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medicina critica

Jesús Abelardo Barea-Mendoza, Mario Chico-Fernández, Marcelino Sánchez-Casado, Ismael Molina-Díaz, Manuel Quintana-Díaz, José Manuel Jiménez-Moragas, Jon Pérez-Bárcena, Juan Antonio Llompart-Pou
INTRODUCTION: We compared the Geriatric Trauma Outcome Score (GTOS) with the probability of survival using the TRISS methodology (PS-TRISS) in geriatric severe trauma patients admitted to Intensive Care Units (ICU) participating in the Spanish trauma ICU registry (RETRAUCI). METHODS: Retrospective analysis from the RETRAUCI. Quantitative data were reported as median (Interquartile Range (IQR)), and categorical data as number (percentage). We analyzed the validity of the GTOS and PS-TRISS to predict survival...
March 13, 2018: Cirugía Española
G Sirgo Rodríguez, M Chico Fernández, F Gordo Vidal, M García Arias, M S Holanda Peña, B Azcarate Ayerdi, E Bisbal Andrés, A Ferrándiz Sellés, P J Lorente García, M García García, P Merino de Cos, J M Allegue Gallego, A García de Lorenzo Y Mateos, J Trenado Álvarez, P Rebollo Gómez, M C Martín Delgado
Handover is a frequent and complex task that also implies the transfer of the responsibility of the care. The deficiencies in this process are associated with important gaps in clinical safety and also in patient and professional dissatisfaction, as well as increasing health cost. Efforts to standardize this process have increased in recent years, appearing numerous mnemonic tools. Despite this, local are heterogeneous and the level of training in this area is low. The purpose of this review is to highlight the importance of IT while providing a methodological structure that favors effective IT in ICU, reducing the risk associated with this process...
February 6, 2018: Medicina Intensiva
Fernando Chaves, José Garnacho-Montero, José Luis Del Pozo, Emilio Bouza, José Antonio Capdevila, Marina de Cueto, M Ángeles Domínguez, Jaime Esteban, Nuria Fernández-Hidalgo, Marta Fernández Sampedro, Jesús Fortún, María Guembe, Leonardo Lorente, Jose Ramón Paño, Paula Ramírez, Miguel Salavert, Miguel Sánchez, Jordi Vallés
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias)...
February 2018: Enfermedades Infecciosas y Microbiología Clínica
E Jové Ponseti, A Villarrasa Millán, D Ortiz Chinchilla
INTRODUCTION: The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis...
June 8, 2017: Enfermería Intensiva
V López Camps, M A García García, M C Martín Delgado, J M Añón Elizalde, N Masnou Burrallo, O Rubio Sanchiz, A Estella García, J L Monzón Marín
INTRODUCTION: Multiple interventions are performed in critical patients admitted to Intensive Care Units (ICUs). This study explores the presence in the daily practice of ICUs of elements related to the 6 bioethics quality indicators of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units, and the participation of their members in the hospital ethics committees. MATERIALS AND METHODS: A multicenter observational study was carried out, using a survey exploring descriptive aspects of the ICUs, with 25 questions related to bioethics quality indicators, and assessing the participation of ICU members in the hospital ethics committees...
December 2017: Medicina Intensiva
Costantino Roberto Frack Costantini, Jose Antonio Ramires, Costantino Ortiz Costantini, Marcos Antonio Denk, Sergio Gustavo Tarbine, Marcelo de Freitas Santos, Daniel Aníbal Zanuttini, Carmen Weigert Silveira, Admar Moraes de Souza, Rafael Michel de Macedo
BACKGROUND: Functional assessment of coronary artery obstruction is used in cardiology practice to correlate anatomic obstructions with flow decrease. Among such assessments, the study of the coronary fractional flow reserve (FFR) has become the most widely used. OBJECTIVE: To evaluate the correlation between FFR and findings of ischemia obtained by noninvasive methods including stress echocardiography and nuclear medicine and the presence of critical coronary artery obstruction...
January 2017: Arquivos Brasileiros de Cardiologia
M Llauradó-Serra, R Güell-Baró, A Castanera-Duro, I Sandalinas, E Argilaga, M L Fortes-Del Valle, M F Jiménez-Herrera, L Bordonado-Pérez, C Fuentes-Pumarola
BACKGROUND: The implementation of evidence based practice is essential in clinical practice. However, it is still a challenge in critical care patients. AIM: To identify the barriers for conducting research that nursing professionals perceive in intensive care and medical emergency departments, as well as to investigate the areas of interest and motivations to carry out research projects. METHOD: Cross-sectional and multicentre study carried out in 4 intensive care units and in one Medical Emergency Department emergency pre-hospital carein Catalonia on 2014...
October 2016: Enfermería Intensiva
R Fernandez
BACKGROUND: Before deciding increases in the number or capacitance of Intensive Care Units (ICUs), or the regionalization of Units, it is essential to know their present effectiveness. OBJECTIVE: To analyze the daily occupancy rate of ICUs in Catalonia (Spain) and the frequency of denied admission due to lack of capacity. DESIGN: A prospective, observational multicenter study was carried out. PARTICIPANTS: A total of 35 out of 40 ICUs of Catalonia (87%)...
December 2015: Medicina Intensiva
E Celis-Rodríguez, C Birchenall, M Á de la Cal, G Castorena Arellano, A Hernández, D Ceraso, J C Díaz Cortés, C Dueñas Castell, E J Jimenez, J C Meza, T Muñoz Martínez, J O Sosa García, C Pacheco Tovar, F Pálizas, J M Pardo Oviedo, D I Pinilla, F Raffán-Sanabria, N Raimondi, C Righy Shinotsuka, M Suárez, S Ugarte, S Rubiano
INTRODUCTION: Optimal management of sedation, analgesia and delirium offers comfort and security for the critical care patient, allows support measures to be applied more easily and enables an integral approach of medical care, at the same time that lowers the incidence of complications, wich translates in better patient outcomes. OBJECTIVE: To update the Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo published in Medicina Intensiva in 2007, and give recommendations for the management of sedation, analgesia, and delirium...
November 2013: Medicina Intensiva
V Gómez Tello, J Alvarez Rodríguez, A Núñez Reiz, J A González Sánchez, A Hernández Abadía de Barbará, M Martínez Fresneda, P Morrondo Valdeolmillos, J M Nicolás Arfelis, I Pujol Varela, M Calvete Chicharro
INTRODUCTION: Clinical Information Systems (CIS) are becoming a useful tool for managing patients and data in the ICU. However, the existing CIS differ in their capabilities and technical requirements. It is therefore essential for intensivists, as the end clients of these applications, to define the suitable minimum specifications required in order to be operative and helpful. OBJECTIVES: The Spanish Society of Intensive Care Medicine and Coronary Units, through its Organization and Management Workgroup, has designated a group of clinical and software experts to draft a document with the recommendable technical and operating requirements of these systems...
November 2011: Medicina Intensiva
(no author information available yet)
Intensive care medicine is a medical specialty that was officially established in our country in 1978, with a 5-year training program including two years of common core training followed by three years of specific training in an intensive care unit accredited for training. During this 32-year period, intensive care medicine has carried out an intense and varied activity, which has allowed its positioning as an attractive and with future specialty in the hospital setting. This document summarizes the history of the specialty, its current situation, the key role played in the programs of organ donation and transplantation of the National Transplant Organization (after more than 20 years of mutual collaboration), its training activities with the development of the National Plan of Cardiopulmonary Resuscitation, with a trajectory of more than 25 years, its interest in providing care based on quality and safety programs for the severely ill patient...
March 2011: Medicina Intensiva
Emili Díaz, Alejandro Rodríguez, Ignacio Martin-Loeches, Leonardo Lorente, María Del Mar Martín, Juan Carlos Pozo, Juan Carlos Montejo, Angel Estella, Ángel Arenzana, Jordi Rello
OBJECTIVE: A large proportion of patients infected with 2009 influenza A(H1N1) (A[H1N1]) are obese. Obesity has been proposed as a risk factor influencing outcome in these patients. However, its role remains unclear. We evaluate the outcome of patients who are obese and infected with A(H1N1) in the ICU, determining whether obesity is a risk factor for mortality. METHODS: This was a prospective, observational, and multicenter study performed in 144 ICUs in Spain...
February 2011: Chest
A Rodríguez, L Socías, J E Guerrero, J C Figueira, N González, E Maraví-Poma, L Lorente, M Martín, A Albaya-Moreno, A Algora-Weber, J Vallés, C León-Gil, T Lisboa, C Balasini, M Villabón, R Pérez-Padilla, D Barahona, J Rello
INTRODUCTION: Pandemic Influenza A (H1N1)v infection is the first pandemic in which intensive care units (ICU) play a fundamental role. It has spread very rapidly since the first cases were diagnosed in Mexico with the subsequent spread of the virus throughout the Southern Cone and Europe during the summer season. OBJECTIVE: This study has aimed to compare the clinical presentation and outcome among the critical patients admitted to the ICU until July 31, 2009 in Spain with some series from Latin America...
March 2010: Medicina Intensiva
L Lorente, C León
The guidelines to prevent central venous catheter related bloodstream infections (CVCBSI) of the Centers for Disease Control and Prevention (CDC) of 2002, Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias/ Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEMICYUC/SEIMC) of 2004, and the recently published guidelines of the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA(IDSA) of 2008 have recommended using the subclavian vein and avoiding the use of the femoral vein...
December 2009: Medicina Intensiva
Juna C Michelena, Carlos Chamorro, Juan A Falcón, Sandra Garcés
Recently, the work group made up of the National Transplant Organization (Organización Nacional de Trasplantes, ONT), Spanish Society of Intensive, Critical Medicine and Coronary Units (Sociedad Española de Medicina Intensiva, Crítica y de Unidades Coronarias, SEMICYUC) and other Scientific Societies have recommended using 15 mg/kg of methyl prednisolone during the management of lung donors after brain death. This recommendation is based on descriptive and retrospective studies. However, the review of different experimental and clinical studies also suggests a potential benefit of using steroids in either thoracic or abdominal organ donors during management strategies...
June 2009: Medicina Intensiva
Pedro M Olaechea, Francisco Alvarez-Lerma, Miguel Sánchez, Antonio Torres, Mercedes Palomar, Pedro Fernández, José M Miró, José Miguel Cisneros, Manuel Torres, et al.
Recent studies have shown that early attention in patients with serious infections is associated with a better outcome. Assistance in intensive care units (ICU) can effectively provide this attention; hence patients should be admitted to the ICU as soon as possible, before clinical deterioration becomes irreversible. The objective of this article is to compile the recommendations for evaluating disease severity in patients with infections and describe the criteria for ICU admission, updating the criteria published 10 years ago...
June 2009: Enfermedades Infecciosas y Microbiología Clínica
J Mensa, J Barberán, P Llinares, Jj Picazo, E Bouza, F Alvarez-Lerma, M Borges, R Serrano, C León, X Guirao, J Arias, E Carreras, Ma Sanz, Ja García-Rodríguez
Infections due to methicillin-resistant Staphylococcus aureus (MRSA) have undergone important changes in the last five years that have influenced the choice of therapy: i) increase of their frequency in hospital-associated settings and, more recently, in community settings; ii) better knowledge of clinical implications of the pharmacokinetic and pharmacodynamic properties of vancomycin; iii) improvement of current standard methods for rapid detection of MRSA in clinical samples; iv) clear evidence that vancomycin is losing efficacy against MRSA with MIC > 1 microg/mL; and v) appearance of new antibiotics suitable for use in these infections (linezolid, daptomycin, tigecyclin)...
December 2008: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
M C Martín, Ll Cabré, J Ruiz, Ll Blanch, J Blanco, F Castillo, P Galdós, J Roca, R M Saura
The utility of using quality indicators as a tool to measure the common practice and evaluate efficacy of measures established to improve quality has been demonstrated, making it possible to identify and make known the improvements carried out. The project "Quality indicators in the critical patient" has been conducted by the Spanish Society of Intensive and Critical Medicine (SEMICYUC) under the methodological management of the Foundation Avedis Donabedian (FAD) of Barcelona. Its objective was to develop key indicators in the care of the critical patient, considering the following as added values: reaching an agreement on the quality criteria in these patients and providing the professionals with a potent and reliable instrument for clinical evaluation and management, introducing common evaluation methods that make it possible to unify the measure, making a comparative evaluation (benchmarking), having information that makes it possible to develop quality plans (quantitative, objective, reliable and valid data) and having a system that assures total quality of care to the critical patient...
January 2008: Medicina Intensiva
E Celis-Rodríguez, J Besso, C Birchenall, M A de la Cal, R Carrillo, G Castorena, D Ceraso, C Dueñas, F Gil, E Jiménez, J C Meza, M Muñoz, C Pacheco, F Pálizas, D Pinilla, F Raffán, N Raimondi, S Rubiano, M Suárez, S Ugarte
No abstract text is available yet for this article.
November 2007: Medicina Intensiva
A García-Labattut, F Tena, J Díaz, R Pajares, J Sandoval, J González, M A Taberna, A García, H Abdel-Hadi, F J Pérez, L Fernández, M Vázquez
AIM: To determine degree of public awareness regarding the activities and health care professionals that comprise intensive care units (ICUs) in the autonomous community of Castilla y León. DESIGN: Questionaire in the form of a true-false test dealing with a) description of an ICU; b) description of ICU patients, and c) degrees and qualifications held by ICU physicians. LOCATION: Waiting rooms of outpatient clinics and ICUs of 9 hospitals in Castilla y León...
March 2006: Medicina Intensiva
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