Enfermeria Intensiva最新文献

{"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}

{"title":"The use of continuous glucose monitoring: A scoping review of accuracy, feasibility and nursing workload reduction in intensive care setting","authors":"Marc Pañero-Moreno RN, MSc ,&nbsp;Meritxell Muxella-Roson RN ,&nbsp;Gemma Dubè-Llobet RN ,&nbsp;Marta Cabrerizo-Jimenez RN ,&nbsp;Eva Maria Guix-Comellas RN, MSN, PhD ,&nbsp;Alberto Villamor-Ordozgoiti RN, MSN, PhD ,&nbsp;Natalia Marsà-Perez RN","doi":"10.1016/j.enfi.2025.500534","DOIUrl":"10.1016/j.enfi.2025.500534","url":null,"abstract":"<div><h3>Background</h3><div>Hyperglycemia is prevalent in intensive care units (ICUs), associated with increased mortality. Management involves frequent point-of-care glucose (POC-G), but continuous glucose monitoring (CGM) shows promise in improving glycemic control.</div></div><div><h3>Aims</h3><div>To explore the knowledge in the literature about the impact and accuracy of CGM in ICUs.</div></div><div><h3>Design</h3><div>A scoping review was conducted; PubMed, Web of Science, CINAHL, Scopus databases and Gray Literature covering the period from September 2018 to September 2024.</div></div><div><h3>Methods</h3><div>Data abstraction, quality appraisal, and narrative synthesis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.</div></div><div><h3>Results</h3><div>Of the 952 titles reviewed, 20 articles were included. Clinical outcomes were mean absolute relative difference (MARD), ranged from 9.3% to 20.6%. Additionally, there was a 30–71% reduction of POC-G measurements. Time in range (TIR) varied from 46.1% to 100%. Clarke Error Grid (CEG) analysis demonstrated that over 98% of the glucose values fell within zones A and B.</div></div><div><h3>Conclusions</h3><div>CGM in the ICU reduces nursing workload, enhances patient safety, and facilitates early intervention for abnormal glucose levels, demonstrating its feasibility, accuracy and effectiveness in critical care settings. Additional clinical trials are needed to validate these findings and establish optimal usage parameters.</div></div><div><h3>Relevance to clinical practice</h3><div>CGM came to stay in ICU. Therefore, it is crucial to start training critical care nurses in the use of CGM. This will enable us to maximize their benefits in terms of reducing nursing workload and enhancing patient safety.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500534"},"PeriodicalIF":1.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843718","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":"Efecto de una intervención de musicoterapia en el estado de ánimo del enfermo crítico","authors":"M. del Mar Vega Castosa MSN,&nbsp;M. del Carmen Jover Sancho MSN, PhD,&nbsp;Joan Trujols Albet PhD","doi":"10.1016/j.enfi.2025.500549","DOIUrl":"10.1016/j.enfi.2025.500549","url":null,"abstract":"<div><h3>Introduction</h3><div>The critically ill patient is in a state of fragility, helplessness, and vulnerability that hinders the communication of their emotions and feelings. Music therapy could be a valid tool to improve mood. The main objective was to evaluate the effect on mood of an individualized music therapy intervention compared to standard care and analyze the impact on pain and hemodynamic variables.</div></div><div><h3>Methodology</h3><div>Randomized, parallel, and open clinical trial. Patients were randomized into the experimental group, receiving combined music therapy and standard care, or the control group, receiving standard care only. The study population consisted of patients admitted to the Intensive Care Unit with a Glasgow 15-11<!--> <!-->T score, excluding those with confusion, agitation, and significant cognitive deficits. The primary variable was mood, assessed using the Profile of Mood States questionnaire. Secondary variables included pain, heart rate, blood pressure, respiratory rate, and oxygen saturation.</div></div><div><h3>Results</h3><div>A total of 151 patients were included, randomly distributed into the experimental group (n<!--> <!-->=<!--> <!-->75) and the control group (n<!--> <!-->=<!--> <!-->76). Mood improvement was significant in all 6 subscales of the Profile of Mood States questionnaire, in the time effect between pre- and post-intervention assessment, and in the time effect by group interaction for Anger (p<!--> <!-->=<!--> <!-->0.020), Fatigue (p<!--> <!-->=<!--> <!-->0.002), Vigor (p<!--> <!-->=<!--> <!-->0.029), and Tension (p<!--> <!-->=<!--> <!-->0.042), indicating that the improvement was related to the music therapy intervention in the experimental group. Following the music therapy intervention, a decrease in pain (p<!--> <!-->=<!--> <!-->0.024) and heart rate (p<!--> <!-->=<!--> <!-->0.017) was observed in the time effect, and an increase in systolic blood pressure (p<!--> <!-->=<!--> <!-->0.004) was related to the music therapy intervention.</div></div><div><h3>Discussion</h3><div>This clinical trial demonstrates that music therapy, with a personalized music intervention, has a positive effect on the mood of critically ill patients. Further lines of research are needed to continue advancing scientific knowledge and develop news forms of assistance to improve mood.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500549"},"PeriodicalIF":1.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838503","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":"Eficacia del acompañamiento familiar y de medidas ambientales para reducir la incidencia de delirio en una unidad de agudos cardiovasculares: un estudio cuasi-experimental. Reducir el delirio sin fármacos es posible, es mejor","authors":"Luis Guerra-Sánchez PhD ,&nbsp;Sara González-Alfonso RN ,&nbsp;Pablo Lerma-Lara RN ,&nbsp;Miguel Bernardino-Santos RN ,&nbsp;Rosario Cortijo-González RN ,&nbsp;Soraya Bustamante-González RN","doi":"10.1016/j.enfi.2025.500546","DOIUrl":"10.1016/j.enfi.2025.500546","url":null,"abstract":"<div><h3>Introduction</h3><div>The occurrence of delirium casts a shadow over the prognosis of patients, especially the critically ill. Prevention and treatment of delirium is more effective and with fewer adverse effects with multicomponent interventions than with pharmacological measures alone. The objective was to assess whether a non-pharmacological care-related intervention can reduce the incidence of delirium in an acute cardiovascular care unit.</div></div><div><h3>Methods</h3><div>Quasi-experimental study (before/after). ‘Before’: From November 2018 to March 2019, 190 patients aged 18 years and older, admitted to an acute cardiovascular care unit, were assessed using the Confusion Assessment Method for the ICU. From April to November 2019, a series of actions related to the physical environment and accompaniment were implemented. The ‘after’ started in November 2019 and 189 patients were assessed until early March 2020.</div></div><div><h3>Results</h3><div>The incidence of delirium before introducing the actions was 11,6%, which fell to 4,2% (p<!--> <!-->=<!--> <!-->0,012) after the actions.</div></div><div><h3>Discussion</h3><div>Management of delirium includes effective diagnosis, delirium prevention activities and treatment, which ideally should be free of side effects.</div></div><div><h3>Conclusions</h3><div>The implementation of a bundle of measures related to environmental changes and involving the family, significantly reduced the incidence of delirium, to less than half.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500546"},"PeriodicalIF":1.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777259","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":"Bacteriemia asociada a catéter venoso central en el paciente crítico: epidemiología y factores de riesgo","authors":"Esther Mancheño-Maciá PhD ,&nbsp;Beatriz Muñoz-Sánchez RN ,&nbsp;Inés González-Sánchez PhD ,&nbsp;Marina Leal-Clavel RN MsN ,&nbsp;Vanesa Escudero-Ortiz PhD","doi":"10.1016/j.enfi.2025.500538","DOIUrl":"10.1016/j.enfi.2025.500538","url":null,"abstract":"<div><h3>Introduction</h3><div>Central venous catheter-related bacteremia is a common nosocomial infection in intensive care units (ICU), the prevalence is worrying. In recent years, due to Covid-19, the number of central venous catether's patients, treated with immunosuppressive drugs, has been increased. Our objective was to determine the prevalence of central catheter bacteremia in ICU, during 2022, as well as to determine associated risk factors.</div></div><div><h3>Method</h3><div>Descriptive cross-sectional study in ICU of hospita (HGU Dr. Balmis Hospital Alicante, Spain). Were included 466 patients admitted to ICU in 2022. Sociodemographic, clinical, catheter-related data and APACHE-II and q-SOFA scale scores were collected.</div></div><div><h3>Results</h3><div>The prevalence of bacteriemia was 3.65%. Significant factors associated with bacteriemia were the number of catheters inserted in each patient (p<!--> <!-->&lt;<!--> <!-->0.001) and the use of immunosuppressive drugs (p<!--> <!-->=<!--> <!-->0.002). Patients who had a peripherally inserted catheter (PICC) had a lower probability of develop bacteriemia and patients with conventional catheter and PICC had a higher probability. The rest of the variables, including Covid-19, without significant differences.</div></div><div><h3>Discussion and conclusions</h3><div>In line with other authors, we can affirm that the administration of immunosuppressive drugs is a risk factor of central venous catheter-related bacteremia; A correct risk-benefit assessment is recommended when prescribing these drugs, in Covid's patients the biological drug tocilizumab could be the recommended one. An increase by one unit in the number of catheters inserted causes a 5-fold increase in probability of developing bacteremia (Odds ratio: 4.984, 95% confidence interval 2.984-9.136). Covid-19, sex, age, comorbidities and q-SOFA and APACHE-II scores do not seem to show a relationship whith bacteremia and PICCs devices do seem to be safer <em>versus</em> conventional CVCs.</div></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"36 3","pages":"Article 500538"},"PeriodicalIF":1.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777260","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}