Enfermeria intensiva最新文献

{"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.enfie.2026.500590","DOIUrl":"10.1016/j.enfie.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":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 2","pages":"Article 500590"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147739833","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":"Mapping transitional care models after ICU discharge for ECMO survivors: A scoping review","authors":"Paulo Costa RN, MSc ,&nbsp;Amélia Ferreira RN, PhD ,&nbsp;Roberto Roncon-Albuquerque MD, PhD","doi":"10.1016/j.enfie.2026.500598","DOIUrl":"10.1016/j.enfie.2026.500598","url":null,"abstract":"<div><h3>Introduction</h3><div>ECMO survivors frequently develop post-intensive-care syndrome (PICS) with cognitive, psychological, and functional sequelae. Transitional care seeks to bridge ICU discharge and community recovery but remains variably structured, timed, and evaluated.</div></div><div><h3>Objectives and methodology</h3><div>To map transitional care models for ECMO survivors after ICU discharge, describing what is implemented, when (timing), and which outcomes are measured. Scoping review (JBI), reported per PRISMA-ScR. Databases: MEDLINE/PubMed, B-On, Web of Science (January 2015–June 2025). Grey literature: Google Scholar, OpenGrey, ELSO, OSF, ClinicalTrials.gov. Keywords and MeSH terms used: Extracorporeal Membrane Oxygenation [MeSH], Aftercare [MeSH], post-intensive care syndrome [MeSH], Critical Care [MeSH], Transitional Care [MeSH]. Eligibility: adults (≥18) on VV/VA ECMO with post-ICU data; excluded intra-operative ECMO &lt; 24 h and studies without extractable ECMO-specific outcomes.</div></div><div><h3>Results</h3><div>Search retrieved 4101 studies, screening identified 740 records; 41 were included; 699 were excluded (duplicates; non-ECMO or intra-operative ECMO; no transitional intervention; no ECMO-specific outcomes). Seven domains were identified: structured follow-up pathways (<em>n</em> = 12); multidisciplinary interventions (<em>n</em> = 10); psychological/PICS support (<em>n</em> = 7); functional rehabilitation (<em>n</em> = 6); educational/organizational training (<em>n</em> = 5); telemonitoring/digital follow-up (<em>n</em> = 3); palliative/survivorship models (<em>n</em> = 2). Follow-up timings: pre-discharge; ∼1 month; 3–6 months; ≥12 months. Common outcomes: HRQoL, functional status (e.g., 6MWT/ADL), return to work, psychological symptoms (e.g., anxiety/depression/PTSD), readmissions/complications. Designs were predominantly observational/qualitative; trials with comparators were infrequent.</div></div><div><h3>Discussion</h3><div>Emerging concepts—ECMO survivorship, digital follow-up pathways—are not yet indexed in MeSH. Heterogeneity in structures, timing, and instruments limits comparability. Limitations include reliance on descriptive designs, variable reporting, and potential overlap across reviews.</div></div><div><h3>Conclusions</h3><div>This scoping review identified seven domains of transitional care for ECMO survivors after ICU discharge. However, the implementation of these domains and the outcome measures used to evaluate them were heterogeneous and inconsistently reported across studies, highlighting the need for more robust, outcome-focused research.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 2","pages":"Article 500598"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847761","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":"Nurses’ perceptions of team huddle in an Intensive Care Unit: An exploratory qualitative study","authors":"Francisco Paredes-Garza RN, MsC,&nbsp;María Luisa García-Fernández RN, MsC,&nbsp;Eva Gutiérrez-García RN,&nbsp;Elena Santoyo-Jimenez RN","doi":"10.1016/j.enfie.2026.500592","DOIUrl":"10.1016/j.enfie.2026.500592","url":null,"abstract":"<div><h3>Introduction</h3><div>Team huddles have been recognized as an effective tool to improve patient safety and communication in complex healthcare settings. However, their successful implementation requires understanding the perceptions of the healthcare team regarding their usefulness and feasibility.</div></div><div><h3>Objective</h3><div>To analyse the perceptions of nurses in an intensive care unit (ICU) regarding the huddle methodology, with the aim of generating recommendations that facilitate its future implementation.</div></div><div><h3>Methods</h3><div>A qualitative descriptive study was conducted in an Intensive Care Unit of a tertiary hospital in Madrid, using focused interviews with 12 purposively selected nurses. An inductive thematic analysis was performed following Braun and Clarke’s framework.</div></div><div><h3>Results</h3><div>Four overarching themes emerged: improved work organization and team climate, optimization of patient care and safety through greater situational awareness and continuity of care, the need for clear protocols to guide huddle dynamics, and the influence of unit infrastructure on the location and effectiveness of team huddles.</div></div><div><h3>Conclusion</h3><div>Team huddles are perceived as a potentially beneficial strategy, but their successful implementation requires structured planning, clear protocols, staff training, and adaptation to the unit’s physical and organizational context.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 2","pages":"Article 500592"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147649951","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":"Continuous glucose monitoring in a critically ill patient with extracorporeal membrane oxygenation (ECMO), intra-aortic balloon pump, and continuous renal replacement therapy: Case report","authors":"Marc Pañero-Moreno RN, MSc ,&nbsp;Cristina Carbonell-Sabate RN ,&nbsp;Rut Conesa-González RN ,&nbsp;Laura Risco-Patiño RN ,&nbsp;Eva Maria Guix-Comellas RN, MSN, PhD ,&nbsp;Alberto Villamor-Ordozgoiti RN, MSN, PhD ,&nbsp;Tània Cordón-Arnau RN","doi":"10.1016/j.enfie.2026.500589","DOIUrl":"10.1016/j.enfie.2026.500589","url":null,"abstract":"<div><h3>Introduction</h3><div>Glycemic control in critically ill patients is essential to prevent complications. This study evaluates the use of Continuous Glucose Monitoring (MCG) in a 58-year-old patient with Acute Myocardial Infarction (IAM), complicated by intraventricular communication (CIV) and progression to cardiogenic shock, admitted to the Intensive Care Unit (UCI).</div></div><div><h3>Methods</h3><div>The patient received advanced hemodynamic support with Extracorporeal Membrane Oxygenation (ECMO), Intra-Aortic Balloon Pump (BCIA), and Continuous Renal Replacement Therapy (TRRC). A Dexcom G7 sensor was used for 10.5 days to monitor glucose levels. Accuracy (Mean Absolute Relative Difference (MARD)) and clinical reliability (Clarke Error Grid) were analyzed, along with the impact on glycemic control and nursing workload.</div></div><div><h3>Results</h3><div>The CGM system showed preliminarily high accuracy, with a MARD of 7.12%, and 100% of values fell within zones A and B of the Clarke Error Grid. During 98.00% of the monitored time, glucose remained within the target range (70–180 mg/dL), with a mean of 138 mg/dL and no hypoglycaemic episodes. A 27.62% reduction in point-of-care glucose (POC-G) measurements was observed, and the need for capillary glucose testing was eliminated.</div></div><div><h3>Discussion</h3><div>This case aligns with findings from other authors, demonstrating that CGM in critically ill patients requiring advanced hemodynamic support is accurate, reduces invasive procedures and nursing workload, and improves glycemic control. Larger clinical trials are needed to validate its routine use in the ICU.</div></div><div><h3>Conclusions</h3><div>CGM in patients with advanced hemodynamic support shows high accuracy and effectiveness, reducing invasiveness and nursing burden, and positioning itself as a promising tool for glycemic management in intensive care, but more clinical trials are needed.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 2","pages":"Article 500589"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147649950","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":"Utility of the Shock Index at ICU admission as a prognostic tool in patients with COVID-19-related ARDS: Implications for nursing practice","authors":"Marcos Alécio Bispo-de-Andrade MD, MSc ,&nbsp;Érika Ramos-Silva PT, PhD ,&nbsp;Rafael Ciro Marques-Cavalcante RPh, PharmD ,&nbsp;Daniel Vieira-de-Oliveira MD, PhD ,&nbsp;Rita de Cássia Almeida-Vieira RN, PhD ,&nbsp;Eduesley Santana-Santos RN, PhD","doi":"10.1016/j.enfie.2026.500591","DOIUrl":"10.1016/j.enfie.2026.500591","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the prognostic value of the Shock Index (SI) at intensive care unit (ICU) admission in predicting hospital mortality among patients with Acute Respiratory Distress Syndrome (ARDS), and to explore its potential application in nursing-led risk assessment.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted in five public and private hospitals in Sergipe, Brazil, between April 2020 and January 2022. Adult patients diagnosed with ARDS and admitted to ICUs were included if data were available to calculate the SI (heart rate/systolic blood pressure), along with clinical and laboratory variables. All ARDS cases in this cohort were exclusively secondary to COVID-19 infection. Patients were categorized as survivors or non-survivors. Bivariate analyses, logistic regression, and Cox regression models were used to assess associations with hospital mortality.</div></div><div><h3>Results</h3><div>A total of 180 patients were included. The hospital mortality rate was 45%. Patients with SI ≥ 0.9 at ICU admission had a significantly higher risk of death (HR: 1.57; 95% CI: 1.01–2.45; p = 0.046). In the adjusted analysis, SI ≥ 0.9 remained independently associated with increased mortality risk (OR: 2.63; 95% CI: 1.21–6.09; p = 0.018), regardless of age, comorbidities, or severity scores. Additional predictors of mortality included advanced age, renal dysfunction, and elevated SAPS-3 and SOFA scores.</div></div><div><h3>Conclusion</h3><div>The Shock Index at ICU admission demonstrated independent prognostic value for hospital mortality in COVID-19–related ARDS patients. As a simple, cost-effective, and nurse-accessible tool, SI may support early risk stratification, guide care prioritization, and assist in clinical decision-making in intensive care settings.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 2","pages":"Article 500591"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147739832","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 adult survivors of a high-complexity intensive care unit in Colombia","authors":"José Julián Bernal-Sánchez PT, MSc ,&nbsp;Yulieth Linares-Caicedo PT ,&nbsp;Jennifer Catherine Calderón-Erazo PT ,&nbsp;Sebastián Adalberto Chalapud-Bustos PT ,&nbsp;Sandra Lucia Lozano-Álvarez MD, MSc ,&nbsp;Esther Cecilia Wilches-Luna PT, PhD","doi":"10.1016/j.enfie.2026.500593","DOIUrl":"10.1016/j.enfie.2026.500593","url":null,"abstract":"<div><h3>Background</h3><div>Post-intensive care syndrome (PICS) encompasses physical, cognitive, and psychological sequelae that may persist for months or years after ICU discharge, affecting survivors’ reintegration and long-term functioning. Although extensively studied in high-income countries, evidence from Latin America remains limited.</div></div><div><h3>Objectives</h3><div>To describe the sociodemographic and clinical characteristics of PICS in adult ICU survivors in southwestern Colombia, assessing functional, cognitive, and psychological domains using the Spanish-validated Healthy Aging Brain Care Monitor (HABC-M).</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted between December 2024 and March 2025. Fifty-seven adults (≥18 years) discharged from the ICU for at least 14 days provided informed consent. Patients with pre-existing cognitive impairment were excluded using the telephone version of the Montreal Cognitive Assessment (MoCA-t). Data were obtained through medical record review and subsequently through structured telephone assessment for the administration of validated quantitative instruments, conducted by trained physiotherapists. Sociodemographic variables (age, sex, socioeconomic stratum, health insurance) and clinical data (admission diagnosis, APACHE II, SOFA, need and type of ventilation) were recorded. PICS was assessed using the Spanish-validated <em>Healthy Aging Brain Care Monitor</em> (HABC-M). Descriptive statistics, logistic regression, and Spearman’s correlations were applied.</div></div><div><h3>Results</h3><div>The study included 57 patients, 29 were women (50.9%), with a mean age of 53.7 ± 17.3 years. All patients presented some degree of sequelae, with the functional domain showing the greatest severity (15.8% classified as severe). No significant associations were observed between the presence or severity of PICS and SOFA scores or the use of mechanical ventilation.</div></div><div><h3>Discussion</h3><div>PICS was present in all participants, with greater involvement in the functional domain and mild symptoms in the cognitive and psychological domains. The lack of associations with age, clinical severity, or mechanical ventilation may be related to sample size and clinical heterogeneity. The predominant socioeconomic context provides relevant information for interpreting the findings, although no statistical associations were identified.</div></div><div><h3>Conclusions</h3><div>All evaluated patients presented some degree of PICS, with greater involvement in the functional domain in a population characterized by socioeconomic vulnerability. No associations were observed with age, severity scores, or mechanical ventilation.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 2","pages":"Article 500593"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147739831","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":"Emotional intelligence in the ICU: From the invisible to the essential","authors":"Mónica Vázquez-Calatayud PhD ,&nbsp;Rosana Goñi-Viguria MSN","doi":"10.1016/j.enfie.2026.500603","DOIUrl":"10.1016/j.enfie.2026.500603","url":null,"abstract":"","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 2","pages":"Article 500603"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849925","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":"Mother’s and father’s perceived experiences of breastfeeding a preterm infant in a neonatal intensive care unit","authors":"Èlia Santiveri-Camacho RN, MSc ,&nbsp;Alejandro Bosch-Alcaraz RN, PNP, MSc, PhD ,&nbsp;Mariela Patricia Aguayo-González RN, MSc, PhD ,&nbsp;M. Ángeles Saz-Roy RN, PNP, MSc, PhD","doi":"10.1016/j.enfie.2025.500571","DOIUrl":"10.1016/j.enfie.2025.500571","url":null,"abstract":"<div><h3>Introduction</h3><div>A premature birth involves stress derived from the context of the NICU where the baby is cared for. In addition, the separation between mother and father/couple and child involves an interruption of the biological process of breastfeeding. The experiences lived in this process between mother and father/couple are unequal, which entails different care needs to be covered by the health professional through informative and educational activities.</div></div><div><h3>Objective</h3><div>To explore the experiences of mothers and fathers/couple breastfeeding PTNB during their stay in the NICU.</div></div><div><h3>Design and methods</h3><div>A qualitative phenomenological study was carried out. The population studied were mothers and fathers/couple of PTNB in a neonatal unit who were breastfeeding. Using purposive convenience sampling and the principle of information saturation, the participants were 5 mothers and 4 fathers. Semi-structured interviews were conducted and organised into the following thematic areas: knowledge, environment, feelings, coping strategies and challenges.</div></div><div><h3>Results</h3><div>The mothers' and fathers'/couples’ experiences are grouped into four themes: previous lack of knowledge about the breastfeeding process, BF as a personal challenge, barriers and facilitators during the process of breastfeeding a PTNB, and the feelings of the families.</div></div><div><h3>Conclusions</h3><div>From the perceptions and feelings reported by breastfeeding mothers and fathers/couples of PTNB, changes can be made to improve nursing care in the NICU. Improving early expressing within the first hour, developing specific protocols for breastfeeding in PTNB and updated training for nursing staff are aspects that emerge from the study and could help to priorities and meet the expressed needs for breastfeeding support in the NICU.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 1","pages":"Article 500571"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077943","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":"Occurrence of adverse events with arterial catheters and their contributing factors: A cross-sectional study","authors":"Patriny Marcelle Mariano-Gomes MSc ,&nbsp;Adriana Ouverney-Braz RN, PhD ,&nbsp;Graciele Oroski-Paes RN, PhD","doi":"10.1016/j.enfie.2025.500575","DOIUrl":"10.1016/j.enfie.2025.500575","url":null,"abstract":"<div><h3>Introduction</h3><div>The insertion of an arterial line is one of the most important invasive procedures in intensive care, but it may still pose risks to patients.</div></div><div><h3>Objectives</h3><div>To determine the prevalence and analyze the association of contributing factors with the occurrence of adverse events related to the use of arterial catheters.</div></div><div><h3>Method</h3><div>Cross-sectional, retrospective, analytical and quantitative study. The sample included all reports of adverse events involving arterial catheters over the past five years. The hospital's electronic and physical medical records were used to supplement the patients' clinical data. Descriptive and inferential analysis was carried out using frequency calculations and association tests, including chi-square and Fisher's exact test. A significance level of up to 10% (<em>p</em>-value &lt; 0.1) was used for all analyses. The study adhered to the STROBE Checklist guidelines (a checklist of items recommended for reports of cross-sectional studies).</div></div><div><h3>Results</h3><div>Between 2019 and 2023, 3104 arterial catheters were inserted in the hospital's intensive care units. 39 reports of adverse events with these catheters were included, with an occurrence rate of 1.25% (95% confidence interval). The most prevalent incident was inadvertent loss (41%), followed by pseudoaneurysm and/or hematoma formation (25.6%), and obstruction (20.51%). Human resources (<em>p</em>-value 0.069), need for sedation (<em>p</em>-value 0.011) and insertion site (<em>p</em>-value 0.074) were factors that were associated with accidental device loss. Factors related to the patient (<em>p</em>-value 0.079) and the puncture method (<em>p</em>-value 0.079) were related to the formation of pseudoaneurysms and hematomas. Human resources (<em>p</em>-value 0.001), the use of vasoactive amines (<em>p</em>-value 0.032) and the insertion site (<em>p</em>-value 0.012) were associated with system obstruction.</div></div><div><h3>Conclusion</h3><div>The results elucidated potential weaknesses that could compromise the safety of critically ill patients using blood pressure monitoring, such as the method of puncture, circuit management and the clinical characteristics of the patients. In addition to the negative impact on patients and costs, litigation can also result from failures in healthcare safety.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 1","pages":"Article 500575"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926684","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":"Lung collapse during postural repositioning in a mechanically ventilated patient, could it have been avoided? A case report","authors":"María Dolores Rodríguez-Huerta RN, MSc ,&nbsp;Ana Díez-Fernández RN, MSc, PhD ,&nbsp;María Jesús Rodríguez-Alonso RN ,&nbsp;María Martín-Rodríguez RN ,&nbsp;Mario Fernández-Izquierdo RN","doi":"10.1016/j.enfie.2025.500583","DOIUrl":"10.1016/j.enfie.2025.500583","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse through a clinical case the need for comprehensive management of bronchial secretions by nurses, with a proactive and preventive character to improve mechanically ventilated patients’ safety.</div></div><div><h3>Clinical case presentation</h3><div>A 76-year-old man under invasive mechanical ventilation admitted to the ICU due to pulmonary infection, who presented subtotal left lung collapse during routine postural changes. Trying to recover the left lung ventilation, the patient was repositioned, an endotracheal suctioning and two recruitment manoeuvres were made without any ventilation improvement. The previous level of left ventilation was not achieved until secretions were completely eliminated after three more suctioning manoeuvres.</div></div><div><h3>Discussion and implications for practice</h3><div>Critically ill patient care is complex, requiring general basic attention and monitoring, including the assessment of the risks that certain interventions and nursing care may entail for each individual patient. Both, postural repositioning and endotracheal suctioning constitutes tow integral parts of routine care for all mechanically ventilated patients. This case shows how the presence of deep secretions during postural repositioning can greatly affect the respiratory function, with no significant immediate or short-term changes observed on routine monitoring, as electrical impedance monitoring is not standard practice, so the changes described in this case would not have been observed in short term.</div></div><div><h3>Conclusions</h3><div>The implementation of a nursing integral care protocol for the management of secretions in mechanically ventilated patients, could be very useful in preventing adverse events, ineffective multiple endotracheal suctioning, which are not free of potential complications, and in reducing the need for deep airway clearance by fibrobronchoscopy.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 1","pages":"Article 500583"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020330","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}