Medicina intensiva
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Traumatic disease is a major public health concern. Monitoring the quality of services provided is essential for the maintenance and improvement thereof. ⋯ Many quality indicators have been used in this condition, although very few ones have a solid level of scientific evidence to recommend their routine use. The information contained in the trauma registries, spread around the world in recent decades, is essential to know the current health care reality, identify opportunities for improvement and contribute to the clinical and epidemiological research.
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The use of propranolol has been proposed to reduce the hypermetabolic response of patients with burn injuries. ⋯ Propranolol reduces the hypermetabolic response in pediatric burn patients. More studies on its effects in adult burn patients are needed.
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Comparative Study Observational Study
Regional oxygen saturation index (rSO2) in brachioradialis and deltoid muscle. Correlation and prognosis in patients with respiratory sepsis.
To compare oxygen saturation index (rSO2) obtained simultaneously in two different brachial muscles. ⋯ Both BR and D muscles were appropriate for measuring rSO2.
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Ventilator-associated tracheobronchitis (VAT) is a frequent complication in critical patients. The 90% of those who develop it receive broad-spectrum antibiotic (ATB) treatment, without any strong evidence of its favorable impact. ⋯ Several studies suggest that an adequate nebulization technique can ensure high levels of ATB even in areas of lung consolidation, and to obtain clinical and microbiological cure. New studies are needed to properly assess the impact of treatment with nebulized ATB on the emergence of resistance.
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Multicenter Study
Survey on the management of acute renal failure and renal replacement techniques in Spanish intensive care units.
To analyze knowledge and experience in the diagnosis and management of acute renal failure (ARF) and the use of renal replacement therapy (RRT) in different Spanish Intensive Care Units (ICUs). ⋯ There is great variability in the ARF detection methods, and adequate incorporation of the RIFLE/AKIN systems to daily clinical practice in the ICU is still lacking. Written protocols aimed at establishing an early diagnosis of ARF are needed, based on these systems. On the other hand, there is growing interest in RRT, despite the fact that there are no definitive indications or guidelines on the use and handling of such techniques.