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[PMID]:29243898
[Au] Autor:Saarinen J
[Ti] Título:Invasive treatment of superficial veins of the lower extremities.
[So] Source:Duodecim;133(11):1069-75, 2017.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Modern invasive treatment of superficial venous insufficiency of the lower extremities is largely based on the use of intravenous procedures under ultrasound guidance. The first-line treatment is thermoablation, in which the insufficient superficial vein, typically vena saphena magna or parva, is constricted by using laser or radio frequency energy under ultrasound guidance. The procedure is nearly always successful under local anesthesia and can be performed as an outpatient operation. When necessary, visible collateral varices can be treated with foam sclerotherapy or by surgical excision. The need for associated medication or longer follow-up is limited and recovery is fast. The patients can be mobilized immediately, and only a couple of days of sick leave are usually required.
[Mh] Termos MeSH primário: Perna (Membro)/irrigação sanguínea
Insuficiência Venosa/cirurgia
[Mh] Termos MeSH secundário: Técnicas de Ablação
Deambulação Precoce
Seres Humanos
Fluxo Sanguíneo Regional
Escleroterapia
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:29188977
[Au] Autor:Savikko J; Kössi J; Scheinin T
[Ti] Título:Optimized recovery programs in gastrointestinal surgery.
[So] Source:Duodecim;132(19):1805-9, 2016.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Optimized or enhanced recovery programs have been applied to intestinal surgery already for a long time. They are being widely initiated also within bariatric, hepatic and pancreatic surgery. The programs aim at an increasingly better well-being of surgical patients by avoiding procedures which slow down the recovery and favoring those that promote it. Informing the patient is also an essential part of the programs. Effective pain management avoiding opioids, early started oral nutrition, and mobilization immediately after the operation prevent postoperative decreased intestinal motility and nausea. At best, the programs will guarantee the patients' excellent recovery and shorten the length of stay on the ward.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Digestório
Cuidados Pós-Operatórios/métodos
Complicações Pós-Operatórias/prevenção & controle
[Mh] Termos MeSH secundário: Analgésicos/uso terapêutico
Deambulação Precoce
Nutrição Enteral
Seres Humanos
Manejo da Dor/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:28743548
[Au] Autor:Johnson K; Petti J; Olson A; Custer T
[Ad] Endereço:Honor Health Thompson Peak Medical Center, 7400 E. Thompson Peak Parkway, Scottsdale, AZ, 85255, United States. Electronic address: Kari.Johnson@honorhealth.com.
[Ti] Título:Identifying barriers to early mobilisation among mechanically ventilated patients in a trauma intensive care unit.
[So] Source:Intensive Crit Care Nurs;42:51-54, 2017 Oct.
[Is] ISSN:1532-4036
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Mechanically ventilated patients can be at risk for functional decline (Cameron et al., 2015). Early mobilisation of mechanically ventilated patients can improve outcomes after critical illness to prevent this decline. Although registered nurses understand the importance of early mobilisation there are nurses who are unwilling to mobilise patients. AIM: The aim of this study is to examine whether nurses' attitudes and beliefs are barriers for early mobilisation and evaluate whether an education intervention can improve early mobilisation. METHOD: Pre-test, post-test intervention with registered nurses and charge nurses in a 22 bed trauma intensive care setting. PROCEDURE: Pre-test, post-test survey assessed perceived barriers in knowledge, attitudes, and behaviours followed by targeted education. RESULTS: Dependent Sample T-test revealed a statistically significant increase in post-test responses for the subscales knowledge, attitudes, and behaviours with early mobilisation. This over-all increase in post-test results support that understanding barriers can improve patient outcomes. CONCLUSION: Use of structured surveys to identify barriers for early mobilisation among nursing can assist in providing targeted education that address nurse's perception. The education intervention appeared to have a positive impact on attitudes but it is unknown if the difference was sustained over time or affected participants practice or patient outcomes.
[Mh] Termos MeSH primário: Deambulação Precoce/enfermagem
Enfermeiras e Enfermeiros/psicologia
Percepção
Respiração Artificial/enfermagem
[Mh] Termos MeSH secundário: Adulto
Arizona
Atitude do Pessoal de Saúde
Enfermagem de Cuidados Críticos/recursos humanos
Enfermagem de Cuidados Críticos/normas
Feminino
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Unidades de Terapia Intensiva/tendências
Masculino
Meia-Idade
Enfermeiras e Enfermeiros/normas
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE


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[PMID]:28457689
[Au] Autor:Brissie MA; Zomorodi M; Soares-Sardinha S; Jordan JD
[Ad] Endereço:Acute Care Nurse Practitioner, UNC Health Care, Neuroscience Intensive Care Unit, Department of Neurology, 170 Manning Drive, Campus Box 7025, Chapel Hill, NC 27599-7025, United States. Electronic address: Megan.Brissie@unchealth.unc.edu.
[Ti] Título:Development of a neuro early mobilisation protocol for use in a neuroscience intensive care unit.
[So] Source:Intensive Crit Care Nurs;42:30-35, 2017 Oct.
[Is] ISSN:1532-4036
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Through evaluation of the literature and working with a team of multidisciplinary healthcare providers, our objective was to refine an interprofessional Neuro Early Mobilisation Protocol for complex patients in the Neuroscience Intensive Care Unit. RESEARCH METHODOLOGY: Using the literature as a guide, key stakeholders, from multiple professions, designed and refined a Neuro Early Mobilisation Protocol. SETTING: This project took place at a large academic medical center in the southeast United States classified as both a Level I Trauma Center and Comprehensive Stroke Center. MAIN OUTCOME MEASURES: Goals for protocol development were to: (1) simplify the protocol to allow for ease of use, (2) make the protocol more generalizable to the patient population cared for in the Neuroscience Intensive Care Unit, (3) receive feedback from those using the original protocol on ways to improve the protocol and (4) ensure patients were properly screened for inclusion and exclusion in the protocol. RESULTS: Using expert feedback and the evidence, an evidence-based Neuro Early Mobilisation Protocol was created for use with all patients in the Neuroscience Intensive Care Unit. CONCLUSION: Future work will consist of protocol implementation and evaluation in order to increase patient mobilisation in the Neuroscience Intensive Care Unit.
[Mh] Termos MeSH primário: Deambulação Precoce/métodos
Guias como Assunto/normas
Enfermeiras e Enfermeiros/psicologia
Desenvolvimento de Programas/métodos
[Mh] Termos MeSH secundário: Lista de Checagem/instrumentação
Enfermagem de Cuidados Críticos/tendências
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Doenças do Sistema Nervoso/enfermagem
Sudeste dos Estados Unidos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28958318
[Au] Autor:Oliveira RA; Guatura GMGBDS; Peniche ACG; Costa ALS; Poveda VB
[Ti] Título:An Integrative Review of Postoperative Accelerated Recovery Protocols.
[So] Source:AORN J;106(4):324-330.e5, 2017 Oct.
[Is] ISSN:1878-0369
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We undertook an integrative literature review of articles pertaining to perioperative nursing care provided to patients using postoperative accelerated recovery protocols. To select the articles, we searched the MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature, and LiteraturaLatino-Americana e do Caribe em Ciências da Saúde databases. We identified 329 studies, 13 of which met our inclusion criteria and described perioperative nursing care activities. Nursing activities noted in these articles were hypothermia prevention and maintenance of normothermia, restriction of IV fluids, assessment of vital signs, management of symptoms and pain, support of early ambulation, care for tubes and drains, oral administration of carbohydrate-rich foods, assessment of ability to tolerate diet, and encouragement to resume activities of daily living. There was a lack of research on this topic by nursing professionals; additional research by nursing professionals is needed regarding nurses' roles in providing this care.
[Mh] Termos MeSH primário: Enfermagem Perioperatória
Cuidados Pós-Operatórios
Recuperação de Função Fisiológica
[Mh] Termos MeSH secundário: Atividades Cotidianas
Deambulação Precoce
Seres Humanos
Hipotermia/enfermagem
Hipotermia/prevenção & controle
Dor Pós-Operatória/enfermagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170930
[St] Status:MEDLINE


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[PMID]:28863011
[Au] Autor:Marhong JD; DeBacker J; Viau-Lapointe J; Munshi L; Del Sorbo L; Burry L; Fan E; Mehta S
[Ad] Endereço:1Cleveland Clinic Medical Center, Cleveland, OH. 2Department of Medicine and Interdepartmental Division of Critical Care Medicine, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada. 3Department of Medicine and Interdepartmental Division of Critical Care Medicine, University Health Network and University of Toronto, Toronto, ON, Canada. 4Department of Pharmacy and Medicine, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada.
[Ti] Título:Sedation and Mobilization During Venovenous Extracorporeal Membrane Oxygenation for Acute Respiratory Failure: An International Survey.
[So] Source:Crit Care Med;45(11):1893-1899, 2017 Nov.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To characterize sedation, analgesia, delirium, and mobilization practices in patients supported with venovenous extracorporeal membrane oxygenation for severe acute respiratory failure. DESIGN: Cross-sectional electronic survey administered January 2016 to March 2016. SETTING: Three-hundred ninety-four extracorporeal membrane oxygenation centers registered with the Extracorporeal Life Support Organization. SUBJECTS: Extracorporeal membrane oxygenation medical directors and program coordinators. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed responses from 209 respondents (53%), mostly from academic centers (63%); 41% respondents provide venovenous extracorporeal membrane oxygenation to adults exclusively. Following venovenous extracorporeal membrane oxygenation initiation, 97% respondents administer sedative/analgesic infusions, and the sedation target was "sedated" or "very sedated" for 59%, "calm and cooperative" for 25%, and "unarousable" for 16%. Use of daily sedation interruption and a sedation/analgesia protocol was reported by 51% and 39%, respectively. Midazolam (48%) and propofol (19%) were reported as the most frequently used sedatives; fentanyl (44%) and morphine (20%) the most frequent opioids. Use of a delirium scale was reported by 55% respondents. Physical therapy was reported by 84% respondents, with 41% initiating it within 72 hours after cannulation. Mobilization goals varied from range of motion exercises (81%) to ambulation (22%). The most frequently perceived barriers to mobilization were hemodynamic instability, hypoxemia, and dependency on venovenous extracorporeal membrane oxygenation support. CONCLUSIONS: The majority of respondents reported targeting moderate to deep sedation following cannulation, with the use of sedative and opioid infusions. There is considerable variability surrounding early physical therapy and mobilization goals for patients with acute respiratory failure supported by venovenous extracorporeal membrane oxygenation.
[Mh] Termos MeSH primário: Analgesia/métodos
Anestesia/métodos
Oxigenação por Membrana Extracorpórea/métodos
Síndrome do Desconforto Respiratório do Adulto/terapia
[Mh] Termos MeSH secundário: Analgesia/efeitos adversos
Anestesia/efeitos adversos
Estudos Transversais
Delírio/induzido quimicamente
Deambulação Precoce/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Amplitude de Movimento Articular
Síndrome do Desconforto Respiratório do Adulto/reabilitação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002702


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[PMID]:28860401
[Au] Autor:Fawi HMT; Saba K; Cunningham A; Masud S; Lewis M; Hossain M; Chopra I; Ahuja S
[Ad] Endereço:Welsh Centre for Spinal Trauma and Surgery, Cardiff and Vale LHB, Cardiff CF14 4XW, UK.
[Ti] Título:Venous thromboembolism in adult elective spinal surgery: a tertiary centre review of 2181 patients.
[So] Source:Bone Joint J;99-B(9):1204-1209, 2017 Sep.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To evaluate the incidence of primary venous thromboembolism (VTE), epidural haematoma, surgical site infection (SSI), and 90-day mortality after elective spinal surgery, and the effect of two protocols for prophylaxis. PATIENTS AND METHODS: A total of 2181 adults underwent 2366 elective spinal procedures between January 2007 and January 2012. All patients wore anti-embolic stockings, mobilised early and were kept adequately hydrated. In addition, 29% (689) of these were given low molecular weight heparin (LMWH) while in hospital. SSI surveillance was undertaken using the Centers for Disease Control and Prevention criteria. RESULTS: In patients who only received mechanical prophylaxis, the incidence of VTE was 0.59% and that of SSI 2.1%. In patients who were additionally given LMWH, the incidence of VTE was 0% and that of SSI 0.7%. The unadjusted p-value was 0.04 for VTE and 0.01 for SSI. There were no cases of epidural haematoma or 90-day mortality in either group. When adjusted for case-mix, LMWH remained a significant factor (p = 0.006) for VTE, but not for SSI. CONCLUSION: A peri-operative protocol involving mechanical anti-embolism stockings, adequate hydration, and early post-operative mobilisation is effective in significantly reducing the incidence of VTE. The addition of LMWH is safe in patients at higher risk of developing VTE. Cite this article: 2017;99-B:1204-9.
[Mh] Termos MeSH primário: Doenças da Coluna Vertebral/cirurgia
Tromboembolia Venosa/etiologia
Tromboembolia Venosa/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Deambulação Precoce
Procedimentos Cirúrgicos Eletivos
Feminino
Hidratação
Hematoma/epidemiologia
Hematoma/etiologia
Hematoma/prevenção & controle
Heparina de Baixo Peso Molecular/uso terapêutico
Mortalidade Hospitalar
Seres Humanos
Incidência
Masculino
Meia-Idade
Fatores de Risco
Meias de Compressão
Infecção da Ferida Cirúrgica/epidemiologia
Infecção da Ferida Cirúrgica/etiologia
Infecção da Ferida Cirúrgica/prevenção & controle
Atenção Terciária à Saúde
Tromboembolia Venosa/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Heparin, Low-Molecular-Weight)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B9.BJJ-2016-1193.R2


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[PMID]:28838589
[Au] Autor:Moradian ST; Najafloo M; Mahmoudi H; Ghiasi MS
[Ad] Endereço:Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
[Ti] Título:Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: A randomized clinical trial.
[So] Source:J Vasc Nurs;35(3):141-145, 2017 Sep.
[Is] ISSN:1532-6578
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Atelectasis and pleural effusion are common after coronary artery bypass graft surgery (CABG). Longer stay in the bed is one of the most important contributing factors in pulmonary complications. Some studies confirm the benefits of early mobilization (EM) in critically ill patients, but the efficacy of EM on pulmonary complications after CABG is not clear. This study was designed to examine the effect of EM on the incidence of atelectasis and pleural effusion in patients undergoing CABG. In a single-blinded randomized clinical trial, 100 patients who were undergoing coronary artery bypass graft surgery were randomly assigned into two groups each consisted of 50 patients. Patients in the experimental group were enrolled in a mobilization protocol consisting of the mobilization from the bed in the first 3 days after surgery in the morning and evening. Patients in the control group were mobilized from bed in third postoperation day, according to the hospital routine. Arterial blood gases, pleural effusion, and atelectasis were compared between groups. Atelectasis and pleural effusion was reduced in experimental group. The partial pressure of oxygen in arterial blood in third postoperative day and the percentage of arterial oxygen saturation in the fourth postoperative day were higher in the intervention group (P value < .05). EM from bed could be an effective intervention in reducing atelectasis and pleural effusion in patients undergoing CABG.
[Mh] Termos MeSH primário: Ponte de Artéria Coronária/efeitos adversos
Deambulação Precoce
Derrame Pleural/etiologia
Complicações Pós-Operatórias
Atelectasia Pulmonar/etiologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Derrame Pleural/epidemiologia
Período Pós-Operatório
Atelectasia Pulmonar/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170826
[St] Status:MEDLINE


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[PMID]:28787293
[Au] Autor:Morandi A; Piva S; Ely EW; Myatra SN; Salluh JIF; Amare D; Azoulay E; Bellelli G; Csomos A; Fan E; Fagoni N; Girard TD; Heras La Calle G; Inoue S; Lim CM; Kaps R; Kotfis K; Koh Y; Misango D; Pandharipande PP; Permpikul C; Cheng Tan C; Wang DX; Sharshar T; Shehabi Y; Skrobik Y; Singh JM; Slooter A; Smith M; Tsuruta R; Latronico N
[Ad] Endereço:1Department of Rehabilitation, Ancelle Hospital, Cremona, Italy. 2Geriatric Research Group, Brescia, Italy. 3Department of Anesthesia, Critical Care and Emergency, SpedaliCivili University Hospital, Brescia, Italy. 4Division of Pulmonary and Critical Care and Health Services Research, Vanderbilt University and VA Geriatric Research Education Clinical Center (GRECC), Nashville, TN. 5Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai, India. 6Department of Critical Care, D'or Institute for Research and Education and Post-Graduate Program Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 7Addis Hiwot General Hospital, Addis Ababa, Ethiopia. 8Medical Intensive Care Unit, Hôpital Saint-Louis, ECSTRA team, Biostatistics and clinical epidemiology, UMR 1153 (Center of Epidemiology and Biostatistics Sorbonne Paris Cité, CRESS), INSERM, Paris Diderot Sorbonne University, Paris, France. 9School of Medicine and Surgery, University of Milano-Bicocca, Milano Geriatric Clinic, San Gerardo University Hospital, Monza, Italy. 10Department of Anaesthesia and Intensive Care, Medical Centre, Hungarian Defence Force, Budapest, Hungary. 11Interdepartmental Division of Critical Care Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 12University Health Network, Toronto, ON, Canada. 13CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh and UPMC Health System, Pittsburgh, PA. 14International Research Project Humanizing Intensive Care (Proyecto HU-CI), Intensive Care Unit, Hospital Universitario de Torrejón, Madrid. Spain. 15Department of Emergency and Critical Care Medicine, Tokai University, School of Medicine, Kanagawa, Japan. 16Department of Pulmonary and Critical Care Medicine Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 17General Hospital Novo mesto, Novo mesto, Slovenia. 18Department of Anaesthesia, Intensive Care and Acute Poisioning, Pomeranian Medical University, Szczecin, Poland. 19Aga Khan University Hospital, Nairobi, Kenya. 20Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine Vanderbilt University Medical Center, Nashville, TN. 21Siriraj Hospital, Bangkok, Thailand. 22Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China. 23Department of Intensive Care Medicine Raymond Poincaré Hospital, Paris, France. 24School of Clinical Sciences, Faculty of Medicine, Monash University & Medical Center, Melbourne, VIC, Australia. 25University New South Wales, Clinical School of Medicine, NSW, Australia. 26Department of Medicine, McGill University, Montreal, QC, Canada. 27Regroupement de Soins Critiques Respiratoires, Réseau de Santé Respiratoire FRQS, Montreal, QC, Canada. 28Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. 29Krembil Neuroscience Centre, University Health Network, Toronto, ON, Canada. 30Department of Intensive Care Medicine, Brain Center Rudolf Magnus, Utrecht University, University Medical Center Utrecht, The Netherlands. 31Department of Neurocritical Care, University College London Hospitals, UCLH/UCL National Institute for Health Research Biomedical Research Centre, London, United Kingdom. 32Acute & General Medicine, Yamaguchi Graduate School of Medicine, Yamaguchi, Japan. 33Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. 34Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy.
[Ti] Título:Worldwide Survey of the "Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment" (ABCDEF) Bundle.
[So] Source:Crit Care Med;45(11):e1111-e1122, 2017 Nov.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To assess the knowledge and use of the Assessment, prevention, and management of pain; spontaneous awakening and breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise; and Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines. DESIGN: Worldwide online survey. SETTING: Intensive care. INTERVENTION: A cross-sectional online survey using the Delphi method was administered to intensivists worldwide, to assess the knowledge and use of all aspects of the ABCDEF bundle. MEASUREMENT AND MAIN RESULTS: There were 1,521 respondents from 47 countries, 57% had implemented the ABCDEF bundle, with varying degrees of compliance across continents. Most of the respondents (83%) used a scale to evaluate pain. Spontaneous awakening trials and spontaneous breathing trials are performed in 66% and 67% of the responder ICUs, respectively. Sedation scale was used in 89% of ICUs. Delirium monitoring was implemented in 70% of ICUs, but only 42% used a validated delirium tool. Likewise, early mobilization was "prescribed" by most, but 69% had no mobility team and 79% used no formal mobility scale. Only 36% of the respondents assessed ICU-acquired weakness. Family members were actively involved in 67% of ICUs; however, only 33% used dedicated staff to support families and only 35% reported that their unit was open 24 hr/d for family visits. CONCLUSIONS: The current implementation of the ABCDEF bundle varies across individual components and regions. We identified specific targets for quality improvement and adoption of the ABCDEF bundle. Our data reflect a significant but incomplete shift toward patient- and family-centered ICU care in accordance with the Pain, Agitation, Delirium guidelines.
[Mh] Termos MeSH primário: Unidades de Terapia Intensiva/estatística & dados numéricos
Conhecimento
Pacotes de Assistência ao Paciente/métodos
Pacotes de Assistência ao Paciente/utilização
Médicos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos Transversais
Delírio/diagnóstico
Delírio/terapia
Deambulação Precoce/estatística & dados numéricos
Família
Seres Humanos
Medicina/estatística & dados numéricos
Meia-Idade
Manejo da Dor
Medição da Dor
Respiração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002640


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[PMID]:28682962
[Au] Autor:Carmichael JC; Keller DS; Baldini G; Bordeianou L; Weiss E; Lee L; Boutros M; McClane J; Feldman LS; Steele SR
[Ad] Endereço:1 Department of Surgery, University of California, Irvine School of Medicine, Irvine, California 2 Department of Surgery, Baylor University Medical Center, Dallas, Texas 3 Department of Anesthesiology, McGill University, Montreal, Quebec, Canada 4 Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 5 Department of Colorectal Surgery, Cleveland Clinic Florida, Westin, Florida 6 Department of Surgery, McGill University, Montreal, Quebec, Canada 7 Norwalk Hospital, Western Connecticut Medical Group, Norwalk, Connecticut 8 Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio.
[Ti] Título:Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons.
[So] Source:Dis Colon Rectum;60(8):761-784, 2017 Aug.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Digestório/métodos
Deambulação Precoce
Dor Pós-Operatória/terapia
Assistência Perioperatória/métodos
Náusea e Vômito Pós-Operatório/prevenção & controle
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Antieméticos/uso terapêutico
Colo/cirurgia
Cirurgia Colorretal
Endoscopia do Sistema Digestório
Hidratação
Seres Humanos
Íleus/prevenção & controle
Cuidados Intraoperatórios
Procedimentos Cirúrgicos Minimamente Invasivos
Manejo da Dor
Náusea e Vômito Pós-Operatório/tratamento farmacológico
Reto/cirurgia
Sociedades Médicas
Cateterismo Urinário
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Nm] Nome de substância:
0 (Antiemetics)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000883



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