RESUMEN
INTRODUCTION: There is an increasing demand for multi-organ donors for organ transplantation programmes. This study protocol describes the Donation Network to Optimise Organ Recovery Study, a planned cluster randomised controlled trial that aims to evaluate the effectiveness of the implementation of an evidence-based, goal-directed checklist for brain-dead potential organ donor management in intensive care units (ICUs) in reducing the loss of potential donors due to cardiac arrest. METHODS AND ANALYSIS: The study will include ICUs of at least 60 Brazilian sites with an average of ≥10 annual notifications of valid potential organ donors. Hospitals will be randomly assigned (with a 1:1 allocation ratio) to the intervention group, which will involve the implementation of an evidence-based, goal-directed checklist for potential organ donor maintenance, or the control group, which will maintain the usual care practices of the ICU. Team members from all participating ICUs will receive training on how to conduct family interviews for organ donation. The primary outcome will be loss of potential donors due to cardiac arrest. Secondary outcomes will include the number of actual organ donors and the number of organs recovered per actual donor. ETHICS AND DISSEMINATION: The institutional review board (IRB) of the coordinating centre and of each participating site individually approved the study. We requested a waiver of informed consent for the IRB of each site. Study results will be disseminated to the general medical community through publications in peer-reviewed medical journals. TRIAL REGISTRATION NUMBER: NCT03179020; Pre-results.
Asunto(s)
Lista de Verificación/métodos , Obtención de Tejidos y Órganos , Muerte Encefálica/diagnóstico , Brasil , Medicina Basada en la Evidencia/métodos , Humanos , Unidades de Cuidados Intensivos/organización & administración , Evaluación de Resultado en la Atención de Salud/métodos , Obtención de Tejidos y Órganos/métodos , Obtención de Tejidos y Órganos/organización & administraciónRESUMEN
Dengue is presently the most relevant viral infection transmitted by a mosquito bite that represents a major threat to public health worldwide. Acute kidney injury (AKI) is a serious and potentially lethal complication of this disease, and the actual incidence is unknown. In this review, we will assess the most relevant epidemiological and clinical data regarding dengue and the available evidence on the frequency, etiopathogenesis, outcomes and treatment of dengue-associated AKI.
RESUMEN
A doença renal crônica (DRC) afeta a qualidade de vida do paciente sendo necessário controlar e/ou prevenir as complicações. Estudo transversal que objetivou identificar as complicações de 195 pacientes renais crônicos durante a hemodiálise, de acordo com suas variáveis sócio-demográficas no Hospital de Ensino de São José do Rio Preto. Para coleta de dados utilizou-se observação sistematizada e entrevista estruturada. A análise dos dados foi estatística descritiva, com aplicação dos testes: t student, análise de variância e qui quadrado. 57,95% sexo masculino, com idade média de 57,13±15,34 anos, 53,85% casados, 51,28% aposentados, 74,36% católicos, 77,95% de cor branca e 61,03% ensino fundamental incompleto. As complicações prevalentes: 40,88% hipotensão, 14,70% dor e 11,16% cefaléia. Condutas: 43,24% administração de medicação, 33,05% de soro e 7,40% soro e diminuição da ultrafiltração. Os resultados estão em concordância com dos estudos brasileiros e assim medidas preventivas precisam ser realizadas para evitar tais complicações, como o monitoramento mais efetivo dos pacientes durante a hemodiálise que oferecerá subsídios para garantir a qualidade da assistência e segurança destes pacientes.