RESUMEN
BACKGROUND: Novel devices based on the emission of near-infrared electromagnetic radiation (NIR) have been developed to minimize venous puncture failures. These instruments produce an "augmented reality" image, in which subcutaneous veins are depicted on a LCD display. We compared the new technique with standard venipuncture in a population of elderly patients. METHODS: Patients admitted in Intensive Care Unit were randomized to standard or to NIR assisted procedure. RESULTS: In the 103 enrolled patients (age 74 ± 12 years; standard venipuncture-N = 56; NIR-N = 47), no differences were found in procedure length, number of attempts, and referred pain. With NIR there was a lower incidence of hematomas and fewer anxiety and depressive symptoms. CONCLUSIONS: The use of the novel NIR-based device is safer and more psychologically tolerable, and it is not associated to an increase of procedure length or number of attempts.
Asunto(s)
Flebotomía , Anciano , Ansiedad/etiología , Ansiedad/prevención & control , Investigación sobre la Eficacia Comparativa , Enfermedad Crítica/psicología , Enfermedad Crítica/terapia , Diseño de Equipo , Seguridad de Equipos , Femenino , Hematoma/etiología , Hematoma/prevención & control , Humanos , Rayos Infrarrojos/uso terapéutico , Unidades de Cuidados Intensivos , Masculino , Ensayo de Materiales , Flebotomía/efectos adversos , Flebotomía/instrumentación , Flebotomía/métodos , Flebotomía/psicología , Proyectos PilotoRESUMEN
BACKGROUND AND AIMS: Atrial fibrillation (AF) is the most common arrhythmia in elderly people, yet oral anticoagulation is underused in the aged. We tried to determine whether new oral anticoagulants (NOA) have greater psychological tolerability than warfarin. METHODS: Age-, gender-matched groups of AF patients receiving NOA (N = 15) or warfarin (N = 15) were assessed with the Anti-Clot Treatment Scale (ACTS) and the Perceived Stress Scale (PSS). RESULTS: Patients were old (81 ± 9 years). NOA group showed greater psychological satisfaction, with lower therapy-related burden (ACTS burdens: 16.3 ± 4.5 vs. 32.9 ± 10.2, p < 0.001) and higher awareness of benefits (ACTS benefits: 13.0 ± 1.3 vs. 10.8 ± 1.9, p = 0.001). Even stress was lower (PSS: 13.1 ± 4.0 vs. 17.1 ± 4.2, p = 0.013). The multivariate analysis confirmed these findings, showing that higher levels of anxiety and depression could justify more stress in warfarin patients. CONCLUSIONS: The results of this preliminary study show that NOA have an improved psychological impact compared with warfarin in elderly patients.