Admission, discharge and triage guidelines for paediatric intensive care units in Spain. / Guias de ingreso, alta y triage para las unidades de cuidados intensivos pediátricos en España.

A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition.

[Liver trauma. Description of a cohort and evaluation of therapeutic options]. / Traumatismo hepático. Descripción de una cohorte y valoración de opciones terapéuticas.

INTRODUCTION: Complex liver injuries carry high morbidity and mortality ranging between 40 and 80%. OBJECTIVES: To describe the characteristics of patients with liver trauma in the intensive care unit of our hospital, and the causes, severity scales, diagnoses, and treatments of these injuries, as well as length of hospital stay, morbidity and mortality. PATIENTS AND METHOD: We retrospectively reviewed the patients with liver trauma admitted to our intensive care unit (ICU) from January 2000 to December 2005. There were two groups of patients: those who underwent surgery and those who received conservative treatment. RESULTS: Univariate analysis revealed statistically significant differences between the two groups in the Acute Physiology and Chronic Health Evaluation II (APACHE II) score on admission to the ICU, the Injury Severity Score (ISS), and the percentage of severelesions according to the Liver Injury Scale (LIS), as well as in the coexistence of lesions in the large intestine. CONCLUSIONS: From the statistical point of view, the two main variables guiding the therapeutic approach were hemodynamic instability and the need for transfusion. The indication for surgery showed a clear, although non-significant, association with mortality. Lastly, there was an association between the surgical option of packing and mortality.