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OBJECTIVES: to verify the relationship of cardiovascular diseases with acute kidney injury and assess the prognosis of patients in renal replacement therapy. METHODS: a cohort study, carried out in a public hospital specialized in cardiology. Treatment, comorbidities, duration of treatment, laboratory tests, discharge and deaths were analyzed. RESULTS: of the 101 patients, 75 (74.3%) received non-dialysis treatment. The most frequent cardiological diagnoses were hypertension, cardiomyopathies and coronary syndrome. Hospitalization in patients undergoing dialysis was 18 days, hemoglobin <10.5g/dl and anuria in the first days of hospitalization contributed to the type of treatment. Each increase in hemoglobin units from the first day of hospitalization decreases the chance of dialysis by 19.2%. There was no difference in mortality. CONCLUSIONS: the main cardiological diseases were not predictive of dialysis indication, and clinical treatment was the most frequent. Anuria and anemia were predictors for dialysis treatment.
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Injúria Renal Aguda , Anuria , Cardiopatias , Injúria Renal Aguda/complicações , Injúria Renal Aguda/terapia , Estudos de Coortes , Hemoglobinas/análise , Humanos , Prognóstico , Diálise Renal/efeitos adversosRESUMO
ABSTRACT Objectives: to verify the relationship of cardiovascular diseases with acute kidney injury and assess the prognosis of patients in renal replacement therapy. Methods: a cohort study, carried out in a public hospital specialized in cardiology. Treatment, comorbidities, duration of treatment, laboratory tests, discharge and deaths were analyzed. Results: of the 101 patients, 75 (74.3%) received non-dialysis treatment. The most frequent cardiological diagnoses were hypertension, cardiomyopathies and coronary syndrome. Hospitalization in patients undergoing dialysis was 18 days, hemoglobin <10.5g/dl and anuria in the first days of hospitalization contributed to the type of treatment. Each increase in hemoglobin units from the first day of hospitalization decreases the chance of dialysis by 19.2%. There was no difference in mortality. Conclusions: the main cardiological diseases were not predictive of dialysis indication, and clinical treatment was the most frequent. Anuria and anemia were predictors for dialysis treatment.
RESUMEN Objetivos: verificar la relación de las patologías cardíacas con la insuficiencia renal aguda y evaluar el pronóstico del paciente en terapia de reemplazo renal. Métodos: estudio de cohorte, realizado en un hospital público especializado en cardiología. Se analizó el tratamiento, las comorbilidades, la duración del tratamiento, los exámenes de laboratorio, el alta y las muertes. Resultados: de los 101 pacientes, 75 (74,3%) recibieron tratamiento no dialítico. Los diagnósticos cardiológicos más frecuentes fueron hipertensión arterial, miocardiopatías y síndrome coronario. La hospitalización en pacientes en diálisis fue de 18 días, la hemoglobina <10,5 g/dl y la anuria en los primeros días de hospitalización contribuyeron al tipo de tratamiento. Cada aumento de unidades de hemoglobina desde el primer día de hospitalización disminuye la posibilidad de diálisis en un 19,2%. No hubo diferencia en la mortalidad. Conclusiones: las principales enfermedades cardiológicas no fueron predictoras de indicación de diálisis, siendo el tratamiento clínico el más frecuente. La anuria y la anemia fueron predictores para el tratamiento de diálisis.
RESUMO Objetivos: verificar a relação de patologias cardíacas com injuria renal aguda e avaliar o prognóstico do paciente em terapia de substituição renal. Métodos: estudo de coorte, realizado em hospital público especializado em cardiologia. O tratamento, comorbidades, tempo de tratamento, exames laboratoriais, alta e óbitos foram analisados. Resultados: dos 101 pacientes, 75 (74,3%) receberam tratamento não dialítico. Os diagnósticos cardiológicos mais frequentes foram hipertensão arterial, miocardiopatias e síndrome coronariana. A internação nos pacientes dialíticos foi de 18 dias, a hemoglobina <10,5g/dl e a anuria nos primeiros dias de internação contribuíram para o tipo de tratamento. Cada aumento de unidade de hemoglobina a partir do primeiro dia de internação diminui em 19,2% a chance de diálise. Não houve diferença na mortalidade. Conclusões: as principais doenças cardiológicas não foram preditivas de indicação de diálise, e o tratamento clínico foi o mais frequente. Anuria e anemia foram preditores para o tratamento dialítico.
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OBJECTIVE: The objective of this study was to evaluate the incidence of nosocomial infection and the impact of cross-transmission of SARS-CoV-2 among inpatients at a tertiary care teaching hospital. METHODS: This was a retrospective cohort study involving inpatients admitted to a tertiary university hospital in the city of São Paulo, Brazil, between March 2020 and February 2021. Cases were identified on the basis of a positive reverse-transcription polymerase chain reaction result for SARS-CoV-2 and the review of electronic medical records. Nosocomial transmission was defined by applying the criteria established by the Brazilian National Health Regulatory Agency. RESULTS: We identified 2146 cases of SARS-CoV-2 infection, 185 (8.6%) of which were considered cases of nosocomial transmission. The mean age was 58.3 years. The incidence density was 1.78 cases per 1,000 patient-days on the general wards, being highest on the cardiac surgery ward, and only 0.16 per 1,000 patient-days on the COVID-19 wards. Of the 185 patients evaluated, 115 (62.2%) were men, 150 (81.1%) cases had at least one comorbidity, and 104 (56.2%) evolved to death. CONCLUSIONS: Despite the preventive measures taken, nosocomial transmission of SARS-CoV-2 occurred throughout our hospital. Such measures should be intensified when the incidence of community transmission peaks.
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COVID-19 , Infecção Hospitalar , Brasil/epidemiologia , Infecção Hospitalar/epidemiologia , Hospitais Universitários , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2RESUMO
OBJECTIVES: to assess the prevalence of colonization and infection by multidrug-resistant bacteria in patients undergoing kidney transplantation and identify the rate of infection, morbidity and mortality and associated risk factors. METHODS: a prospective cohort of 200 randomly included kidney transplant recipients. Epidemiological surveillance of the studied microorganisms was carried out in the first 24 hours and 7 days after transplantation. RESULTS: ninety (45%) patients were considered colonized. Female sex, hypertension and diabetes (p<0.005), dialysis time (p<0.004), length of stay after transplantation, delayed renal function, and length of stay were identified as risk factors. The microorganisms were isolated from surgical site, bloodstream and urinary tract infections. CONCLUSIONS: colonization by resistant microorganisms in kidney transplant patients was frequent and risk factors associated with infection were identified. The results should guide the care team in order to minimize morbidity and mortality related to infectious causes in this population.
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Transplante de Rim , Infecções Urinárias , Feminino , Humanos , Estudos Prospectivos , Diálise Renal , Fatores de RiscoRESUMO
BACKGROUND: Data on short-term peripheral intravenous catheter-related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied. METHODS: International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used. RESULTS: In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635-2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975-1.6351; P = .040).The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%. CONCLUSIONS: Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.
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Infecção Hospitalar , Sepse , Argentina , Brasil , Catéteres , Colômbia , Costa Rica , Infecção Hospitalar/epidemiologia , República Dominicana/epidemiologia , Equador/epidemiologia , Humanos , Unidades de Terapia Intensiva , América Latina/epidemiologia , México , Panamá , Estudos Prospectivos , VenezuelaRESUMO
ABSTRACT Objectives: to assess the prevalence of colonization and infection by multidrug-resistant bacteria in patients undergoing kidney transplantation and identify the rate of infection, morbidity and mortality and associated risk factors. Methods: a prospective cohort of 200 randomly included kidney transplant recipients. Epidemiological surveillance of the studied microorganisms was carried out in the first 24 hours and 7 days after transplantation. Results: ninety (45%) patients were considered colonized. Female sex, hypertension and diabetes (p<0.005), dialysis time (p<0.004), length of stay after transplantation, delayed renal function, and length of stay were identified as risk factors. The microorganisms were isolated from surgical site, bloodstream and urinary tract infections. Conclusions: colonization by resistant microorganisms in kidney transplant patients was frequent and risk factors associated with infection were identified. The results should guide the care team in order to minimize morbidity and mortality related to infectious causes in this population.
RESUMEN Objetivos: evaluar la prevalencia de colonización e infección por bacterias multirresistentes en pacientes sometidos a trasplante renal, identificar la tasa de infección, morbimortalidad y factores de riesgo asociados. Métodos: cohorte prospectiva de 200 receptores de trasplante renal incluidos aleatoriamente. La vigilancia epidemiológica de los microorganismos estudiados se realizó en las primeras 24 horas y 7 días posteriores al trasplante. Resultados: noventa (45%) pacientes fueron considerados colonizados. Se identificaron como factores de riesgo: sexo femenino, hipertensión y diabetes (p<0,005), tiempo en diálisis (p<0,004), tiempo de estancia después del trasplante, función renal retrasada, tiempo de estancia. Los microorganismos se aislaron de infecciones del sitio quirúrgico, del torrente sanguíneo y del tracto urinario. Conclusiones: la colonización por microorganismos resistentes en pacientes con trasplante renal fue frecuente y se identificaron factores de riesgo asociados a infección. Los resultados deben orientar al equipo asistencial para minimizar la morbimortalidad relacionada con causas infecciosas en esta población.
RESUMO Objetivos: avaliar a prevalência de colonização e infecção por bactéria multirresistente em pacientes em transplante renal, identificar a taxa de infecção, morbimortalidade e os fatores de risco associados. Métodos: coorte prospectivo de 200 transplantados renais incluídos aleatoriamente. Realizou-se vigilância epidemiológica dos microrganismos em estudo nas primeiras 24 horas e 7 dias pós-transplante. Resultados: noventa (45%) pacientes foram considerados colonizados. Identificaram-se como fatores de risco: sexo feminino, hipertensão arterial e diabetes (p<0,005), tempo de diálise (p<0,004), tempo de internação pós-transplante, função renal retardada, tempo de internação. Os microrganismos foram isolados das infecções em sítio cirúrgico, corrente sanguínea e trato urinário. Conclusões: a colonização por microrganismos resistentes nos pacientes transplantados renais foi frequente e os fatores de riscos associados à infecção foram identificados. Os resultados devem direcionar a equipe assistencial, a fim de minimizar a morbimortalidade relacionada às causas infecciosas nesta população.
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OBJECTIVE: compare the quality of life (QOL) of aged residents in homes for aged people with or without symptoms of depression, and identify social, physical activity; leisure; health and basic activities of daily living (ADL) variables that correlate with QOL scores. METHOD: cross-sectional study conducted with 101 institutionalized aged. Multiple linear regression was used for data analysis. RESULTS: symptoms of depression changed negatively the QOL in the domains: autonomy; present, past and future activities; social participation; intimacy and total score. Dependent aged presented lower QOL for the performance of ADL in the domains: autonomy; social participation and total score; dancing without limitation of movement; liking the residential and not presenting symptoms of depression were the variables that positively influenced the QOL of the aged. CONCLUSION: social and psychological support, good living conditions and stimulating assistance can improve the QOL of institutionalized elderlies.
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Depressão/complicações , Institucionalização/normas , Qualidade de Vida/psicologia , Atividades Cotidianas , Idoso , Brasil , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Institucionalização/métodos , Institucionalização/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
ABSTRACT Objective: to analyze clinical, serological, biochemical and hematological aspects in patients infected with the hepatitis B (HBV) and Delta (HDV) viruses. Method: cross-sectional, descriptive and retrospective study, performed with patients chronically infected with HBV and superinfected with HDV. Results: among the 112 patients selected, 74% were monoinfected with HBV (Group HBV) and 26% were superinfected with HDV (Group HBV+HDV). There was no difference in gender distribution. The average age was 36 years with standard deviation of ±12 years. The symptoms and signs presented a higher proportion in Group HBV+HDV (p=0.001). In both groups, most patients had non-reactive AgHBe. The records of biochemical and hematologic changes showed highest proportion in Group VHB+VHD Group (p<0.05). Conclusion: the study found that patients were in clinical stages of the disease different from those in the initial examination for monitoring their chronic condition. The clinical profile suggests greater severity of liver disease among the patients superinfected with HDV.
RESUMEN Objetivo: Analizar los aspectos clínicos, serológicos, bioquímicos y hematológicos de pacientes infectados por el virus de las hepatitis B (VHB) y Delta (VHD). Método: Se trata de un estudio transversal, descriptivo, retrospectivo, realizado entre pacientes crónicos infectados de VHB y sobre infectados de VHD. Resultados: Entre los 112 pacientes seleccionados, el 74% estaba mono infectado por VHB (Grupo VHB) y el 26%, sobre infectado por VHD (Grupo VHB+VHD). No se encontró diferencia en la distribución por género. La edad promedio era 36 años, con desviación típica de ±12 años. Los síntomas y signos sobresalían en mayor proporción en el grupo VHB+VHD (p=0,001). Para ambos grupos, la mayoría de los pacientes estaba con AgHBe no reactivo. El registro de alteraciones bioquímicas y hematológicas atribuyó proporción más grande al grupo VHB+VHD (p<0,05). Conclusión: El estudio demostró que los pacientes, en la consulta inicial para el seguimiento de la condición crónica, estaban en diferentes estadios clínicos de la enfermedad. El perfil clínico sugiere que la gravedad de la enfermedad hepática es mayor entre pacientes sobre infectados de VHD.
RESUMO Objetivo: Analisar aspectos clínicos, sorológicos, bioquímicos e hematológicos entre pacientes infectados por vírus das hepatites B (VHB) e Delta (VHD). Método: Estudo transversal, descritivo, retrospectivo, realizado com pacientes cronicamente infectados por VHB e superinfectados por VHD. Resultados: Entre os 112 pacientes selecionados, 74% estavam monoinfectados por VHB (Grupo VHB) e 26% superinfectados por VHD (Grupo VHB+VHD). Não houve diferença na distribuição por gênero. A idade média foi de 36 anos, com desvio padrão de ±12 anos. Os sintomas e sinais apresentaram maior proporção no grupo VHB+VHD (p=0,001). Para ambos os grupos, a maioria dos pacientes estava com AgHBe não reagente. O registro de alterações bioquímicas e hematológicas apresentou maior proporção no grupo VHB+VHD (p<0,05). Conclusão: O estudo revelou que os pacientes estavam em diferentes estágios clínicos da doença na consulta inicial para acompanhamento de condição crônica. O perfil clínico sugere maior gravidade da doença hepática entre os pacientes superinfectados por VHD.
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Humanos , Masculino , Feminino , Adulto , Hepatite D/classificação , Hepatite B/classificação , Hepatite D/epidemiologia , Brasil/epidemiologia , Vírus Delta da Hepatite/classificação , Vírus da Hepatite B/classificação , Estudos Transversais , Estudos Retrospectivos , Hepatite B/epidemiologia , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: to analyze clinical, serological, biochemical and hematological aspects in patients infected with the hepatitis B (HBV) and Delta (HDV) viruses. METHOD: cross-sectional, descriptive and retrospective study, performed with patients chronically infected with HBV and superinfected with HDV. RESULTS: among the 112 patients selected, 74% were monoinfected with HBV (Group HBV) and 26% were superinfected with HDV (Group HBV+HDV). There was no difference in gender distribution. The average age was 36 years with standard deviation of ±12 years. The symptoms and signs presented a higher proportion in Group HBV+HDV (p=0.001). In both groups, most patients had non-reactive AgHBe. The records of biochemical and hematologic changes showed highest proportion in Group VHB+VHD Group (p<0.05). CONCLUSION: the study found that patients were in clinical stages of the disease different from those in the initial examination for monitoring their chronic condition. The clinical profile suggests greater severity of liver disease among the patients superinfected with HDV.
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Hepatite B/classificação , Hepatite D/classificação , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Hepatite B/epidemiologia , Vírus da Hepatite B/classificação , Hepatite D/epidemiologia , Vírus Delta da Hepatite/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
OBJECTIVE: To evaluate the risk factors related to Klebsiella pneumoniae carbapenemase infection after renal transplantation. METHODS: This was a retrospective epidemiological (case-control) study, conducted from October 2011 to march 2016. Transplanted patients with infection by this bacteria during hospitalization were selected as cases. The controls were paired by age, sex, type of donor and transplant time. The proportion of cases and controls was 1:2. RESULTS: Thirty hundred and five patients were included in the study (45 cases and 90 controls). The risk factors found for infection by KPC were: time of hospitalization after the transplant (OR: 4.82; CI95% 2.46-9.44), delayed kidney function (OR: 5.60; CI95% 1.91-11.01) and previous infectious for another microorganism ( OR: 34.13 CI95% 3.52-132.00). CONCLUSION: The risk of acquisition of this bacterium was directly related to invasive procedures and exposure to the hospital environment. The findings reinforce the importance of prevention measures and control of infection by this microorganism.
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Proteínas de Bactérias/efeitos adversos , Transplante de Rim/efeitos adversos , Infecções por Klebsiella/etiologia , Pneumonia/etiologia , beta-Lactamases/efeitos adversos , Adulto , Proteínas de Bactérias/metabolismo , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Transplante de Rim/métodos , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/metabolismo , Klebsiella pneumoniae/metabolismo , Klebsiella pneumoniae/patogenicidade , Masculino , Pessoa de Meia-Idade , Pneumonia/induzido quimicamente , Pneumonia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , beta-Lactamases/metabolismoRESUMO
ABSTRACT Objective: To evaluate the risk factors related to Klebsiella pneumoniae carbapenemase infection after renal transplantation. Methods: This was a retrospective epidemiological (case-control) study, conducted from October 2011 to march 2016. Transplanted patients with infection by this bacteria during hospitalization were selected as cases. The controls were paired by age, sex, type of donor and transplant time. The proportion of cases and controls was 1:2. Results: Thirty hundred and five patients were included in the study (45 cases and 90 controls). The risk factors found for infection by KPC were: time of hospitalization after the transplant (OR: 4.82; CI95% 2.46-9.44), delayed kidney function (OR: 5.60; CI95% 1.91-11.01) and previous infectious for another microorganism ( OR: 34.13 CI95% 3.52-132.00). Conclusion: The risk of acquisition of this bacterium was directly related to invasive procedures and exposure to the hospital environment. The findings reinforce the importance of prevention measures and control of infection by this microorganism.
RESUMEN Objetivo: Evaluar los factores de riesgo relacionados con la infección por Klebsiella pneumoniae carbapenemasa después del trasplante renal. Método: Estudio retrospectivo epidemiológico (caso-control), realizado de octubre de 2011 a marzo de 2016. Pacientes transplantados con infección por esa bacteria durante la internación fueron seleccionados como casos. Los controles se parearon por edad, sexo, tipo de donante y tiempo de trasplante. La proporción de casos y controles fue de 1: 2. Resultados: Treinta y cinco pacientes fueron incluidos en el estudio (45 casos y 90 controles). Los factores de riesgo para la infección encontrados por KPC fueron: tiempo de hospitalización después del trasplante (OR: 4,82, IC95% 2,46-9,44), función renal retardada (OR: 5,60, IC95% 1, 91-11,01) y anterior infecciosa para otro microorganismo (OR: 34,13 IC95% 3,52-132,00). Conclusión: El riesgo de adquisición de esta bacteria estuvo directamente relacionado a procedimientos invasivos y exposición al ambiente hospitalario. Los hallazgos refuerzan la importancia de medidas de prevención y control de la infección por ese microorganismo.
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Humanos , Masculino , Feminino , Adulto , Pneumonia/etnologia , Proteínas de Bactérias/efeitos adversos , beta-Lactamases/efeitos adversos , Infecções por Klebsiella/etiologia , Transplante de Rim/efeitos adversos , Pneumonia/induzido quimicamente , Pneumonia/epidemiologia , Proteínas de Bactérias/metabolismo , beta-Lactamases/metabolismo , Brasil/epidemiologia , Infecções por Klebsiella/metabolismo , Infecções por Klebsiella/epidemiologia , Estudos de Casos e Controles , Estudos Retrospectivos , Fatores de Risco , Transplante de Rim/métodos , Klebsiella pneumoniae/metabolismo , Klebsiella pneumoniae/patogenicidade , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: to identify studies about strategies for prevention of ventilator-associated pneumonia deployed in health services and classify their level of evidence. METHOD: integrative review of the literature, in 7 databases, which included the following descriptors: Prevention and Control AND Pneumonia Ventilator-Associated AND Intensive Care Units AND Bundle AND Patient Care. RESULTS: twenty-three scientific productions were included. Of the preventive measures identified, 9 (39.1%) correspond from three to five strategies. The most frequent were: 22 (95.6%) lying with head elevated, 19 (82.6%) oral hygiene with chlorhexidine and 14 (60.8%) reduction of sedation whenever possible. FINAL CONSIDERATION: the application of measures based on scientific evidence is proven to be effective when carried out in conjunction, impacting the reduction of the incidence of ventilator-associated pneumonia.
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Pneumonia Associada à Ventilação Mecânica/enfermagem , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/normas , Higiene Bucal/normasRESUMO
ABSTRACT Objective: to identify studies about strategies for prevention of ventilator-associated pneumonia deployed in health services and classify their level of evidence. Method: integrative review of the literature, in 7 databases, which included the following descriptors: Prevention and Control AND Pneumonia Ventilator-Associated AND Intensive Care Units AND Bundle AND Patient Care. Results: twenty-three scientific productions were included. Of the preventive measures identified, 9 (39.1%) correspond from three to five strategies. The most frequent were: 22 (95.6%) lying with head elevated, 19 (82.6%) oral hygiene with chlorhexidine and 14 (60.8%) reduction of sedation whenever possible. Final Consideration: the application of measures based on scientific evidence is proven to be effective when carried out in conjunction, impacting the reduction of the incidence of ventilator-associated pneumonia.
RESUMEN Objetivo: identificar estudios sobre estrategias de prevención de neumonía asociadas a la ventilación mecánica implantadas en servicios de salud y clasificar el nivel de evidencia de los mismos. Método: revisión integrativa de la literatura, en 7 bases de datos, que incluyó los siguientes descriptores: Prevention and Control AND Pneumonia Ventilator-Associated AND Intensive Care Units AND Bundle AND Patient Care. Resultados: Se incluyeron 23 producciones científicas. Entre los conjuntos de medidas de prevención identificados, 9 (39,1%) contemplan entre tres a cinco estrategias. Fueron las más frecuentes: el decúbito elevado, 22 (95,6%); la higiene oral con clorhexidina, 19 (82,6%); y la reducción de la sedación siempre que sea posible, 14 (60,8%). Consideraciones Finales: La aplicación de medidas basadas en evidencias científicas es comprobadamente eficaz cuando se aplica en conjunto, impactando en la reducción de la densidad de incidencia de neumonía asociada a la ventilación mecánica.
RESUMO Objetivo: identificar estudos acerca de estratégias de prevenção de pneumonia associada à ventilação mecânica implantadas em serviços de saúde e classificar o nível de evidência destes. Método: revisão integrativa da literatura, em sete bases de dados, incluindo os seguintes descritores: "Prevention and Control AND Pneumonia Ventilator-Associated AND Intensive Care Units AND Bundle AND Patient Care". Resultados: foram incluídas 23 produções científicas. Dentre os conjuntos de medidas de prevenção identificados, nove (39,1%) contemplam de três a cinco estratégias. As mais frequentes foram: decúbito elevado - 22 (95,6%); higiene oral com clorexidina - 19 (82,6%); e redução da sedação sempre que possível - 14 (60,8%). Considerações Finais: a aplicação de medidas baseadas em evidências científicas são comprovadamente eficazes quando aplicadas em conjunto, impactando na redução da densidade de incidência de pneumonia associada à ventilação mecânica.
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Humanos , Pneumonia Associada à Ventilação Mecânica/enfermagem , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Higiene Bucal/normas , Unidades de Terapia Intensiva/normas , Unidades de Terapia Intensiva/organização & administraçãoRESUMO
Resumo Objetivo: Avaliar a adesão dos profissionais de saúde a um conjunto de boas práticas de prevenção de Pneumonia Associada à Ventilação Mecânica, índice de conformidade às medidas individuais e associação de características clínicas dos pacientes e adesão ao conjunto de boas práticas com a pneumonia. Métodos: Estudo de coorte prospectivo realizado em uma Unidade de Terapia Intensiva de um hospital universitário no período de maio de 2017 a outubro de 2017. A amostra foi composta por pacientes internados no período do estudo, que preencheram os critérios de inclusão, a coleta de dados foi realizada por meio de consulta a prontuários. Resultados: O item com maior adesão foi a avaliação diária da sedação e redução sempre que possível, 81 (91,0%), seguido da troca do circuito a cada 7 dias, 76 (82,6). A manutenção da pressão do cuff entre 20 e 30 mm H2O foi o item com menor adesão 22 (23,9%). A adesão ao conjunto completo apresentou conformidade em 20 (21,7%) das oportunidades. O estudo mostrou que quanto maior a adesão às medidas de boas práticas, menor é o risco de Pneumonia Associada à Ventilação Mecânica, porém não foi um dado estatisticamente significante. Os pacientes cirúrgicos e em uso de ventilação mecânica apresentaram maior risco de desenvolver PAV (p= 0,05). Conclusão: A Pneumonia Associada à Ventilação Mecânica pode trazer grave repercussão para o paciente, a aplicação de medidas com embasamento científico é fundamental, a fim de se prevenir a ocorrência deste agravo, que é uma das mais frequentes infecções relacionadas à assistência à saúde dentro das Unidades de Terapia Intensiva brasileiras.
Resumen Objetivo: Evaluar la adhesión de los profesionales de salud a un conjunto de buenas prácticas de prevención de Neumonía Asociada a la Ventilación Mecánica, índice de conformidad con las medidas individuales y asociación de características clínicas de los pacientes y adhesión al conjunto de buenas prácticas con la neumonía. Métodos: Estudio de cohorte prospectivo realizado en una Unidad de Terapia Intensiva de un hospital universitario durante el periodo de mayo de 2017 a octubre de 2017. La muestra ha sido formada por pacientes ingresados durante el periodo del estudio y que cumplieron los criterios de inclusión. La recolección de datos fue hecha a través de consulta a archivos. Resultados: El ítem de mayor adhesión fue la evaluación diaria de la sedación y reducción siempre que posible, 81 (91,0%), seguido del cambio del circuito cada 7 días, 76 (82,6). El mantenimiento de la presión del cuff entre 20 y 30 mm H2O fue el ítem con menor adhesión 22 (23,9%). La adhesión al conjunto completo presentó conformidad en 20 (21,7%) de las oportunidades. El estudio mostró que cuanto mayor la adhesión a las medidas de buenas prácticas, menor el riesgo de Neumonía Asociada a la Ventilación Mecánica; sin embargo no es un dato estadísticamente significante. Los pacientes quirúrgicos y en uso de ventilación mecánica presentaron mayor riesgo de desarrollar PAV (p= 0,05). Conclusión: Neumonía Asociada a la Ventilación Mecánica puede traer una grave repercusión al paciente. La aplicación de medidas con embasamiento científico es fundamental para evitar la ocurrencia de este agravio, que es una de las más frecuentes infecciones relacionadas con la asistencia a la salud dentro de las Unidades de Terapia Intensiva brasileñas.
Abstract Objective: To evaluate the compliance of health professionals with a set of good practices for the prevention of Ventilator-Associated Pneumonia, compliance index to individual measures and association of clinical characteristics of patients and compliance with the set of good practices with pneumonia. Methods: A prospective cohort study conducted at an Intensive Care Unit of a university hospital from May 2017 to October 2017. The sample consisted of patients hospitalized during the study period, who met the inclusion criteria. Data collection was performed through review of medical records. Results: The item with the highest compliance was the daily assessment of sedation and reduction 81 (91.0%) whenever possible, followed by circuit changes every 7 days, 76 (82.6%). The maintenance of cuff pressure between 20- and 30-mm H2O was the item with the lowest compliance 22 (23.9%). Compliance with the complete set showed adherence in 20 (21.7%) of opportunities. This study showed that the greater compliance with good practice measures, the lower the risk of Ventilator-Associated Pneumonia, but it was not statistically significant data. Surgical and mechanical ventilation patients had a higher risk of developing VAP (p=0.05). Conclusion: Ventilator-Associated Pneumonia can cause serious repercussions for patients. Thus, the application of measures with scientific basis is fundamental to prevent the occurrence of this event, which is one of the most frequent infections related to health care within Brazilian Intensive Care Units.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Pneumonia/etiologia , Respiração Artificial/efeitos adversos , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Unidades de Terapia Intensiva , Estudos Prospectivos , Estudos de CoortesRESUMO
ABSTRACT Objective: compare the quality of life (QOL) of aged residents in homes for aged people with or without symptoms of depression, and identify social, physical activity; leisure; health and basic activities of daily living (ADL) variables that correlate with QOL scores. Method: cross-sectional study conducted with 101 institutionalized aged. Multiple linear regression was used for data analysis. Results: symptoms of depression changed negatively the QOL in the domains: autonomy; present, past and future activities; social participation; intimacy and total score. Dependent aged presented lower QOL for the performance of ADL in the domains: autonomy; social participation and total score; dancing without limitation of movement; liking the residential and not presenting symptoms of depression were the variables that positively influenced the QOL of the aged. Conclusion: social and psychological support, good living conditions and stimulating assistance can improve the QOL of institutionalized elderlies.
RESUMEN Objetivo: comparar la calidad de vida (CV) de los ancianos residentes en instituciones de larga permanencia con o sin síntomas de depresión, e identificar variables sociales, de actividad física, de ocio, de salud y de actividades básicas de la vida diaria (ABVD) que se correlacionan con las puntuaciones de CV. Método: estudio transversal realizado con 101 ancianos institucionalizados. Para el análisis de los datos se utilizó la regresión lineal múltiple. Resultados: los síntomas de depresión cambiaron negativamente la CV en los dominios: autonomía; actividades presentes, pasadas y futuras; participación social; intimidad y puntuación total. Los ancianos dependientes para la realización de la ABVD tuvieron menor CV en los dominios: autonomía, participación social y puntuación total; bailar sin limitación de movimiento, gustar de lo hogar, y no mostrar síntomas de depresión, fueron las variables que influenciaron de forma positiva en la CV de los ancianos. Conclusión: el apoyo social y psicológico, unas buenas condiciones de vida y una asistencia estimulante pueden mejorar la calidad de vida de los ancianos institucionalizados.
RESUMO Objetivo: comparar a qualidade de vida (QV) de idosos residentes em instituições de longa permanência com ou sem sinais de depressão, e identificar variáveis sociais, de atividade física, lazer, saúde e atividades básicas da vida diária (ABVD) que se correlacionam aos escores de QV. Método: estudo transversal realizado com 101 idosos institucionalizados. A regressão linear múltipla foi usada para a análise dos dados. Resultados: sinais de depressão alteraram negativamente a QV nos domínios: autonomia, atividades presentes, passadas e futuras, participação social, intimidade e escore total; idosos dependentes para a realização das ABVD apresentaram QV inferior nos domínios: autonomia, participação social e escore total; dançar sem limitação de movimento, gostar do residencial e não apresentar sinais de depressão foram as variáveis que influenciaram positivamente a QV dos idosos. Conclusão: suporte social e psicológico, boas condições de moradia e assistência estimuladora podem melhorar a QV de idosos institucionalizados.
Assuntos
Humanos , Masculino , Feminino , Idoso , Qualidade de Vida/psicologia , Depressão/complicações , Institucionalização/normas , Brasil , Atividades Cotidianas , Estudos Transversais , Inquéritos e Questionários , Depressão/psicologia , Institucionalização/métodos , Institucionalização/estatística & dados numéricos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To identify in the literature studies that evaluate the quality of life in pediatric patients with kidney transplant through use of specific, validated instruments in Pediatrics. METHOD: Systematic review of the literature with searches conducted in the following databases: Medline, PubMed, LILACS, CINAHL, SciELO and Cochrane Library. Main keywords: Quality of life, Kidney transplantation and Pediatrics. RESULTS: A total of 366 studies were selected and eight observational studies were included that evaluated the quality of life of children with kidney transplant by means of evaluation instruments of quality of life. CONCLUSION: The quality of life of children with kidney transplant is inferior compared to healthy children. The post-transplant period presents better results compared to pre-transplant children. The identification of mental, physical and social conditions related to the quality of life of this population allows for better planning the assistance provided to them.
Assuntos
Transplante de Rim/efeitos adversos , Pediatria/normas , Qualidade de Vida/psicologia , Adolescente , Criança , Pré-Escolar , Humanos , Transplante de Rim/psicologia , Pediatria/métodosRESUMO
OBJETIVO: investigar o consumo de álcool entre universitários de enfermagem e avaliar intervenção breve para abusadores de álcool. MÉTODO: estudo longitudinal, experimental. Dados coletados por questionário autoaplicável e três instrumentos. Análise estatística descritiva e utilização de testes específicos. RESULTADOS: participaram 36 universitários e as drogas mais utilizadas foram: álcool (vodka, cerveja), tabaco e maconha. Idade do primeiro uso de álcool: 15 anos; repercussões após uso: quedas, cefaleia, vômitos e amnésia; e os motivos para consumo: social, sensação e prazer. Intervenção breve diminuiu significativamente o consumo de risco entre os abusadores. Entre os bebedores de baixo risco, metade referiu estar preparada para diminuir o consumo. CONCLUSÃO: intervenção breve diminui significativamente o padrão de consumo de álcool, promovendo a saúde.
OBJECTIVE: to investigate the alcohol consumption among nursing college students and evaluate a brief intervention for abusers of alcoholic beverages. METHOD: longitudinal, experimental study. Data obtained through a self-applicable questionnaire and three instruments. Descriptive statistical analysis and use of specific tests. RESULTS: 36 college students participated in this study. The most used drugs were: alcohol (vodka, beer), tobacco and marijuana. Age of first contact with alcoholic beverages: 15 years; repercussions after use: falls, headache, vomiting and amnesia; and the reasons for consumption: socialization, sensation and pleasure. The brief intervention significantly decreased the risk of consumption among those who abused alcoholic beverages. Among low-risk alcohol consumers, half of them said they were ready to reduce consumption. CONCLUSION: the short intervention significantly decreased the pattern of alcohol consumption thus promoting the health of the students.
OBJETIVO: investigar el consumo de alcohol entre universitarios de enfermería y evaluar la intervención breve para los abusadores de alcohol. MÉTODO: estudio longitudinal, experimental. Los datos recolectados por cuestionario autoaplicable y tres instrumentos. Análisis estadístico descriptivo y uso de pruebas específicas. RESULTADOS: participaron 36 universitarios, las drogas más utilizadas fueron alcohol (vodka, cerveza), seguido de tabaco y marihuana. La edad del primer uso de alcohol 15 años, repercusiones después del uso fueron caídas, cefalea, vómitos y amnesia y los motivos para el consumo: social, sensación y placer. La intervención breve disminuyó significativamente el consumo de riesgo entre los abusadores y entre los bebedores de bajo riesgo, la mitad, dijo estar dispuesta a disminuir el consumo. CONCLUSIÓN: intervención breve disminuye significativamente el patrón de consumo de alcohol promoviendo la salud.
Assuntos
Humanos , Masculino , Feminino , Serviços de Saúde Escolar , Estudantes , Saúde do Estudante , Consumo de Álcool na FaculdadeRESUMO
OBJECTIVE: To evaluate nursing university students' alcohol consumption patterns, Brief Intervention and Quality of Life (QoL). METHOD: This is a prospective and longitudinal study containing sociodemographic, economic information concerning alcoholic beverages, BI and QoL evaluation among 281 nursing university students. Since surveys have been applied, seminars have been given and consumption patterns have been discussed, an educational material was delivered after university students' revaluation and BI reinforcement. Descriptive and analytical statistics have been conducted. RESULTS: 90% of the students have already consumed alcohol and 20.6% that consumed for the first time and abused alcohol were minors. After the implementation of BI, the alcohol consumption has decreased among university students. Besides the vitality, generate state of health, and emotional aspects have decreased, mental health was substantially low among the students that used to drink. CONCLUSION: BI contributes to decrease alcoholic beverages consumption and promotes health.