RESUMO
Sepsis and acute kidney injury (AKI) are two major public health concerns that contribute significantly to illness and death worldwide. Early diagnosis and prompt treatment are essential for achieving the best possible outcomes. To date, there are no specific clinical, imaging, or biochemical indicators available to diagnose sepsis, and diagnosis of AKI based on the KDIGO criterion has limitations. To improve the diagnostic process for sepsis and AKI, it is essential to continually evolve our understanding of these conditions. Delays in diagnosis and appropriate treatment can have serious consequences. Sepsis and AKI often occur together, and patients with kidney dysfunction are more prone to developing sepsis. Therefore, identifying potential biomarkers for both conditions is crucial. In this review, we talk about the main biomarkers that evolve the diagnostic of sepsis and AKI, namely neutrophil gelatinase-associated lipocalin (NGAL), proenkephalin (PENK), and cell-free DNA.
RESUMO
Objetivou-se identificar o custo total meÌdio (CTM) da instalaçaÌo e desligamento de hemodiaÌlise em pacientes portadores de cateter venoso central. Trata-se de pesquisa quantitativa, exploratoÌria e descritiva na modalidade estudo de caso uÌnico, realizada em um hospital universitaÌrio puÌblico. A amostra, naÌo probabiliÌstica, correspondeu aÌ observaçaÌo de cem instalaçoÌes e cem desligamentos de hemodiaÌlises em 42 pacientes, durante 23 dias de coleta. Obteve-se o CTM multiplicando-se o tempo despendido por profissionais de enfermagem pelo custo unitaÌrio da maÌo de obra direta, somando-se ao custo dos materiais, soluçoÌes e medicamentos. Para a realizaçaÌo dos caÌlculos, utilizou-se a moeda brasileira (R$). O CTM da instalaçaÌo foi de R$ 80,10; e do desligamento, de R$ 13,04, totalizando R$ 93,14 por sessaÌo de hemodiaÌlise. Os resultados obtidos favoreceraÌo um melhor planejamento da alocaçaÌo de recursos humanos, materiais e financeiros, assim, propiciando o incremento de estrateÌgias gerenciais visando aÌ eficieÌncia econoÌmica.
The objective was to identify the average total cost (ATC) for installing and turning off hemodialysis on patients with central venous catheters. This quantitative, exploratory, and descriptive research, in the mode of a single-case study, was conducted in a public university hospital. The non-probabilistic sample corresponded to the observation of 100 installations and 100 terminations of hemodialysis on 42 patients during 23 days of collection. The ATC was calculated by multiplying the time spent by nurses by the unit cost of direct labor, and adding the cost of materials, solutions, and medications. The Brazilian currency (R$) was used for the calculations. The ATC for installation was R$ 80.10 and for shutting off was R$ 13.04, totaling R$ 93.14 per hemodialysis session. The results obtained will facilitate a better planning of the allocation of human, material, and financial resources enabling the increase of managerial strategies aimed at economic efficiency.
Se objetivoÌ identificar el costo medio total (CMT) de la instalacioÌn y desconexioÌn de hemodiaÌlisis en pacientes portadores de cateÌter venoso central. InvestigacioÌn cuantitativa, exploratoria, descriptiva, modalidad estudio de caso uÌnico, realizada en hospital universitario puÌblico. Muestra no probabiliÌstica correspondiente a la observacioÌn de 100 instalaciones y 100 desconexiones de hemodiaÌlisis en 42 pacientes durante 23 diÌas de recoleccioÌn. Se obtuvo el CMT multiplicando el tiempo empleado por profesionales por el costo unitario de mano de obra directa, sumaÌndosele el costo de materiales, soluciones y medicamentos. Para la realizacioÌn de los caÌlculos, se utilizoÌ moneda brasilenÌa (R$). El CMT de la instalacioÌn fue de R$80,10, y el de la desconexioÌn, R$13,04; totalizando R$93,14 por sesioÌn de hemodiaÌlisis. Los resultados obtenidos favoreceraÌn una mejor planificacioÌn de la utilizacioÌn de recursos humanos, materiales y financieros, haciendo propicio el incremento de estrategias gerenciales apuntadas a la eficiencia econoÌmica.