RESUMEN
Acute respiratory distress syndrome (ARDS) secondary to influenza in adults is associated with a high rate of morbidity and mortality. Extracorporeal membrane oxygenation (ECMO) is a supportive alternative for severe and refractory cases. This study aimed to perform a hospital-based case-control study between February 2018 and February 2020 for determining the factors associated with 30 day survival in adults with severe ARDS caused by influenza infection who are provided ECMO support. A total of 17 adults received ECMO support, mostly veno-venous for hypoxemic respiratory failure, with a 30 day survival rate of 65%. The cohort of patients who did not survive at 30 days compared with the cohort of those who did survive had higher body mass index (34 vs. 31), higher Sequential Organ Failure Assessment score (9.5 vs. 7) and lower Respiratory ECMO Survival Prediction score (2 vs. 4). This study shows the importance of evaluating the severity scores of patients before ECMO support initiation, which offers an acceptable survival in patients with severe ARDS, making it a feasible alternative in critical patients who are refractory to conventional management.
Asunto(s)
Oxigenación por Membrana Extracorpórea , Gripe Humana , Síndrome de Dificultad Respiratoria , Adulto , Estudios de Casos y Controles , Humanos , Gripe Humana/complicaciones , Gripe Humana/terapia , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/terapia , Estudios RetrospectivosRESUMEN
El presente estudio tiene como objetivo describir la experiencia de los profesionales de enfermería al cuidar en ambientes altamente tecnológicos. Este es un trabajo de investigación con enfoque fenomenológico husserliano en el cual se entrevistaron 14 profesionales de enfermería que llevaban más de 1 año trabajando en la Unidad de Cuidado Intensivo de la Fundación Clínica Shaio (Bogotá, Colombia). La recolección de datos se llevó a cabo por medio de una entrevista abierta, y éstos fueron analizados bajo el abordaje de Colaizzi. Después de analizar los datos se determinó que la experiencia de cuidar en ambientes altamente tecnológicos para los profesionales de enfermería se enmarca en 3 categorías: La dificultad por trabajar en estas áreas por la misma complejidad de los pacientes, los riesgos de rutinizar el cuidado y perder el contacto con el paciente; la satisfacción por el trabajo realizado que se logra al identificar todas las necesidades del paciente creando un vínculo con ellos y sus familias que permite evidenciar una reciprocidad durante el cuidado y la búsqueda diaria por armonizar el cuidado con la tecnología, en donde su uso prima para identificar y brindar un cuidado que responda a las necesidades del paciente sin convertir estas herramientas en la prioridad de cuidado. La experticia de los enfermeros en el manejo de la tecnología se convierte en un elemento clave para brindar un cuidado humanizado, siendo un puente de ayuda para identificar las necesidades de los pacientes y sus familias.
This investigation aims at describing the experience of professional nurses when caring in highly technological environments, from a husserlian phenomenological approach. Interviews were held with 14 professional nurses whose work experiences in the Intensive Care Unit at Fundación Clínica Shaio (Bogotá, Colombia) were longer than one year. Data collection was achieved through an open interview and the obtained information was analyzed by following Colaizzi´s proposals. Data analysis allowed framing the experience lived by professional nurses when caring in highly technological environments in three categories: difficulties of working in these areas due to the patients' complexity and risks that arise when the care becomes routine and the contact with the patient is lost; satisfaction produced by the own work that allows identifying the patient´s necessities and creating a bond with him or her and their families, which ultimately evidences a reciprocity during the caring activities; and the daily effort for harmonizing care with technology, with the main objective of using it in order to provide an appropriate care that fulfills the patient´s needs without turning technological tools into a priority. Nurses' expertise when it comes to technology is a key element when providing a humanized care, since this element constitutes an assistance technical tool for identifying the necessities of patients and their families.
