Enfermeria Intensiva最新文献

{"title":"Seguridad de la nutrición enteral intermitente frente a la continua en los pacientes críticos. Ensayo clínico aleatorizado","authors":"María Dolores Saiz-Vinuesa RN, MSc, PhD candidate ,&nbsp;Eloina Rodriguez-Moreno RN ,&nbsp;Francisca Calero-Yánez RN, MSc, PhD candidate ,&nbsp;Ana María Piqueras-Carrión TCAE ,&nbsp;Carmen Carrilero-López RN ,&nbsp;Isabel Murcia-Sáez MD, PhD ,&nbsp;María Pilar Córcoles-Jimenez RN, MSc, PhD ,&nbsp;Milagros Molina-Alarcón Psy, PhD","doi":"10.1016/j.enfi.2025.500561","DOIUrl":"10.1016/j.enfi.2025.500561","url":null,"abstract":"<div><h3>Introduction</h3><div>Enteral nutrition (EN) is a common nutritional support in intensive care units (ICU). The administration method can be continuous (CEN)or intermittent (IEN), but there are controversies and a lack of evidence on which method is more effective in achieving good nutritional status while minimizing complications.</div></div><div><h3>Objectives</h3><div>To evaluate the safety (no increase in complications) IEN versus CEN during administration of EN with a gastric feeding tube (GFT) in ICU patients.</div></div><div><h3>Methods</h3><div>Randomized, open clinical trial. Registered in Clinical Trials. Population: Adults<!--> <!-->&gt;18 years admitted to ICU, with GFT, indication of EN, signed consent. Exclusion: insulin-dependent diabetic. Intervention: Control (CEN): continuous administration via infusion pump; Experimental (IEN): the total amount divided into 4 doses, administered q 6<!--> <!-->h via infusion pump, for 1 hour each dose. Outcome variables: complications (gastrointestinal, respiratory, metabolic), achievement of caloric goal (CG) Others: demographic data, nutritional status, severity (APACHE), EN type, mechanical ventilation (MV), duration of EN, causes of interruption. Statistical analysis: SPSS. Intention-to-treat analysis. Measures of central tendency and dispersión (standard deviation or interquartile range: IQR), absolute and relative frequencies. Bivariate analysis: Chi-cuadrado, t-Student and U-Mann-Whitney.Ethical aspects: CEIm approval.</div></div><div><h3>Results</h3><div>Forty patients (18 CEN/22 IEN), 70% (28) men, age 62.65 DE: 13.27 years (95% CI: 58.40-66.90), BMI: 27.93 (IQR: 4.6), APACHE II: 18.85 DE: 5.83 (95% CI: 16.98-20.72), MV: 11.5<!--> <!-->days (IQR: 13). 17.5% (7) diabetic. The CEN and IEN groups were homogeneous for all variables except APACHE (CEN 21.22 vs. IEN 16.91; <em>P</em>=.018). CG was achieved by 82.5% (33) (88.9 CEN vs.77.3% IEN; <em>P</em>=.33), time to achieve it (36<!--> <!-->hours CEN vs. 34<!--> <!-->h IEN; <em>P</em>=.28). Complications: vomiting: 20% (8) patients (4 per group; <em>P</em>=.75). Diarrhea: (16.7% CEN vs. 22.7% IEN; <em>P</em>=.63). Bronchial aspiration and GRV<!--> <!-->&gt;<!--> <!-->500<!--> <!-->cc 1 case in IEN. Median interruptions (2.5 [IQR: 2] CEN vs. 1 [IQR: 2] IEN; <em>P</em>=.005).</div></div><div><h3>Discussion</h3><div>The results are similar to other studies. CG was achieved in a high percentage, with no differences between groups. The use of INE shows feweer interruptions, which may lead to better compliance with caloric guidelines without increasing complications, maintaining physiological guidelines.</div></div><div><h3>Conclusion</h3><div>IEN in ICU patients shows no differences in terms of complications, compared to CEN, nor less effectiveness in achieving the CG. A larger sample is needed to identify the advantages and complications of each method.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500561"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489931","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":"Sleep quality and associated factors among critical care nurses in Jordan: A cross-sectional study","authors":"Kholood E. Al-Nbabteh MSN ,&nbsp;Rezan Bani Bkar MSN ,&nbsp;Ayman M. Al-Qaaneh PhD ,&nbsp;Eqbal M. Alfarajat PhD ,&nbsp;Sonia Kraishan MSN","doi":"10.1016/j.enfi.2025.500562","DOIUrl":"10.1016/j.enfi.2025.500562","url":null,"abstract":"<div><h3>Background</h3><div>Sleep is an essential component of daily living, yet sleep disturbances are prevalent among nurses in critical care settings. Poor sleep quality is linked to adverse outcomes, including diminished cognitive and physical performance, mood disorders, and an increased risk of chronic diseases. This study aimed to evaluate the sleep quality of critical care nurses in Jordanian public hospitals and identify the associated factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in two major hospitals affiliated with Jordan's Ministry of Health. A convenience sample of 172 critical care nurses completed the Pittsburgh Sleep Quality Index (PSQI), the National Aeronautics and Space Administration Task Load Index (NASA-TLX), and the Depression Anxiety Stress Scale (DASS). Data were analyzed using multiple regression analysis in SPSS version 28.</div></div><div><h3>Results</h3><div>A total of 82.6% of nurses reported poor sleep quality, with an average global PSQI score of 10.87<!--> <!-->±<!--> <!-->3.19. Workload (<em>B</em> <!-->=<!--> <!-->2.844, <em>p</em> <!-->&lt;<!--> <!-->0.001) and anxiety (<em>B</em> <!-->=<!--> <!-->1.087, <em>p</em> <!-->&lt;<!--> <!-->0.001) were the most significant predictors of poor sleep quality. Marital status (<em>B</em> <!-->=<!--> <!-->1.466, <em>p</em> <!-->=<!--> <!-->0.017) and working shifts (<em>B</em> <!-->=<!--> <!-->1.826, <em>p</em> <!-->=<!--> <!-->0.022) were also significantly associated with poor sleep quality.</div></div><div><h3>Conclusion</h3><div>Poor sleep quality level was found among the majority of critical care nurses, highlighting the need of implementing immediate interventions; including routine assessment of nurses sleep quality, ongoing support and counseling. Policymakers should prioritize initiatives such as workload management, disciplined shift scheduling, and stress reduction programs to improve nurses’ well-being. Implementing these procedures may reduce fatigue-related medical errors and increase patient safety.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500562"},"PeriodicalIF":1.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322394","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":"Validez y sensibilidad al cambio de la Clinical Frailty Scale-España en pacientes ingresados en cuidados intensivos","authors":"Susana Arias-Rivera RN, MSN ,&nbsp;Marta Raurell-Torredà RN, PhD ,&nbsp;María Nieves Moro-Tejedor RN, PhD ,&nbsp;Israel John Thuissard-Vasallo PhD ,&nbsp;Cristina Andreu-Vázquez MVD, MsC, PhD ,&nbsp;Fernando Frutos-Vivar MD, PhD ,&nbsp;grupo CFS-Es-UCI","doi":"10.1016/j.enfi.2025.500558","DOIUrl":"10.1016/j.enfi.2025.500558","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty scales, developed to assess elderly patients, are being implemented in critically ill patients. One of the most widely used is Clinical Frailty Scale, wrecently adapted to Spanish (CFS-Spain).</div></div><div><h3>Objective</h3><div>To evaluate the validity and sensitivity to change of the CFS-España in a cohort of critically ill patients aged ≥18 years.</div></div><div><h3>Methodology</h3><div>A prospective, multicenter, observational, metric-based study was conducted between January-2020 and July-2024. Adult patients with ICU stays<!--> <!-->&gt;48<!--> <!-->hours were included. Follow-up was performed during the stay and up to one year after discharge. Variables: frailty, sociodemographic characteristics, quality of life, comorbidities, severity (SAPS3), ICU outcome variables, length of stay, and discharge destination. Statistical analysis: exploratory, bivariate regression to assess the relationship between frailty and the recorded variables; multivariate regression of significant variables in bivariate. Spearman correlation of CFS-Spain with quantitative variables. Comparison of means with Student's t-test for sensitivity to change.</div></div><div><h3>Results</h3><div>A total of 493 patients were included, 17.4% of whom were frail (CFS-Spain<!--> <!-->=<!--> <!-->5-9). Age, being female, and being dependent increased the risk of frailty, as did previous hospitalizations, comorbidities, poorer physical quality of life, low academic level, and low annual income. Frailty predicts muscle weakness, hypoglycemia, the need for extrarenal blood pressure, invasive mechanical ventilation, vasoactive drugs, cardiopulmonary resuscitation, or limitation of life-sustaining treatment, and is associated with mortality. Frailty was not associated with mental quality of life, SAPS3, SOFA or ICU/hospital stay. The greatest change observed was between admission and 3 months after discharge. The effect size for changes in CFS-Es between admission, midpoints, and discharge was high (<em>d</em> <!-->=<!--> <!-->0.832).</div></div><div><h3>Conclusions</h3><div>The CFS-Spain shows good convergent validity with age, women, dependency, poorer physical quality of life, days of previous hospitalization, academic level and low annual income. Good predictive validity for the level of vital support in ICU, mortality and destination at hospital discharge.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500558"},"PeriodicalIF":1.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330788","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":"Percepción de necesidades de los familiares de pacientes en unidades de cuidados críticos pediátricos","authors":"Mónica Padilla-Lamadrid RN, MSN ,&nbsp;Ana Pardo-Fernández RN, MSN ,&nbsp;Raquel Torres-Luna RN, MSc ,&nbsp;Alberto García-Gómez RN, MSN ,&nbsp;Julia de Villarreal-Arracò RN, MSN ,&nbsp;Elena García-González RN, MSN ,&nbsp;Laura Frade-Pardo RN, MSN ,&nbsp;Pedro Piqueras-Rodríguez RN, MSN ,&nbsp;Eva del Ara Muñoz-Granda RN","doi":"10.1016/j.enfi.2025.500557","DOIUrl":"10.1016/j.enfi.2025.500557","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric critical care has undergone important changes in the last decades. In order to adapt pediatric care to the patient-family binomial and guarantee its quality, the evaluation of the needs perceived by family members during hospital stay is becoming increasingly relevant.</div></div><div><h3>Objective</h3><div>To determine the perception of the needs of the relatives of patients admitted to the pediatric critical care units (PCCU) in a tertiary level hospital.</div></div><div><h3>Methods</h3><div>Cross-sectional descriptive observational quantitative study was run through the distribution of the modified version of the Critical Care Family Needs Inventory. <em>Population:</em> Parents or legal caregivers of patients admitted to 2<!--> <!-->PCCUs with<!--> <!-->&gt;48<!--> <!-->h stay between September 2023 and January 2024. Descriptive analysis, Mann-Whitney U and Kruskal-Wallis tests were performed.</div></div><div><h3>Results</h3><div>Eighty-four questionnaires were completed. The median total score on the questionnaire was 15.00, corresponding to a high perception of fulfillment of needs. The subscale with the highest degree of compliance of the needs was «Patient care» (3.00), followed by «Information and communication» (3.00) and «Family care» (4.50); the subscale «Possible perceived improvements» (4.50) was the one with the worst results. Statistically significant differences were found when comparing the total score between units (<em>P</em> <!-->=<!--> <!-->0.046) and according to the type of room (<em>P</em> <!-->=<!--> <!-->0.016) and the educational level of the relatives (<em>P</em> <!-->=<!--> <!-->0.049). No significant differences were found during the analysis of the remaining variables.</div></div><div><h3>Conclusions</h3><div>The findings suggest that the hospital environment, specifically type of room, have a significant impact on the perception of family members’ needs fulfillment. It is considered essential to adapt pediatric critical care units in order to suit today's family-centered care approach.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 4","pages":"Article 500557"},"PeriodicalIF":1.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330032","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":"Clinical skills in therapeutic plasmapheresis in intensive care: A scoping review","authors":"Pedro Ramos-Figueiras MSc ,&nbsp;Maria Pinto-Marques PhD ,&nbsp;Margarida Palma-Goes PhD ,&nbsp;Henrique Oliveira PhD","doi":"10.1016/j.enfi.2025.500556","DOIUrl":"10.1016/j.enfi.2025.500556","url":null,"abstract":"<div><h3>Background</h3><div>Therapeutic plasmapheresis is a procedure primarily focused on modulating the immune system by removing specific antibodies and albumin-bound toxins implicated in the development of serious pathologies, and it is being used more frequently in intensive care units. In this therapeutic intervention, nursing teams mostly use the knowledge and skills acquired through experience with continuous dialysis techniques. However, the procedure is complex and advanced, requiring the development of specific skills.</div></div><div><h3>Aim</h3><div>To map the nursing interventions that facilitate the development of specific clinical skills for therapeutic plasmapheresis.</div></div><div><h3>Methodology</h3><div>The methodology adopted was based on a scoping review. The Population, Concept, Context methodology was used to formulate the review question and to select the articles. The search was carried out in the scientific databases CINAHL, MEDLINE, COCHRANE, Virtual Health Library and international journals specializing in apheresis techniques knowledge, with the inclusion criteria “nursing care”, “peer-reviewed articles” and the exclusion criteria “no full text” and “date less than 2017” applied. In addition, the most recent international guidelines on therapeutic plasmapheresis were included.</div></div><div><h3>Results</h3><div>A total of 11 articles were identified, of which 7 are textual evidence articles, based on expert opinions and database searches, and 4 are quantitative studies; in addition to 5 guidelines related to the subject under analysis. These reflect the importance of developing skills in therapeutic plasmapheresis, categorized into general, technical, management and communication domains. Nursing interventions are based on the principle of clinical reasoning, promoting evidence-based practice. The relevance of certifying these skills through training is also highlighted, emphasizing the need for structured programs for an adequate approach to highly complex therapeutic interventions.</div></div><div><h3>Conclusion</h3><div>Therapeutic plasmapheresis plays an essential role in intensive care settings, covering various clinical scenarios, which requires an individualized approach and careful consideration of the person's specific clinical condition.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500556"},"PeriodicalIF":1.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322397","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 intervenciones enfermeras nocturnas en las unidades de cuidados críticos pediátricos españolas","authors":"Alicia Gomez-Merino RN, MSc ,&nbsp;Patricia Luna-Castaño PhD, RN, MSc ,&nbsp;Marta Martín-Velasco RN ,&nbsp;Natalia González-Martínez RN, MSc ,&nbsp;Pedro Piqueras-Rodríguez RN, MSc ,&nbsp;Irina Marcos-Blázquez RN, MSc ,&nbsp;Sara Álvarez-Blanco RN ,&nbsp;Lucía Gutiérrez-Horrillo RN, MSc ,&nbsp;Elia Mas-Company RN ,&nbsp;Enara Otero-Arbella RN ,&nbsp;Elena Martín-Camacho RN, MSc ,&nbsp;María Teresa Arias-Latorre RN, MSc ,&nbsp;Sara Rodríguez-Flórez RN, MSc ,&nbsp;María de los Ángeles Morán-Barrio RN ,&nbsp;María Teresa Moreno-Casbas RN, PhD, FEAN, FAAN","doi":"10.1016/j.enfi.2025.500555","DOIUrl":"10.1016/j.enfi.2025.500555","url":null,"abstract":"<div><h3>Introduction</h3><div>The hostile environment in paediatric intensive care units (PICU) favours sleep-wake biorhythm dysregulation. Sleep disorders have detrimental impact on the immune, neurological and cardiovascular systems, in addition to increasing morbidity and mortality rates. Sleep plays a crucial role in brain development, rendering paediatric patients particularly vulnerable to the adverse effects of sleep disorders due to their ongoing neurological growth. The factors that affect rest include, among others, noise, lighting, treatment, and nocturnal nursing interventions, although the evidence for the latter is still scarce.</div></div><div><h3>Objective</h3><div>To identify the nocturnal nursing interventions, following the NIC taxonomy, carried out in PICU.</div></div><div><h3>Method</h3><div>A multicentre, cross-sectional, descriptive study was performed using an <em>ad hoc</em> survey to identify nocturnal nursing interventions in the PICU. The collected variables were characteristics of the participating PICU and those derived from the nursing interventions. During the analysis, mean and standard deviation of quantitative variables, and frequency tables and percentages were generated for qualitative variables. The variables were operationalized and Student's t-test and ANOVA were calculated for comparison between variables.</div></div><div><h3>Results</h3><div>One hundred records were obtained, encompassing 5017 interventions, with the most repeated intervention being “vital signs monitoring”. The mean number of different interventions identified was 23<!--> <!-->±<!--> <!-->7.66 and the mean frequency of these was 50.17<!--> <!-->±<!--> <!-->19.28. There were significant differences between the hospital variable and the number and frequency of interventions performed (p<!--> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Discussion</h3><div>We agreed with other studies in identifying “vital signs monitoring” as the most frequent intervention. “Improving sleep” was one of the most frequently reported, in contrast to other studies where interventions related to rest were not documented.</div></div><div><h3>Conclusions</h3><div>The most frequently performed interventions in the PICU were identified. In most of the registers some intervention on improving rest was identified, which could indicate the latent concern of the health care professionals for the sleep of the critical child.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500555"},"PeriodicalIF":1.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254741","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":"Análisis de disponibilidad, formación y uso de ecografía por enfermeras en urgencias intra y extrahospitalarias. Una encuesta nacional","authors":"Sergio Yago-Rios RN. MsC ,&nbsp;Raimunda Montejano-Lozoya RN, MsC, PhD ,&nbsp;Llucia Valentín-Martín RN, MsC ,&nbsp;Carmen Casal-Angulo RN, MsC, PhD ,&nbsp;Brais Quintairos-Manso ,&nbsp;Ángeles Rodríguez-Herrera RN, MsC, PhD ,&nbsp;Vicente Isidro Manrique-Ortiz RN ,&nbsp;Jorge Prieto-González RN. MsC ,&nbsp;Juan Carlos Miranda-Domínguez RN. MsC ,&nbsp;Àngela Soler-Sanchís RN, MsC ,&nbsp;Pablo Sánchez-Ballesteros RN, MsC ,&nbsp;Álvaro Solaz-García RN, MsC, PhD","doi":"10.1016/j.enfi.2025.500552","DOIUrl":"10.1016/j.enfi.2025.500552","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of ultrasound devices in emergency services has grown significantly, particularly point-of-care ultrasound (POCUS), which has enhanced patient management and treatment, reduced costs, and minimized radiation exposure. In nursing, POCUS has become an essential tool, especially for vascular access procedures. However, disparities in training and access to ultrasound equipment exist across emergency services in different regions of Spain. This study aims to explore these differences and their impact on clinical practice.</div></div><div><h3>Methodology</h3><div>A cross-sectional, descriptive, observational study was conducted, involving nurses from emergency services throughout Spain. Data were collected via an online survey validated through the Delphi method. The study received approval from the Ethics Committee.</div></div><div><h3>Results</h3><div>A total of 424 professionals from all regions except the Balearic Islands participated, representing 123 hospital emergency services, 15 prehospital services, and 20 primary care centers. Overall, 79% had access to ultrasound devices, with significant differences across service types (<em>P</em>&lt;.01). Only 36% reported having access to a full range of probes. Notably, 63% of participants lacked formal ultrasound training. Variability in equipment availability and training differed significantly between regions (<em>P</em>&lt;.05).</div></div><div><h3>Discussion</h3><div>The findings highlight substantial disparities in the availability of ultrasound devices and probes across different services and regions. Additionally, most nursing professionals lack ultrasound training. Compared to other European countries, availability in Spain is lower. The lack of training may stem from the absence of nationally accredited programs, leaving individual resources as the primary means of acquiring skills.</div></div><div><h3>Conclusion</h3><div>Significant inequalities exist in access to ultrasound equipment and training among emergency services and regions in Spain. Professional training in this field varies depending on the region studied.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500552"},"PeriodicalIF":1.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184511","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 vacunación frente al COVID-19 en los costos hospitalarios en los enfermos ingresados en una unidad de cuidados intensivos durante la cuarta, quinta y sexta oleada de la pandemia","authors":"Alejandro González-Castro MD, pHD ,&nbsp;David Iglesias MD ,&nbsp;Yhivian Peñasco MD, pHD ,&nbsp;Carmen Huertas Marín MD ,&nbsp;Elena Cuenca-Fito MD ,&nbsp;Trinidad Dierssen-Soto MD, pHD ,&nbsp;Reinhard Wallmann MD ,&nbsp;Raquel Ferrero-Franco RN ,&nbsp;Camilo González MD ,&nbsp;Juan Carlos Rodríguez-Borregán MD","doi":"10.1016/j.enfi.2025.500551","DOIUrl":"10.1016/j.enfi.2025.500551","url":null,"abstract":"<div><h3>Background and objective</h3><div>COVID-19 vaccination may alter the course of severe disease and influence hospital discharge costs. This study compares hospital discharge costs among ICU-admitted COVID-19 patients based on vaccination status, adjusted for All Patient Refined Diagnosis Related Groups (APR-DRG) and severity.</div></div><div><h3>Patients and methods</h3><div>A retrospective study (March 2020-March 2022) was conducted in an ICU, categorizing patients into three groups: unvaccinated, fully vaccinated, and partially vaccinated. Full vaccination included all required doses and boosters per the vaccination schedule. Disease severity was classified as mild, moderate, severe, and critical. Direct hospital costs, including ICU stay, medical procedures, medications, and life support, were analyzed using data from Order SAN/35/2017, adjusted for inflation. Chi-square and Kruskal-Wallis tests with Bonferroni correction were used for comparisons.</div></div><div><h3>Results</h3><div>A total of 456 patients were included: 262 (57%) unvaccinated, 32 (7%) partially vaccinated, and 162 (35%) fully vaccinated. Median costs were:<ul><li><span>•</span><span><div>Unvaccinated: €10,653 (IQR: €6,160-€18,274)</div></span></li><li><span>•</span><span><div>Partially vaccinated: €17,360 (IQR: €5,061-€26,085)</div></span></li><li><span>•</span><span><div>Fully vaccinated: €10,653 (IQR: €6,160-€26,085)</div></span></li></ul></div><div>Cost differences were not statistically significant (<em>P</em>=.28). Critical severity patients had the highest costs, while mild cases had the lowest (<em>P</em>&lt;.05). No significant cost differences were found within each severity level or in APR-DRG relative weight (<em>P</em>=.38).</div></div><div><h3>Conclusions</h3><div>No significant differences in hospital discharge costs by APR-DRG were found based on vaccination status. However, vaccination may reduce disease severity and the need for intensive resources, with potential economic and clinical implications for future research.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500551"},"PeriodicalIF":1.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105769","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":"Infarto de miocardio alérgico por picadura de abeja","authors":"Beatriz Gómez-Martín RN, MSN","doi":"10.1016/j.enfi.2025.500550","DOIUrl":"10.1016/j.enfi.2025.500550","url":null,"abstract":"<div><h3>Introduction and case presentation</h3><div>Kounis Syndrome is the association of acute coronary syndrome (ACS) in the context of a hypersensitivity reaction whose prevalence is difficult to identify and its etiology is multifactorial, which makes its early detection difficult. The unusual case of a woman who suffers an acute myocardial infarction (AMI) with cardiorespiratory arrest (CPA) secondary to the accidental sting of a bee is presented. The objective is, regarding the case, to define the nursing interventions and the individualized care plan.</div></div><div><h3>Assessment</h3><div>Based on Virginia Henderson's care model, the assessment of the nursing care process was carried out.</div></div><div><h3>Diagnosis and planning</h3><div>According to the NANDA taxonomy, the nursing diagnoses and potential problems that developed during their stay in the unit were described. Standardized language was used establishing NOC objectives and NIC interventions.</div></div><div><h3>Discussion and conclusions</h3><div>The combination of both pathologies in a single entity can make the management of this syndrome in the acute phase difficult, which modifies the conventional scenario of a CPA. Defining a standardized care plan is a fundamental axis to provide optimal quality of care based on evidence in the absence of standardized algorithms in the literature.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500550"},"PeriodicalIF":1.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902603","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":"Incidencia de complicaciones en pacientes sometidos a terapia de reemplazo renal continuo anticoagulada con citrato sódico","authors":"Juan Carlos Muñoz-Camargo RN, MSc, PhD,&nbsp;Inmaculada Vázquez-Rodríguez-Barbero RN,&nbsp;Alicia Muñoz-Torrero-Peña RN,&nbsp;Amadeo Puebla-Martín RN","doi":"10.1016/j.enfi.2025.500544","DOIUrl":"10.1016/j.enfi.2025.500544","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute kidney injury (AKI) is a frequent complication in Intensive Care Unit (ICU) patients with high morbidity and mortality.</div></div><div><h3>Objective</h3><div>To analyze the incidence of mechanical and metabolic adverse events associated with continuous renal replacement therapy using sodium citrate as a regional anticoagulant.</div></div><div><h3>Material and methods</h3><div>Observational, descriptive and prospective study performed in a polyvalent ICU during three years. Patients with AKI treated with renal replacement therapy and sodium citrate (Prismocitrate 18/0 mmol/L [0.5%]) were included. Patients with liver failure, active bleeding, severe thrombocytopenia, ICU stay of less than 24<!--> <!-->hours or treated with other anticoagulants were excluded. Demographic variables, severity index (APACHE II), vasoactive drug use, adverse events, and catheter characteristics were recorded. Anticoagulation efficacy was assessed with filter duration. Statistical analysis was performed with SPSS v.28.0, with p&lt;<!--> <!-->0.05 as the significance level. The study was approved by the ethics committee and informed consent was obtained from the patients or their relatives.</div></div><div><h3>Results</h3><div>We studied 100 patients, 62% men, with a mean age of 63<!--> <!-->±<!--> <!-->14.5 years. The main causes of AKI were septic shock, hemorrhagic shock and Covid-19. The median ICU stay was 16 days (RIC 8-43), with intra-ICU mortality of 48%. Therapy lasted a median of 60.5<!--> <!-->hours (RIC 38-107). Only one patient presented bleeding, and in 26% the filter coagulated. There were no cases of citrate toxicity. Electrolyte complications included hypocalcemia (45%), hypokalemia (41%), hyponatremia (36%) and metabolic acidosis (30%).</div></div><div><h3>Conclusions</h3><div>Mechanical and metabolic complications are common in continuous renal replacement therapies with sodium citrate. It is essential for ICU staff to be aware of their high prevalence in order to optimize clinical management.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500544"},"PeriodicalIF":1.1,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848323","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}