Endotracheal suction in intubated critically ill adult patients undergoing mechanical ventilation: a systematic review.

AIM: identify and analyze in the literature the evidence of randomized controlled trials on care related to the suctioning of endotracheal secretions in intubated, critically ill adult patients undergoing mechanical ventilation. METHOD: the search was conducted in the PubMed, EMBASE, CENTRAL, CINAHL and LILACS databases. From the 631 citations found, 17 studies were selected. RESULTS: Evidence was identified for six categories of intervention related to endotracheal suctioning, which were analyzed according to outcomes related to hemodynamic and blood gas alterations, microbial colonization, nosocomial infection, and others. CONCLUSIONS: although the evidence obtained is relevant to the practice of endotracheal aspiration, the risks of bias found in the studies selected compromise the evidence's reliability.

Endotracheal suction in intubated critically ill adult patients undergoing mechanical ventilation: a systematic review / Aspiração endotraqueal em pacientes adultos com via aérea artificial: revisão sistemática / Aspiración endotraqueal en pacientes adultos con veía aérea artificial: revisión sistemática

AIM: identify and analyze in the literature the evidence of randomized controlled trials on care related to the suctioning of endotracheal secretions in intubated, critically ill adult patients undergoing mechanical ventilation. METHOD: the search was conducted in the PubMed, EMBASE, CENTRAL, CINAHL and LILACS databases. From the 631 citations found, 17 studies were selected. RESULTS: Evidence was identified for six categories of intervention related to endotracheal suctioning, which were analyzed according to outcomes related to hemodynamic and blood gas alterations, microbial colonization, nosocomial infection, and others. CONCLUSIONS: although the evidence obtained is relevant to the practice of endotracheal aspiration, the risks of bias found in the studies selected compromise the evidence's reliability.

OBJETIVO: identificar e analisar evidências oriundas de ensaios clínicos controlados e randomizados sobre os cuidados relacionados à aspiração de secreções endotraqueais em pacientes adultos, em estado crítico, intubados e sob ventilação mecânica. MÉTODO: a busca foi realizada nas bases de dados Pubmed, Embase, Central, Cinahl e Lilacs. Das 631 referências encontradas, 17 estudos foram selecionados. RESULTADOS: identificaram-se evidências quanto a seis categorias de intervenções relacionadas à aspiração endotraqueal, as quais foram analisadas segundo desfechos referentes a alterações hemodinâmicas e dos gases sanguíneos, colonização microbiana, infecção nosocomial, dentre outros. RESULTADOS: as evidências obtidas são relevantes para a prática da aspiração endotraqueal, entretanto, os riscos de viés dos estudos selecionados comprometem a sua confiabilidade.

OBJETIVO: identificar y analizar evidencias oriundas de ensayos clínicos controlados y hechos aleatorios sobre las atenciones relacionados a la aspiración de secreciones endotraqueales en pacientes adultos, en estado crítico, intubados y bajo ventilación mecánica. MÉTODO: la busca fue realizada en las bases de datos PUBMED, EMBASE, CENTRAL, CINAHL y LILACS. De las 631 referencias encontradas, 17 estudios fueron seleccionados. RESULTADOS: se identificaron evidencias en cuanto a seis categorías de intervenciones relacionadas a la aspiración endotraqueal, las cuales fueron analizadas según los resultados referentes a alteraciones hemodinámicas y de los gases sanguíneos, colonización microbiana, infección nosocomial, entre otros. RESULTADOS: las evidencias logradas son relevantes para la práctica de la aspiración endotraqueal, mientras, los riesgos de bies de los estudios seleccionados comprometen su confiabilidad.

[Patients' perception regarding the use of a long-term catheter]. / A percepção o do paciente referente a ser portador de um cateter de longa permanência.

This study aimed to evaluate patients' perception regarding their use of a Totally Implanted Catheter (TIC). This descriptive study uses the Critical Incident Technique (CI) for data analysis. The study was performed at a Teaching Hospital in São Paulo State, Brazil. Study participants were 15 patients using TIC. Data were grouped into four categories: Activity Performance (40% of the CI showed that patients were more independent, while 60% revealed that some kind of activity was restricted due to the TIC); Altered Body Image (57% showed the patients' dissatisfaction after the TIC implant, 14% of the CI revealed pre-implant problems, 28% of the CI showed that the TIC favored body esthetics); Catheter Implantation (75% of the CI revealed catheter implantation as a traumatizing procedure, while 25% of the CI revealed patients remained calm and confident during the procedure); Chemotherapy Infusion (100% of the CI showed that the catheter made chemotherapy easier).

Relations between nursing data collection, diagnoses and prescriptions for adult patients at an intensive care unit.

This descriptive, retrospective study aimed to analyze the relation between nursing data collection, diagnoses and prescriptions for 26 adult patients who were hospitalized at the intense care unit of a large teaching hospital for at least 24 hours. Through the analysis of medical records, 135 diagnoses and 421 nursing prescriptions were established, and 24 different diagnosis categories and 20 different items for prescriptions were identified. The most frequent diagnosis risk was that for infection, present in the medical records of 22 (84.60%) patients, with 175 prescriptions (42%) related to this diagnosis. The data the nurses collected were sufficient to establish the nursing diagnoses, and the majority of prescriptions (87.9%) were related to the diagnoses.

A percepção do paciente referente a ser portador de um cateter de longa permanência / Patients' perception regarding the use of a long-term catheter / La percepción del paciente respecto a ser portador de un catéter de permanencia prolongada

Este trabalho buscou avaliar a percepção do paciente portador de Cateter Totalmente Implantado (CTI). Trata-se de um estudo descritivo, que utiliza a Técnica dos Incidentes Críticos (IC) para análise dos dados. Foi desenvolvido em um Hospital Escola do interior paulista do qual participaram 15 portadores de CTI. Os dados foram agrupados em quatro categorias: Desempenho de Atividades (40 por cento dos IC demonstraram maior independência do paciente e 60 por cento evidenciaram restrição de algum tipo de atividade devido ao CTI); Alteração da Imagem Corporal (57 por cento evidenciaram insatisfação do paciente pós-implante do CTI, 14 por cento dos IC mostraram problemas pré-implante do CTI e 28 por cento dos IC mostraram que o CTI favoreceu a estética corporal); Implantação do Cateter (75 por cento dos IC mostraram a implantação do cateter como um procedimento traumatizante e 25 por cento dos IC permaneceram tranqüilos e seguros durante o procedimento); Infusão de Quimioterapia (100 por cento dos IC apontaram o cateter como um facilitador do tratamento quimioterápico).

This study aimed to evaluate patients' perception regarding their use of a Totally Implanted Catheter (TIC). This descriptive study uses the Critical Incident Technique (CI) for data analysis. The study was performed at a Teaching Hospital in São Paulo State, Brazil. Study participants were 15 patients using TIC. Data were grouped into four categories: Activity Performance (40 percent of the CI showed that patients were more independent, while 60 percent revealed that some kind of activity was restricted due to the TIC); Altered Body Image (57 percent showed the patients' dissatisfaction after the TIC implant, 14 percent of the CI revealed pre-implant problems, 28 percent of the CI showed that the TIC favored body esthetics); Catheter Implantation (75 percent of the CI revealed catheter implantation as a traumatizing procedure, while 25 percent of the CI revealed patients remained calm and confident during the procedure); Chemotherapy Infusion (100 percent of the CI showed that the catheter made chemotherapy easier).

La finalidad del trabajo fue evaluar la percepción del paciente portador de un Catéter Totalmente Implantado (CTI). Se trata de un estudio descriptivo, que utiliza para el análisis de los datos la Técnica de los Incidentes Críticos (IC). Fue desarrollado en un Hospital Escuela del interior de Sao Paulo-Brasil, del cual participaron 15 portadores de CTI. Los datos fueron agrupados en 4 categorías: Desempeño de Actividades (el 40 por ciento de los IC demostraron mayor independencia del paciente, mientras que el 60 por ciento evidenció restricción de algún tipo de actividad debido al CTI); Alteración de la Imagen Corporal (el 57 por ciento evidenciaron insatisfacción post implante del CTI, el 14 por ciento mostró problemas pre-implante del CTI y el 28 por ciento de los IC mostró que el CTI favoreció la estética corporal); Implantación del Catéter (el 75 por ciento de los IC mostraron que la implantación del catéter es un procedimiento traumatizante, mientras que el 25 por ciento de los IC mostró que el paciente siguió tranquilo y seguro durante el procedimiento); Infusión de Quimioterapia (100 por ciento de los IC evidenció el catéter como un facilitador del tratamiento quimioterápico).

Relations between nursing data collection, diagnoses and prescriptions for adult patients at an intensive care unit / Relaciones entre la recolección de datos, diagnósticos y prescripciones de enfermería a pacientes adultos en una unidad de terapia intensiva / Relações entre a coleta de dados, diagnósticos e prescrições de enfermagem a pacientes adultos de uma unidade de terapia intensiva

This descriptive, retrospective study aimed to analyze the relation between nursing data collection, diagnoses and prescriptions for 26 adult patients who were hospitalized at the intense care unit of a large teaching hospital for at least 24 hours. Through the analysis of medical records, 135 diagnoses and 421 nursing prescriptions were established, and 24 different diagnosis categories and 20 different items for prescriptions were identified. The most frequent diagnosis risk was that for infection, present in the medical records of 22 (84.60 percent) patients, with 175 prescriptions (42 percent) related to this diagnosis. The data the nurses collected were sufficient to establish the nursing diagnoses, and the majority of prescriptions (87.9 percent) were related to the diagnoses.

La finalidad de este estudio descriptivo y retrospectivo fue analizar la relación entre la recolección de datos, diagnósticos y prescripciones de enfermería para 26 pacientes adultos que estuvieron hospitalizados en una unidad de terapia intensiva en un hospital de enseñanza de gran porte, con permanencia mínima de 24 horas. Mediante el análisis de los archivos se establecieron 135 diagnósticos y 421 prescripciones de enfermería, siendo identificados 24 categorías de diagnóstico y 20 diferentes ítems de prescripción. El diagnóstico de riesgo para la infección fue el más frecuente, que estuvo presente en el registro de 22 (84,60 por ciento) pacientes. De las prescripciones, 175 (42 por ciento) se refirieron a este diagnóstico. Se observa que los datos registrados por los enfermeros en la recolección de datos fueron suficientes para establecer los diagnósticos de enfermería y que la mayoría de las prescripciones (87,9 por ciento) estuvieron relacionadas con los diagnósticos.

Trabalho descritivo, retrospectivo, que teve como objetivo analisar a relação entre a coleta de dados, diagnósticos e prescrições de enfermagem estabelecidas por enfermeiros para 26 pacientes adultos que estiveram internados numa unidade de terapia intensiva de um hospital de ensino de grande porte, com permanência mínima de 24 horas. Por meio da análise dos prontuários, foram estabelecidos 135 diagnósticos e 421 prescrições de enfermagem, sendo identificadas 24 diferentes categorias diagnósticas e 20 diferentes itens para prescrição. O diagnóstico de risco para infecção foi o de maior freqüência, presente no prontuário de 22 (84,60 por cento) pacientes. Das prescrições, 175 (42 por cento) relacionaram-se a esse diagnóstico. Observa-se que os dados registrados pelos enfermeiros na coleta de dados foram suficientes para o estabelecimento dos diagnósticos de enfermagem e a maioria das prescrições (87,9 por cento) apresentou relação com os diagnósticos.

A pilot study of a relaxation technique for management of nausea and vomiting in patients receiving cancer chemotherapy.

This study was designed to determine the effect of a progressive muscle relaxation intervention on nausea and vomiting associated with anticancer chemotherapy. Subjects were 30 hematology patients who were hospitalized and received chemotherapy treatment at a large hospital in the interior of São Paulo, Brazil. The results indicated that progressive muscle relaxation lead to statistically significant changes in physiological and muscle conditions and in nausea and vomiting levels. Therefore, this relaxation technique may be an effective nursing intervention method to allay or alleviate nausea and vomiting in patients receiving chemotherapy. For future studies, we suggest using a control group, a homogeneous sample in terms of antiemetic and chemotherapy type and dosage, and the longitudinal following of subjects during chemotherapy.