Uso de las técnicas continuas de reemplazo renal en las Unidades de Cuidados Intensivos en España. Una encuesta a nivel nacional
Use of continuous renal replacement therapies in the intensive care units in spain. A national survey
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"apellidos" => "Herrera gutiérrez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "D." "apellidos" => "Daga ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "G." "apellidos" => "Seller pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "García alcántara" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "C." "apellidos" => "De la rubia de gracia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "L." "apellidos" => "Ruiz del fresno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cuidados Críticos y Urgencias. Complejo Hospitalario Carlos Haya" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Medicina Intensiva. Hospital Universitario Virgen de la Victoria. Málaga" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Dr. M.E. Herrera Gutiérrez. UCI. Complejo Hospitalario Carlos Haya. Avda. Carlos Haya, s/n. 29010 Málaga." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of continuous renal replacement therapies in the intensive care units in spain. A national survey" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2000-07-20" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec82365" "palabras" => array:2 [ 0 => "fracaso renal agudo" 1 => "hemofiltración" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec82366" "palabras" => array:2 [ 0 => "Acute renal failure" 1 => "hemofiltration" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Las técnicas continuas de reemplazo renal (TCRR) están indicadas en pacientes graves; pero su implantación parece condicionada por la existencia de Unidades de Cuidados Intensivos (UCI) cerradas, atendidas por intensivistas.</p> <span class="elsevierStyleSectionTitle">Material</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional mediante una encuesta enviada a las UCI de los hospitales públicos de nuestro país. Se completaron 56 encuestas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El intensivista atiende el fracaso renal agudo en un 62,7% de los hospitales que cuentan con nefrología. El 91% usan TCRR (16,6 [14,5] procedimientos/año y UCI): veno-venosa el 79,6%; hemodialfiltración el 65,3% y arterio-venosa el 49%. Se limita la producción de ultrafiltrado en el 71,8%, con una media de recambio de 803 (538) ml/h. Los filtros tienen una duración de 49,4 (20,5) horas (4,4 [2] filtros/paciente). Las membranas preferidas son AN69 (48,6%) y polisulfona (45,7%). Entre las indicaciones no renales se aceptan: control de volumen el 88%, intoxicaciones el 46% y pancreatitis el 40%. Su uso se centra en UCI (nefrología 19,6%, anestesia 7,1%). La enfermería de intensivos inicia la técnica en el 77,6% y se encarga de su manejo en el 100%, con una relación enfermero/paciente de 1/2 en el 54,4% y 1/1 en el 43,5%. El seguimiento y control es responsabilidad exclusiva del intensivista en el 73,5%. La aceptación inicial fue baja en el 12,8% del personal médico y en el 29,8% de la enfermería. Los datos del tratamiento no difieren según el tamaño de la UCI.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las TCRR se utilizan preferentemente en la UCI, donde es casi el único medio de tratamiento de depuración siendo el intensivista el responsable de su indicación y control. Es realizada por la enfermería de intensivos. El tipo de Unidad no condiciona diferencias en cuanto al rendimiento. Continuous renal replacement therapies (CRRT) are used in critically ill patients, and it seems to be better accepted in closed intensive care units (ICUs). This therapy is mainly attended by intensivists.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Methods</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The study was observational. It consisted in a survey mailed to all the ICUs from public heath service. We received 56 complete answers.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Intensivists care for Acute Renal Failure (ARF) patients in 62.7% of the hospitals with nephrology facilities. 91% of these physicians use CRRT (16.6 [14.5] procedures/year/ICU): venovenous in 79.6%, hemodialfiltration in 65.3%, arterio- venous 49%. Ultrafiltrate flow is controlled in 71.8%, with a mean ultrafiltrage production of 803 (538) ml/h. Filters show a life span of 49.4 (20.5) hours (4.4 [2] filters/patient). The referred membranes are AN69 (48.6%) and Polisulfone volume control in 88%, toxic depuration in 46% and pancreatitis in 40%. It’s mainly used in ICUs (in nephrology departments in 19,6%, and in anaesthesiology services in 7.1%). Intensive care nurses start the treatment in 77.6% and follow it in 100%, with a nurse/patient ratio of 1/2 in 54.4% and 1/1 in 43.5%. Intensivists are responsible for follow-up and control in 73.5% of cases. Initial acceptance was low (in 12.8% of the medical staff and in 29.8% of the nursing staff). Data of the treatment are similar with independence of the ICU size.</p> <span class="elsevierStyleSectionTitle">Concluding</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">CRRT are mainly used in the ICU, where it is almost the only renal replacement therapy used, being the intensivist the only one resposible for establishing the indication and controlling it. The ICU nursing staff manages the therapy. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 13 | 15 | 28 |
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| 2023 Septiembre | 46 | 65 | 111 |
| 2023 Agosto | 27 | 35 | 62 |
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| 2023 Marzo | 80 | 75 | 155 |
| 2023 Febrero | 76 | 63 | 139 |
| 2023 Enero | 99 | 37 | 136 |
| 2022 Diciembre | 80 | 49 | 129 |
| 2022 Noviembre | 76 | 56 | 132 |
| 2022 Octubre | 78 | 51 | 129 |
| 2022 Septiembre | 62 | 61 | 123 |
| 2022 Agosto | 50 | 65 | 115 |
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| 2022 Junio | 44 | 48 | 92 |
| 2022 Mayo | 43 | 74 | 117 |
| 2022 Abril | 48 | 75 | 123 |
| 2022 Marzo | 67 | 66 | 133 |
| 2022 Febrero | 63 | 53 | 116 |
| 2022 Enero | 70 | 68 | 138 |
| 2021 Diciembre | 90 | 55 | 145 |
| 2021 Noviembre | 96 | 67 | 163 |
| 2021 Octubre | 74 | 77 | 151 |
| 2021 Septiembre | 54 | 61 | 115 |
| 2021 Agosto | 49 | 52 | 101 |
| 2021 Julio | 39 | 56 | 95 |
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| 2021 Mayo | 55 | 72 | 127 |
| 2021 Abril | 129 | 164 | 293 |
| 2021 Marzo | 134 | 59 | 193 |
| 2021 Febrero | 133 | 47 | 180 |
| 2021 Enero | 99 | 47 | 146 |
| 2020 Diciembre | 82 | 49 | 131 |
| 2020 Noviembre | 84 | 46 | 130 |
| 2020 Octubre | 53 | 35 | 88 |
| 2020 Septiembre | 42 | 36 | 78 |
| 2020 Agosto | 42 | 23 | 65 |
| 2020 Julio | 49 | 25 | 74 |
| 2020 Junio | 38 | 24 | 62 |
| 2020 Mayo | 74 | 45 | 119 |
| 2020 Abril | 52 | 22 | 74 |
| 2020 Marzo | 27 | 31 | 58 |
| 2020 Febrero | 85 | 97 | 182 |
| 2020 Enero | 44 | 31 | 75 |
| 2019 Diciembre | 49 | 44 | 93 |
| 2019 Noviembre | 45 | 29 | 74 |
| 2019 Octubre | 42 | 17 | 59 |
| 2019 Septiembre | 41 | 41 | 82 |
| 2019 Agosto | 45 | 33 | 78 |
| 2019 Julio | 39 | 31 | 70 |
| 2019 Junio | 33 | 26 | 59 |
| 2019 Mayo | 61 | 70 | 131 |
| 2019 Abril | 28 | 47 | 75 |
| 2019 Marzo | 23 | 40 | 63 |
| 2019 Febrero | 15 | 39 | 54 |
| 2019 Enero | 23 | 46 | 69 |
| 2018 Diciembre | 42 | 47 | 89 |
| 2018 Noviembre | 96 | 43 | 139 |
| 2018 Octubre | 23 | 32 | 55 |
| 2018 Septiembre | 5 | 13 | 18 |
| 2018 Agosto | 12 | 15 | 27 |
| 2018 Julio | 10 | 28 | 38 |
| 2018 Junio | 19 | 17 | 36 |
| 2018 Mayo | 7 | 14 | 21 |
| 2018 Abril | 9 | 23 | 32 |
| 2018 Marzo | 13 | 13 | 26 |
| 2018 Febrero | 12 | 25 | 37 |
| 2018 Enero | 9 | 21 | 30 |
| 2017 Diciembre | 10 | 16 | 26 |
| 2017 Noviembre | 21 | 13 | 34 |
| 2017 Octubre | 21 | 38 | 59 |
| 2017 Septiembre | 15 | 33 | 48 |
| 2017 Agosto | 7 | 16 | 23 |
| 2017 Julio | 9 | 14 | 23 |
| 2017 Junio | 17 | 22 | 39 |
| 2017 Mayo | 18 | 15 | 33 |
| 2017 Abril | 23 | 10 | 33 |
| 2017 Marzo | 10 | 54 | 64 |
| 2017 Febrero | 9 | 10 | 19 |
| 2017 Enero | 12 | 9 | 21 |
| 2016 Diciembre | 29 | 17 | 46 |
| 2016 Noviembre | 35 | 16 | 51 |
| 2016 Octubre | 47 | 20 | 67 |
| 2016 Septiembre | 50 | 38 | 88 |
| 2016 Agosto | 31 | 18 | 49 |
| 2016 Julio | 17 | 20 | 37 |
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