Medicina intensiva
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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.
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Multicenter Study Observational Study
Epidemiological study of Clostridium difficile infection in critical patients admitted to the Intensive Care Unit.
Data on the epidemiology of infections caused by Clostridium difficile (CDI) in critically ill patients are scarce and center on studies with a limited time framework and/or epidemic outbreaks. ⋯ The rate of ICD in ICU patients is low, the infection affects severely ill patients, and is associated with high mortality. The presence of CDI is a marker of poor prognosis.
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Multicenter Study
Predictors of the use of the early invasive strategy in women with non-ST-elevation acute coronary syndrome.
To identify determinants associated to an early invasive strategy in women with acute coronary syndromes without ST elevation (NSTE-ACS). ⋯ In women with NSTE ACS, smoking and a high-risk electrocardiogram upon admission were independent factors associated to the early invasive strategy. Previous coronary lesions, age > 80 years and increased heart rate were independent factors associated to conservative treatment.
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Multicenter Study Comparative Study
Prevention of venous thromboembolic disease in the critical patient: An assessment of clinical practice in the Community of Madrid.
To analyze measures referred to venous thromboembolic prophylaxis in critically ill patients. ⋯ Pharmacological prophylaxis with low molecular weight heparin was the most frequently used venous thromboembolic prophylactic measure. In patients with contraindications to pharmacological prophylaxis, mechanical measures were little used. The use of combined prophylaxis was anecdotal. Many of our ICUs lack specific prophylaxis protocols.
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Multicenter Study Observational Study
Acute renal failure according to the RIFLE and AKIN criteria: A multicenter study.
To determine the incidence of acute renal failure (ARF) in critically ill patients using the RIFLE and AKIN criteria. ⋯ RIFLE identified more cases of ARF. UC proved more effective than CC. The presence of ARF and severity levels were correlated to mortality but not to days of stay in the CCU. Implementation of the unified CHD was useful for implementing UC and achieving comparable results.