RESUMO
Introduction: Respiratory muscles are a limiter of exercise capacity in lung transplant patients. It is necessary to know the effectiveness of specific respiratory muscle training techniques carried out in the management of adult lung transplant patients in the postoperative period. Methodology: A systematic review of clinical trials was carried out, which included adult lung transplant patients undergoing post-transplant respiratory training. A search was carried out in the databases PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library between January 2012 and September 2023, using the terms: "breathing exercise", "respiratory muscle training", "inspiratory muscle training", "respiratory exercise", "pulmonary rehabilitation", "lung rehabilitation"; in combination with "lung transplantation", "lung transplant", "posttransplant lung". No language limit. Results: Eleven trials were included with a total of 639 patients analyzed. Most training programs begin upon hospital discharge (more than one month post-transplant), few do so early (Intensive Care Unit). The duration varies from 1-12 months post-transplant. The interventions were based on aerobic training and peripheral muscle strength. Some of them included breathing exercises and chest expansions. The most used outcome variable was submaximal exercise capacity measured with the 6-minute walk test. Conclusions: Training the respiratory muscles of the adult transplant patient favors the improvement of exercise capacity and quality of life. Aerobic training, as well as strength training of the rest of the peripheral muscles, contribute to the improvement of respiratory muscles.
RESUMO
OBJETIVO: describir el grado de cumplimentación del listado de verific ción de seguridad quirúrgica (LVSQ) en el servicio de quirófano de un hospital comarcal. MÉTODO: estudio descriptivo transversal llevado a cabo en el Hospital Santos Reyes de Aranda de Duero (Burgos) entre mayo de 2015 y mayo de 2016. Se realizó un muestreo aleatorio simple de 750 individuos sometidos a cirugía programada para la revisión de los LVSQ contenidos en sus historias clínicas. Se efectuó un análisis descriptivo con frecuencias absolutas y porcentajes de los ítems del listado categorizados por el momento del procedimiento quirúrgico (antes de la inducción anestésica, antes de la incisión cutánea y antes de la salida de quirófano) y por el profesional responsable de su cumplimentación (enfermera, anestesista y cirujano). RESULTADOS: se estudiaron un total de 604 listados de verificaciónde seguridad quirúrgica. Se observó una mayor cumplimentación del LVSQ en los momentos anteriores a la inducción anestésica y a la incisión cutánea que antes de la salida de quirófano y siempre en aquellos ítems cumplimentados por enfermeras. La cumplimentación de las cuestiones propias de las enfermeras rondó el 88%, fue del 49% en el caso de los ítems propios de los anestesistas y del 46,9% en los asignados a cirujanos. Fue necesario corregir el consentimiento informado en el 4,3% de las intervenciones. CONCLUSIONES: hay diferencias en la cumplimentación del LVSQ en función del momento quirúrgico y del profesional responsable. La formación del personal implicado, así como la implicación de los líderes institucionales, podría jugar un papel para conseguir una mayor adherencia en la cumplimentación
OBJECTIVE: to describe the level of compliance with the Surgical Safety Checklist (SSCL) at the Operating Room in a regional hospital. METHOD: a descriptive cross-sectional study conducted at the Hospital Santos Reyes of Aranda de Duero (Burgos) between May, 2015 and May, 2016. Simple random sampling was conducted on 750 individuals undergoing scheduled surgery, in order to review the SSCLs included in their clinical records. Descriptive analysis was conducted with absolute frequencies and percentages of the list items, classified by time point during the surgical procedure (before anesthetic induction, before skin incision, and before leaving the operating room), and by professional responsible for completion (nurse, anesthetist and surgeon). RESULTS: in total, 604 Surgical Safety Checklists were studied. Higher SSCL compliance was observed a the time point before anesthetic induction and skin incision, than before leaving the operating room, and always in those items completed by nurses. Completion of items by nurses reached about 88%; in the case of anesthetists, it was 49%, and 46.9% in those items assigned to surgeons. It was necessary to correct Informed Consents in 4.3% of interventions. CONCLUSIONS: there are differences in SSCL compliance according to the surgical time and the professional in charge. Training for the staff involved, as well as involvement by institution leaders, could play a role in order to achieve a higher adherence in terms of compliance
