[To go in-depth in the knowledge of the device to control fecal elimination in the critical patient]. / Profundizando en el conocimiento sobre el manejo del dispositivo para control de la eliminación fecal en el paciente crítico.

OBJECTIVE: To describe the general characteristics of the patient and device use. To know retention balloon pressure (RBP) and related factors. To identify rate of leakage incidence, relocation and perineal damage due to the device (PSD) and related risk factors. MATERIAL AND METHODS: An analytical observational, cross-sectional study conducted in a polyvalent ICU from June-December 2010 was performed. The sample included Flexi-Seal(®) carriers. Variables evaluated were patient and device use characteristics, RBP, leakage and quantity, relocation and reason, PSD, sedoanalgesia infusion, neuromuscular block, patient position, Flexi-Seal type catheter, ventilatory mode (VM), intra-abdominal pressure (IAP), mean intrathoracic pressure (MITP), PEEP, Glasgow, color-aspect, fecal consistency and volume. Significance P<.05. RESULTS: Twenty-one patients were included, 52% male, aged 54±17 with 30 insertion episodes, Flexi-Seal-Signal(®) 33%, 10±8 days permanency, main indication 33% «diarrhea and injured skin¼," 30% device removal «intolerance and/or spontaneous expulsion¼. Median (Me) PGR =40; RI (61-19) cmH2O. Factors associated to higher PGR: SCI absence, prone-decubitus position, leakage, relocation, conventional Flexi-Seal(®), MV, lower PEEP and IMP, Color-aspect, higher MITP. Leakage, relocation and PSD incidence density 43, 30 and 2 cases/100 days of catheter, respectively. Leakage and relocation risk factors: higher PGR, Glasgow and fecal volume, lower MITP, MV, assisted-spontaneous mode OR 2.5 CI (1.6-3.8) and OR 1.7(1.1-2.7), absence SCI OR 3.3 (2.2-5.1) and OR 2.4(1.5-3.8), absence neuromuscular block OR 2.4 (1.4-3.9) and OR 1.8 (1.1-3.1), Flexi-Seal(®) conventional OR 2.7(1.7-4.1) and OR 2 (1.2-3.3), respectively. Leakage risk factors: color-aspect, supine position, lower IMP and PEEP. CONCLUSIONS: Monitoring RBP may alert us about leakage presence and relocation need. Knowing associated risk factors to RBP, leakage and relocation would help to develop strategies to reduce their high incidence rate such as decreasing RBP by reducing inflated volume.

[Taking over a patient with preclinical laryngeal tube]. / Übernahme eines Patienten mit Larynxtubus aus der Präklinik.

Endotracheal intubation (ETI) is the most effective method for securing the airway. However, the practice and theory of ETI differ considerably. There is a wide gap between reality and the optimum of quality and quantity required by many specialist organizations, e.g., the European Resuscitation Council. Alternative airway devices, such as a laryngeal tube, can be useful provided the hospital staff know how the device functions and how to avoid or control complications.

Ébola / No disponible

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Acompañamiento a la familia del paciente crítico / Support to families of critically ill patients

Introducción. La hospitalización de la persona enferma genera en la familia ansiedad, estrés, etc. Los familiares, en esta situación, no tienen herramientas para afrontar la realidad y desatienden sus necesidades. Objetivo. Identificar la correlación entre las necesidades de la familia y las intervenciones enfermeras. Metodología. Se realizó una revisión bibliográfica en las bases de datos Pubmed, CINAHL, Cuidatge, Cuiden y ScienceDirect. Después de incluir los artículos que cumplían los criterios de selección, se seleccionaron 18 artículos. Resultados y discusión. En los artículos escogidos se analizaron las necesidades que genera la hospitalización de un familiar en la UCI, las actuaciones, intervenciones y propuestas de mejora que se proponen para satisfacer las necesidades y las limitaciones y reticencias que se producen en la práctica. Conclusiones. A pesar de que en la literatura se identifican las necesidades de la familia, los problemas que se plantean y las soluciones que se proponen, las enfermeras no integran estas necesidades en sus intervenciones (AU)

Introduction. The hospitalization of the sick person in the family creates anxiety, stress, etc... The families in this situation have no tools to face reality and ignore their needs. Objective. To identify the relationship between family needs and nursing interventions. Methods. We conducted a literature review in the databases Pub- Med, CINAHL, Cuidatge, Cuiden and ScienceDirect. After including items that meet the selection criteria were selected 18 items Results and discussion. In selected items were analyzed the necessities generated by the hospitalization of a family member in the ICU, performances, interventions and proposals for improvement that are proposed to meet the needs and constraints and reluctance that occur in practice. Conclusions. Although the literature identifies the needs of the family, the problems encountered and solutions proposed, the nurses do not integrate these needs into their operations (AU)