Nursing Team Workload and the Apache Index of Gravity of Patients Post Liver Transplantation: A Cohort Study.

BACKGROUND: Liver transplantation is a complex treatment that demands a high workload from the nursing team. This study evaluated the nursing workload and its relationship with the severity of patients after liver transplantation. MATERIAL AND METHODS: A retrospective cohort study, with a review of 286 medical records of liver transplant patients from January 2014 to June 2018 in a hospital in southern Brazil was performed. Demographic and clinical characteristics were analyzed, as well as the outcome and the scores Model for End-Stage Liver Disease (MELD), Nursing Activity Score (NAS), and Acute Physiology and Chronic Health Evaluation IV (APACHE IV). RESULTS: Men represented 68.9% of the sample, the mean age was 57.6 years (±10), and the MELD and APACHE IV scores respectively showed means of 24.3 (±5.6) and 58.9 (±23.7). The length of stay in the intensive care unit was 5 days (range, 3-7) and mortality was 9.1%. There was a gradual reduction in the mean NAS in 24 hours (94.9 ± 18.5), 48 hours (87.2 ± 17.0), 72 hours (83.3 ± 19.6) and at discharge (82.3 ± 18.0). Associations of NAS with MELD (P ˂ .05), APACHE IV (P ˂ .001), length of stay in the intensive care unit (P ˂ .001), and death outcome (P ˂ .001) were observed. The greatest workload was in checking vital signs, water balance, and administrative tasks (P ˂ .001). CONCLUSIONS: The nursing workload in the postoperative period of liver transplantation exceeds what is recommended and is related to the severity of the patients.

Resting energy expenditure in cirrhotic patients with and without hepatocellular carcinoma.

BACKGROUND: The diagnosis of malnutrition in patients with independent hepatocellular carcinoma (HCC) varies from 20% to 50%, is related to important complications and has a direct impact on the prognosis. Determination of the resting energy expenditure (REE) has become an important parameter in this population, as it allows therapeutic adjustments to recover their nutritional status. The REE in cirrhosis, with and without HCC, is not clearly defined, and requires the identification and definition of the best nutritional approach. AIM: To evaluate the REE of patients with cirrhosis, with and without HCC. METHODS: This is a prospective observational study evaluating the REE of 118 patients, 33 with cirrhosis and hepatocellular carcinoma and a control group of 85 patients with cirrhosis without HCC, using indirect calorimetry (IC), bioimpedance, and predictive formulas. RESULTS: The REE determined by IC in cirrhotic patients with HCC was 1643 ± 364 and in those without HCC was 1526 ± 277 (P = 0.064). The REE value as assessed by bioimpedance was 1529 ± 501 for those with HCC and 1660 ± 385 for those without HCC (P = 0.136). When comparing the values of REE determined by IC and predictive formulas in cirrhotics with HCC, it was observed that only the formulas of the Food and Agriculture Organization (FAO)/World Health Organization (WHO) (1985) and Cunningham (1980) presented values similar to those determined by IC. When comparing the REE values determined by IC and predictive formulas in cirrhotics without HCC, it was observed that the formulas of Schofield (1985), FAO/WHO (1985), WHO (2000), Institute of Medicine (IOM) (2005) and Katch and McArdie (1996) presented values similar to those determined by IC. CONCLUSION: The FAO/WHO formula (1985) could be used for cirrhotic patients with or without HCC; as it is the one with the values closest to those obtained by IC in these cirrhotic patients.

Uso terapêutico de tecidos e órgãos humanos para transplantes: eventos adversos e ações de biovigilância / Uso terapéutico de tejidos y órganos humanos para trasplantes: eventos adversos y acciones de biovigilancia / Therapeutic use of human tissues and organs for transplants: adverse events and biovigilance actions

Objetivo: Identificar evidências na literatura sobre eventos adversos e ações de biovigilância no processo de doação e uso terapêutico de tecidos e órgãos humanos para transplante. Método: Revisão integrativa, utilizando as bases de dados LILACS, MEDLINE e Embase. Critérios de inclusão: estudos primários em inglês, espanhol e português, publicados entre 2015 a 2021, acerca da biovigilância na doação e transplante, riscos e eventos adversos. Resultados: Analisados 10 artigos, identificando a ocorrência de eventos adversos referentes ao processo de doação e transplante e estratégias de biovigilância para reduzir riscos e aumentar a segurança. Conclusão: Riscos e eventos adversos podem ocorrer no processo de doação e transplante. Observaram-se estratégias, para mitigar os riscos e a ocorrência/recorrência de eventos adversos, propiciando maior qualidade assistencial e segurança ao paciente. O enfermeiro tem papel fundamental no que concerne à biovigilância, estando presente em todas as fases do processo de doação e transplante(AU)

Purpose: To identify evidence in the literature regarding adverse events and biovigilance actions in the process of donation and therapeutic use of human tissues and organs for transplantation. Method: An integrative review consulting the following databases: LILACS, MEDLINE, and Embase. Inclusion criteria: Primary studies in English, Spanish and Portuguese, published between 2015 and 2021, about biovigilance in the donation and transplants, risks, and adverse events. Results: 10 articles were analyzed, identifying the occurrence of adverse events related to the process of the donation and transplants, biovigilance strategies aiming to reduce risk and increase safety. Conclusion: Risks and adverse events can occur in the process of donation and transplantation. Estrategies were observed to mitigate the risks and occurrence/recurrence of adverse events, providing assistance with greater quality and patient safety. Nurses have a fundamental role with regard to biosurveillance, as they are present in all stages of the donation and transplants(AU)

Objetivo: Identificar evidencias en la literatura sobre efectos adversos y acciones de biovigilancia en el proceso de donación y uso terapéutico de tejidos y órganos humanos para trasplante. Método: Revisión integradora, utilizando las bases de datos LILACS, MEDLINE y Embase. Criterios de inclusión: estudios primarios en inglés, español y portugués, publicados en 2015-2021, sobre biovigilancia en donación y trasplantes, riesgos y eventos adversos. Resultados: Se analizaron 10 artículos, se identificó la ocurrencia de efectos adversos referentes al proceso de donación y trasplante, estrategias de biovigilancia para reducir riesgos y aumentar la seguridad. Conclusión: Riesgos y efectos adversos pueden ocurrir en el proceso de donación y trasplante. Estrategias para mitigar los riesgos y la ocurrencia/recurrencia de efectos adversos, propician asistencia de mayor calidad y seguridad para el paciente. El enfermero tiene un papel fundamental en la biovigilancia, ya que está presente en todas las etapas del proceso de donación y trasplante(AU)

Processo de doação e transplante de órgãos e tecidos: conhecimentos de acadêmicos de enfermagem, psicologia e serviço social / Process of donation and transplant of organs and tissues: knowledge of nursing, psychology and social service academics / Proceso de donación y trasplante de órganos y tejidos: conocimiento de estudiantes universitarios de enfermería, psicología y servicio social

Objetivo: Avaliar o conhecimento de estudantes dos cursos de Graduação em Enfermagem, Psicologia e Serviço Social sobre o conceito de Morte Encefálica e aspectos do processo de doação e transplante de órgãos e tecidos. Métodos: Estudo de campo, exploratório, descritivo e prospectivo, quantitativo. Realizado em Instituição de Ensino Superior privada. Utilizou-se contendo 10 questões, sobre o processo de doação de órgãos e perguntas relacionadas ao perfil da amostra. Participaram do estudo, acadêmicos de Enfermagem, Psicologia e Serviço Social. Realizada análise descritiva e quantitativa dos dados. Resultados: Participaram do estudo 449 acadêmicos. Constatou-se que os participantes possuem conhecimento a respeito do processo de doação e transplante de órgãos, porém com lacunas, que reverberam a importância destes futuros profissionais buscarem aprofundar os saberes sobre esta temática. Conclusão:Ressalta-se a importância dos profissionais da área da saúde conhecerem o processo de doação e transplante podendo contribuir com o aumento do número de doações

Objective: Evaluate the knowledge of students of undergraduate courses in Nursing, Psychology and Social Work on the concept of Brain Death and aspects of the donation process and organs and tissues transplantation. Method: Field study, exploratory, descriptive and prospective, quantitative. The research was realize in a Private Higher Education Institution. We used 10 questions about the organ donation process and questions related to the profile of the sample. Participating in the study academics of Nursing, Psychology and Social Work. Descriptive and quantitative data analysis. Results: The study included 449 students. It was verified that the participants have knowledge about the process of donation and organ transplantation, but with gaps, which reverberate the importance of these future professionals to seek to deepen the knowledge on this subject. Conclusion: Emphasizes the importance of health professionals knowing the donation process and organ transplantation because that may contribute to the increased number of donations

Objetivo: Evaluar el conocimiento de estudiantes de las carreras de grado en Enfermería, Psicología y Servicio Social sobre el concepto de muerte encefálica y proceso de donación y trasplante de órganos y tejidos. Métodos: Estudio de campo, exploratorio, descriptivo y prospectivo, cuantitativo. Realizado en Institución de Enseñanza Superior privada. Se utilizó cuestionario con 10 preguntas, sobre el proceso de donación de órganos y preguntas relacionadas al perfil de la muestra. Participaron del estudio, académicos de Enfermería, Psicología y Servicio Social. Resultados: Participaron del estudio 449 académicos. Se constató que los participantes tienen conocimiento acerca de donación y trasplante de órganos, pero con lagunas, que reverberan la importancia de estos futuros profesionales buscar profundizar los saberes sobre esta temática. Conclusión: Se resalta la importancia de que los profesionales de salud conozcan el proceso de donación y trasplante de órganos con vistas a que puedan contribuir al aumento del número de donaciones