Enfermería intensiva
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Enfermería intensiva · Oct 2003
[Critical care nursing and continuous renal replacement techniques in the Madrid Community].
The continuous renal replacement techniques (CRRT) aim to substitute the altered renal function during a period of time, presenting advantages compared to conventional hemodialysis (CH). This study aims to determine the situation of the CRRT in the Intensive care units (ICU) of the Madrid Community (MC) using a survey distributed to nurses (n = 131) of 14 ICU. It evaluates four aspects of the CRRT: management model, knowledge, problems and degree of satisfaction. ⋯ A total of 84.7% think that CRRT significantly increases the workloads and 62.6% believe that they should be done by the ICU nurses. The main problem is the lack of knowledge to resolve complications during the technique. We conclude that the ICU nursing can handle the CRRT, adapting the nurse/patient ratio; training programs should be established and the role of the teaching nurse defined in critical renal cares.
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Enfermería intensiva · Oct 2003
[Accumulated fluid balance in patients admitted to the ICU: is it really reliable?].
In most of the textbooks, it is considered that the balance calculated after admission and the losses measured and/or estimated is an inexact way of establishing the real balance. Thus daily monitoring of the weight variations is recommended as a single possible alternative. On the other hand, there are few studies that have strictly studied the reliability of the fluid balance calculated. ⋯ We find that, above all after the 6th day, the accumulated balance calculated adequately reflected the weight changes (mean error/day < 250 ml), regardless of the presence or not of fever, sweat, oral diet, feces or mechanical ventilation. When weight on admission to the ICU was less than 75 kg, the changes in the balance calculated adjusted even more to the weight change, the contrary occurring when the weight was greater than 75 kg. These findings suggest that the accumulated balance calculated represents a valid alternative to daily weighing of the patients and that factors such as body mass and/or surface should be taken into account to reach more exact estimations.