Medicina intensiva
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Patient follow-up after intensive care unit (ICU) discharge allows the early recognition of complications associated to post-intensive care syndrome (PICS). The aim of this project is to standardize outcome variables in a follow-up program for patients at risk of suffering PICS. ⋯ The measures herein suggested for patient follow-up after ICU discharge will facilitate a basic approach to diagnosis and management of the long-term complications associated to PICS.
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Comparative Study
Analysis of the difference between importance and satisfaction of the needs of family members of critical patients.
To analyze the difference between the degree of importance and satisfaction of the needs of family members of patients in an Intensive Care Unit (ICU). ⋯ A high level of importance, compared to low levels of satisfaction, determines a negative gap in most of the needs of the family of the critical patient, particularly those referred to communication. Despite this, a low proportion of the needs should be addressed on a priority basis.
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Important recent insights have emerged regarding the cellular and molecular role of carbon dioxide (CO2) and the effects of hypercapnia. The latter may have beneficial effects in patients with acute lung injury, affording reductions in pulmonary inflammation, lessened oxidative alveolar damage, and the regulation of innate immunity and host defenses by inhibiting the expression of inflammatory cytokines. ⋯ Clearly, hypercapnia has both beneficial and harmful consequences, and it is important to determine the net effect under specific conditions. The purpose of this review is to describe the immunological and physiological effects of carbon dioxide, considering their potential consequences in patients with acute respiratory failure.
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Multicenter Study
Management of analgesia, sedation and delirium in Spanish Intensive Care Units: A national two-part survey.
To know the real clinical practice of Spanish ICUs in relation to analgesia, sedation and delirium, with a view to assessing adherence to current recommendations. ⋯ This survey is the first conducted in Spain on the practices of analgesia, sedation and delirium. We identified specific targets for quality improvement, particularly concerning the management of sedation and the assessment of delirium.