.1016/j.enfi.2023.06.003","DOIUrl":"10.1016/j.enfi.2023.06.003","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 74-75"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135606519","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":"Impacto de la implementación de un método de traspaso de información estandarizada interdisciplinar en sala de partos y unidad de cuidados obstétricos intermedios","authors":"E. Crespo-Mirasol RN, RM, MSc, PhD ,&nbsp;A. Llupià-García MD, MSc, PhD ,&nbsp;J. Bellart-Alfonso MD, MSc, PhD ,&nbsp;A. Peguero-Yus MD, MSc, PhD ,&nbsp;F. Figueras-Retuerta MD, MSc, PhD ,&nbsp;S. Hernández-Aguado MD, MSc, PhD","doi":"10.1016/j.enfi.2023.04.002","DOIUrl":"10.1016/j.enfi.2023.04.002","url":null,"abstract":"<div><h3>Aim</h3><p>This study aims to describe the implementation of the standard methodology for information transfer in the labour ward and Intermediate Obstetric Care Unit and to identify the impact of this implementation on the factors that act as facilitators and barriers in the procedure.</p></div><div><h3>Method</h3><p>Quasi-experimental pretest-posttest study without a control group in an Intermediate Obstetric Care Unit and delivery room of the Maternal-Fetal Medicine Service of a tertiary hospital in Barcelona. Healthcare staff self-completed an <em>ad hoc</em> questionnaire before and after implementing the standardised IDEAS methodology in the service during 2019 and 2020. Personal self-perception in the information transfer procedure was assessed. The Wilcoxon pairwise test was used for comparison before and after.</p></div><div><h3>Results</h3><p>The use of a standardised methodology has shown an impact on improving the transmission of information. Significant differences were detected before and after the intervention in the following dimensions: location, people involved, time period of the procedure, structured, orderly and clear, and sufficient time for questions (p<!--> <!-->&lt;<!--> <!-->0.001); while no differences were observed in: transmission to the referring professional, well-defined actions, and completion of a summary.</p></div><div><h3>Conclusions</h3><p>There are factors such as structural and organisational aspects and lack of time that hinder effective communication and therefore act as barriers to the transfer of information. The implementation of a methodology with the health professionals involved, the time and the appropriate space allows for the improvement of communication aspects in the multiprofessional team and, therefore, patient safety.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 5-12"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130114129","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":"Encuesta nacional sobre cambios en las políticas de comunicación, visitas y cuidados al final de la vida en las unidades de cuidados intensivos durante las diferentes olas de la pandemia de COVID-19 (estudio COVIFAUCI)","authors":"R.J. Fernández-Castillo PhDc, MSc, RN ,&nbsp;M.D. González-Caro RN ,&nbsp;F.J. Arroyo-Muñoz RN ,&nbsp;J. Garnacho-Montero PhD, MD","doi":"10.1016/j.enfi.2023.04.004","DOIUrl":"10.1016/j.enfi.2023.04.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The pandemic derived from the SARS-CoV-2 infection led to changes in care for both relatives and intensive care patients during the different waves of incidence of the virus. The line of humanization followed by the majority of the hospitals was seriously affected by the restrictions applied. As an objective, we propose to know the modifications suffered during the different waves of the SARS-CoV-2 pandemic in Spain regarding the policy of visits to patients in the ICU, monitoring at the end of life, and the use of new technologies of communication between family members, patients and professionals.</p></div><div><h3>Methods</h3><p>Multicenter cross-sectional descriptive study through a survey of Spanish ICUs from February to April 2022. Statistical analysis methods were performed on the results as appropriate. The study was endorsed by the Spanish Society of Intensive Nursing and Coronary Units.</p></div><div><h3>Results</h3><p>Twenty-nine percent of the units contacted responded. The daily visiting minutes of relatives dropped drastically from 135 (87.5-255) to 45 (25-60) in the 21.2% of units that allowed their access, improving slightly with the passing of the waves. In the case of bereavement, the permissiveness was greater, increasing the use of new technologies for patient-family communication in the case of 96.5% of the units.</p></div><div><h3>Conclusions</h3><p>The family of patients admitted to the ICU during the different waves of the COVID-19 pandemic have suffered restrictions on visits and a change from face-to-face to virtual communication techniques. Access times were reduced to minimum levels during the first wave, recovering with the advance of the pandemic but never reaching initial levels. Despite the implemented solutions and virtual communication, efforts should be directed towards improving the protocols for the humanization of healthcare that allow caring for families and patients whatever the healthcare context.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 35-44"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348827","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":"Monitorización de la glucemia en el paciente crítico adulto: tipo de muestra y método de análisis. Revisión sistemática y metanálisis","authors":"S. Arias-Rivera PhDc, MSN, RN ,&nbsp;M. Raurell-Torredà PhD, MSN, RN ,&nbsp;R.J. Fernández-Castillo PhDc, MSN, RN ,&nbsp;C. Campos-Asensio BPharm, MLS ,&nbsp;I.J. Thuissard-Vasallo MsC, PhD ,&nbsp;C. Andreu-Vázquez PhD, MsC, MvD ,&nbsp;M.E. Rodríguez-Delgado MsC, RN","doi":"10.1016/j.enfi.2023.02.003","DOIUrl":"10.1016/j.enfi.2023.02.003","url":null,"abstract":"<div><h3>Introduction</h3><p>The clinical guideline for the management of sepsis recommends using arterial blood samples for glycaemic control. A multicentre study in 86 Spanish intensive care units revealed that 85.4% of these used capillary puncture.</p></div><div><h3>Objective</h3><p>To analyse the reliability of glycaemia by comparing different blood samples (arterial, venous, capillary) and instruments (glucometers, gasometers, central laboratory). Secondarily, to estimate the effect of confounding variables and the performance of measuring instruments as determined by different quality standards.</p></div><div><h3>Methodology</h3><p>Systematic review and meta-analysis with search in PubMed, CINAHL and Embase databases in September-2021 and September-2022, with no time or language limits. Grey literature sources: DART-Europe, OpenGrey and Google Scholar. Results summarised by qualitative (description of results, study characteristics) and quantitative (meta-analysis to assess standardised mean difference) synthesis. Methodological quality of articles assessed with Quality Assessment of Diagnostic Accuracy Studies-2. Protocol: <span>https://osf.io/</span><svg><path></path></svg> DOI 10.17605/OSF.IO/T8KYP.</p></div><div><h3>Results</h3><p>A total of 32 articles and 5451 patients were included. No discrepancies were obtained between arterial glucometer vs. laboratory samples (bias [95%CI]: 0.01 [−0.12 to 0.14] mg/dL). In contrast, arterial samples with a gasometer did significantly overestimate (bias [95%CI]: 0.12 [0.01 to 0.24] mg/dL). The same trend is seen in capillaries with a glucometer, although not significantly (bias [95%CI]: 0.07 [−0.02 to 0.15] mg/dL). There is discrepancy between studies on the effect of haematocrit and acid-base balance. The greatest consensus is on the poor agreement of glucometer with capillary vs. laboratory samples in the presence of shock and vasopressor support, renal failure or during vitamin C treatment.</p></div><div><h3>Conclusions</h3><p>The evidence to date recommends the use of arterial blood with a blood glucose meter for better reliability of glycaemic analysis and less effect of possible confounding variables, frequently present in the critically ill adult patient.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 45-72"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130239923000238/pdfft?md5=8f132a3d100503d60140f427897322de&pid=1-s2.0-S1130239923000238-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127576925","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}