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array:23 [ "pii" => "S0210569112002057" "issn" => "02105691" "doi" => "10.1016/j.medin.2012.05.014" "estado" => "S300" "fechaPublicacion" => "2013-06-01" "aid" => "483" "copyright" => "Elsevier España, S.L. and SEMICYUC" "copyrightAnyo" => "2012" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Intensiva. 2013;37:316-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2685 "formatos" => array:3 [ "EPUB" => 157 "HTML" => 1756 "PDF" => 772 ] ] "itemSiguiente" => array:18 [ "pii" => "S021056911200201X" "issn" => "02105691" "doi" => "10.1016/j.medin.2012.05.010" "estado" => "S300" "fechaPublicacion" => "2013-06-01" "aid" => "479" "copyright" => "Elsevier España, S.L. and SEMICYUC" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Intensiva. 2013;37:320-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4446 "formatos" => array:3 [ "EPUB" => 148 "HTML" => 2875 "PDF" => 1423 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Community-acquired Legionella Pneumonia in the intensive care unit: Impact on survival of combined antibiotic therapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "320" "paginaFinal" => "326" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumonía por legionella intrahospitalaria en la unidad de cuidados intensivos: impacto sobre la supervivencia de la terapia antibiótica combinada" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1412 "Ancho" => 1530 "Tamanyo" => 72238 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Kaplan–Meier survival curve for patients with shock receiving combination therapy versus monotherapy censored at 40 days (log rank test: <span class="elsevierStyleItalic">p</span> value<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.04).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Rello, S. Gattarello, J. Souto, J. Sole-Violan, J. Valles, R. Peredo, R. Zaragoza, L. Vidaur, A. Parra, J. Roig" "autores" => array:11 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Rello" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Gattarello" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Souto" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Sole-Violan" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Valles" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Peredo" ] 6 => array:2 [ "nombre" => "R." "apellidos" => "Zaragoza" ] 7 => array:2 [ "nombre" => "L." "apellidos" => "Vidaur" ] 8 => array:2 [ "nombre" => "A." "apellidos" => "Parra" ] 9 => array:2 [ "nombre" => "J." "apellidos" => "Roig" ] 10 => array:1 [ "colaborador" => "the Community-Acquired Pneumonia in Unidad de Cuidados Intensivos 2 (CAPUCI 2) Study Investigators" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911200201X?idApp=WMIE" "url" => "/02105691/0000003700000005/v1_201306031649/S021056911200201X/v1_201306031649/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0210569113000508" "issn" => "02105691" "doi" => "10.1016/j.medin.2013.03.003" "estado" => "S300" "fechaPublicacion" => "2013-06-01" "aid" => "577" "copyright" => "Elsevier España, S.L. and SEMICYUC" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Intensiva. 2013;37:308-15" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3368 "formatos" => array:3 [ "EPUB" => 188 "HTML" => 2185 "PDF" => 995 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Predictive factors of mortality in severe community-acquired pneumonia: A model with data on the first 24<span class="elsevierStyleHsp" style=""></span>h of ICU admission" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "308" "paginaFinal" => "315" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Factores predictivos de mortalidad en la neumonía adquirida en la comunidad grave: un modelo con los datos de las primeras 24<span class="elsevierStyleHsp" style=""></span>horas de ingreso en la unidad de cuidados intensivos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Sirvent, M. Carmen de la Torre, C. Lorencio, A. Taché, C. Ferri, J. Garcia-Gil, A. Torres" "autores" => array:7 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Sirvent" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Carmen de la Torre" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Lorencio" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Taché" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Ferri" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Garcia-Gil" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Torres" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569113000508?idApp=WMIE" "url" => "/02105691/0000003700000005/v1_201306031649/S0210569113000508/v1_201306031649/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Lesser incidence of accidental catheter removal with femoral versus radial arterial access" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "316" "paginaFinal" => "319" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Lorente, M.T. Brouard, I. Roca, A. Jiménez, E. Pastor, N. Lafuente, M.L. Mora" "autores" => array:7 [ 0 => array:4 [ "nombre" => "L." "apellidos" => "Lorente" "email" => array:1 [ 0 => "lorentemartin@msn.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M.T." "apellidos" => "Brouard" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "I." "apellidos" => "Roca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Jiménez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "E." "apellidos" => "Pastor" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "N." "apellidos" => "Lafuente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "M.L." "apellidos" => "Mora" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Intensive Care, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Research Unit, Department of Intensive Care, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Menor incidencia de retirada accidental de catéter arterial en el acceso femoral que en el radial" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Critically ill patients frequently are undergoing to arterial catheterization to continuous monitoring of systemic arterial pressure arterial and obtain repetitively blood sampling.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> Arterial catheterization involves different risks, such as infection, vascular damage, haemorrhage, thrombosis, or lesion of nerves. Arterial catheter may have an ACR. The importance of ACR lies in that it could cause severe complications, potentially life-threatening, as severe external haemorrhage and vascular damage. However, there are scarce data about accidental removal of arterial catheter.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–9</span></a> In addition, we did not find studies comparing the ACR incidence between different arterial catheter sites. Thus, the objective of this study was to compare the incidence of ACR in femoral and radial arterial catheters.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Materials and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">We performed a retrospective study over six years of all patients who were undergoing femoral or radial arterial catheters during their stay in the polyvalent ICU of the Hospital Universitario de Canarias, Tenerife, Spain. This is a 24-bed ICU and each box is independent with the possibility to close the door. The study was approved by the institutional review board.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The decision to use the femoral or radial site was taken on the basis of the criterion of the physician responsible for the patient because there was no protocol in the ICU. The catheters used were radiopaque polyurethane catheters (Arrow, Reading, PA). The length of arterial catheters used was of 12<span class="elsevierStyleHsp" style=""></span>cm in femoral and 4.45<span class="elsevierStyleHsp" style=""></span>cm in radial access. Femoral catheters were inserted by Seldinger technique, and radial catheters were inserted over needle. Femoral catheters were fixed by silk suture and radial sites by steri-strip. The catheters were inserted in ICU or surgical room. The percutaneous entry sites were examined daily by the ICU nurse assigned to the patient. Physicians and nurses were advised to be attentive and vigilant in order to reduce this undesirable problem. Sedation was prescribed, when necessary, by physicians.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The following data were collected: age, sex, diabetes mellitus, APACHE-II, diagnosis group, catheter access, catheter insertion and removal dates, and cause of catheter removal (planned or accidental).</p><p id="par0025" class="elsevierStylePara elsevierViewall">We considered ACR as the presence of an unplanned removal produced by the patient or the staff. The ACR can be performed by the patient, either by taking hold of it with their hands or by making voluntary movements that led directly to the removal. The ACR can be performed by the staff as a consequence of inadequate handling. The catheters removed due to obstruction of the catheter were not considered as ACR.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Statistical analyses were performed with SPSS 12.0.1 (SPSS Inc., Chicago, IL), LogXact 4.1 (Cytel Co., Cambridge, MA) and StatXact 5.0.3 (Cytel Co., Cambridge, MA). Continuous variables are reported as medians and percentiles 25th–75th, and were compared using Mann–Whitney test. Categorical variables are reported as frequencies and percentages. We used Kruskal–Wallis test for singly ordered <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">c</span> table to compare between femoral and radial groups the proportions of the presence/absence of diabetes, accidental removal. Diagnosis and sex proportions between catheter groups were compared with Chi-square test. The incidence of ACR per 100 catheter-days between groups was compared using Poisson regression. The independent variable was arterial catheter site (femoral vs radial), the dependent variable was ARC and, finally the rate multiplier was time of catheter insertion. The magnitude of the effects is expressed as Odds Ratio (OR) and 95% confidence interval (CI). A <span class="elsevierStyleItalic">p</span>-value less than 0.05 was considered statistically significant.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">We found 207 events of ACR in 3504 (5.91%) catheters during 21,239 days of catheterization (0.97 events of ACR per 100 days of catheterization). A total of 2419 radial arterial catheters were inserted and remain in situ during 14,742 days. And were inserted 1085 arterial femoral catheters that remain in situ during 6497 days. We detected 45 cases of ACR in femoral site and 162 cases in radial arterial site.</p><p id="par0040" class="elsevierStylePara elsevierViewall">As shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, there were no significant differences between both arterial sites in age, sex, diabetes mellitus, APACHE-II, diagnosis group and duration of the catheter. A lower ACR rate was found in femoral than in radial site (4.1% vs 6.7%; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.003)</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Poisson regression analysis showed a lower incidence of ACR in femoral than in radial arterial site (0.69 vs 1.10 events of ACR per 100 catheter-days; OR 0.6, p=0.006, 95%CI 0.01-0.83).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">To our knowledge, this study includes the largest series reporting data on ACR of artery catheters and it is the first comparing ACR incidence between different arterial catheter sites. The most relevant finding of our study is that femoral arterial catheter showed a lower ACR incidence than radial access.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The number of arterial catheters included in previous studies was slow, and the study of Carrion et al. reported the higher number of catheters (792 catheters).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In our study we analyzed 3504 arterial catheters. Our ACR rate (5.91% catheters and 0.97 events of ACR/100 days of catheterization) is within the previously reported rates, which is of a range between 3.8 and 18.4% catheters and of 1.17–1.8 events of ACR per 100 days of catheterization.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–9</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In most of the previous studies there was no description of the artery access;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6–9</span></a> although in the study by Amo Priego 187 radial and 46 femoral artery catheters were included.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In our study we analyzed 2419 radial and 1085 femoral artery catheters. Previously, a comparison of ACR incidence was not reported between different arterial catheter sites, and we report for the first time a lower ACR incidence in femoral than in radial arterial access. In the study by Marcos et al. 64 radial arterial catheters were analyzed and the authors found an ACR rate of 12.5% catheters and 1.8 events of ACR per 100 days of catheterization.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> García et al. published a study with 49 arterial catheters (without description of the artery access) that showed an ACR rate of 18.4% catheters and 1.69 ACR per 100 days of catheterization.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> A study by Goñi Viguria et al. with 101 arterial catheters (without description of the artery access) found an ACR rate of 9.9% of catheters and 1.47 ACR per 100 days of catheterization.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> A total of 792 arterial catheters (without description of the artery access) were analyzed in the study by Carrion et al., and the authors found an ACR incidence of 1.17 per 100 days of catheterization.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In the study by Amo Priego et al., including 233 arterial catheters (187 radial and 46 femoral catheter), an ACR rate of 3.8% was showed (but did not report the number of events per 100 days of catheterization).<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">In a previous study of our team,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> we did not find significant differences in the ACR rate between 1057 radial and 125 femoral arterial sites. Possibly, the increase of sample size to 2419 radial and 1085 femoral arterial catheters has contributed in the appearance of significant differences in our current report.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Our study has some limitations. First, the different insertion vascular sites were observationally compared without randomization. Second, we have not collected data about the sedation level, agitation, mechanical ventilation, nurse/patient relationship and work shift in each arterial catheter site. Third, femoral catheters were fixed by silk suture and radial sites by steri-strip, and this fact could have contributed in the lower incidence of ACR in femoral than in radial site. Fourth, the catheters removed due to obstruction of the catheter were not considered as ACR and this cause was included in the Quality Indicators in critically ill patients published by Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,12</span></a> Five, we have not collected data about the complications associated with ACR.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Possibly, the optimal decision to use an arterial site determined should be carried out on the basis of the patient safety in a global manner, i.e. taking into account different risks of arterial catheter such as ACR, nosocomial infection and mechanical complications. With respect to ARC, we found in this study that femoral arterial site has lower risk of ACR than radial site (0.69 vs 1.10 events/100 catheter-days; OR 0.6, p=0.006, 95%CI 0.01-0.83). Regarding nosocomial infection, our team found a higher risk of catheter-related bloodstream infection in femoral arterial site than in radial site (1.92 vs 0.25/1000 catheter-days, OR 1.9 (95% CI 1.15-3.41), p=0.009).<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> And with respect to mechanical complications, in one clinical review of complications of arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine, was found a higher temporary occlusion and haematoma rate in radial than in femoral site and a higher permanent ischemic damage rate in femoral than in radial arteries<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>; although were not reported complety data about all complications in all studies included in the review.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusion</span><p id="par0080" class="elsevierStylePara elsevierViewall">We found a lower incidence of ACR in femoral than in radial site. We think that in order to improve the safety of patients, it could be interesting to monitor exhaustively the ACR incidence, implement preventive measures and to research about ACR prevention since ACR could give rise to severe complications.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Competing interests</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Funding</span><p id="par0090" class="elsevierStylePara elsevierViewall">This study was supported, in part, by a grant from <span class="elsevierStyleGrantSponsor" id="gs0005">Instituto de Salud Carlos III</span> (<span class="elsevierStyleGrantNumber" refid="gs0005">I3SNS-INT-11-063</span>) (Madrid, Spain).</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:2 [ "identificador" => "xres185014" "titulo" => array:9 [ 0 => "Abstract" 1 => "Background" 2 => "Objective" 3 => "Research design" 4 => "Setting" 5 => "Subjects" 6 => "Measures" 7 => "Results" 8 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec173313" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres185013" "titulo" => array:9 [ 0 => "Resumen" 1 => "Antecedentes" 2 => "Objetivo" 3 => "Diseño del estudio" 4 => "Lugar" 5 => "Sujetos" 6 => "Medidas" 7 => "Resultados" 8 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec173314" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Competing interests" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Funding" ] 11 => array:2 [ "identificador" => "xack47882" "titulo" => "Acknowledgments" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-04-06" "fechaAceptado" => "2012-05-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec173313" "palabras" => array:6 [ 0 => "Accidental" 1 => "Removal" 2 => "Arterial" 3 => "Femoral" 4 => "Radial" 5 => "Catheter" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec173314" "palabras" => array:6 [ 0 => "Accidental" 1 => "Retirada" 2 => "Arterial" 3 => "Femoral" 4 => "Radial" 5 => "Catéter" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Arterial catheterization is a frequent procedure in Intensive Care Units (ICUs). Accidental catheter removal (ACR) can cause severe and potentially life-threatening complications such as severe bleeding and vascular damage. Few data are available on accidental arterial catheter removal, and no studies have been found comparing the incidence of ACR between different arterial catheter sites.</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To compare the incidence of ACR in femoral and radial arterial catheters.</p> <span class="elsevierStyleSectionTitle">Research design</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Retrospective study.</p> <span class="elsevierStyleSectionTitle">Setting</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A polyvalent ICU.</p> <span class="elsevierStyleSectionTitle">Subjects</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">All consecutive patients subjected to femoral or radial arterial catheterization.</p> <span class="elsevierStyleSectionTitle">Measures</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The incidence of ACR per 100 catheter-days between groups was compared using Poisson regression. We considered ACR as the presence of unintended removal produced by the patient or healthcare personnel.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 2419 radial and 1085 femoral arterial catheters were inserted and remained in situ during 14,742 and 6497 days, respectively. We detected 45 cases of ACR with the femoral access and 162 cases with the radial access. The ACR rate was lower with the femoral access (4.1% vs 6.7% in the case of the radial access; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.003). Poisson regression analysis confirmed a lower incidence of ACR with the femoral versus the radial access (0.69 vs 1.10 ACR events per 100 catheter-days; OR 0.6, p=0.006, CI95% 0.01-0.83).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The incidence of ACR was found to be lower with the femoral than with the radial arterial catheters. In order to improve patient safety, it could be interesting to exhaustively monitor the incidence of ACR and adopt preventive measures, since ACR can give rise to serious complications.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Antecedentes</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La cateterización arterial es un procedimiento frecuente en los pacientes de las Unidades de Cuidados Intensivos (UCI). La retirada accidental del catéter (ACR) puede conllevar graves complicaciones, potencialmente vitales, como la hemorragia y la lesión vascular. Existen pocos datos sobre la ACR de los catéteres arteriales y no hemos encontrado estudios que hayan comparado la incidencia de ACR entre los diferentes accesos de canalización arterial.</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Comparar la incidencia de ACR entre los catéteres arteriales localizados en el acceso femoral y radial.</p> <span class="elsevierStyleSectionTitle">Diseño del estudio</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo.</p> <span class="elsevierStyleSectionTitle">Lugar</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Una UCI polivalente.</p> <span class="elsevierStyleSectionTitle">Sujetos</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes consecutivos sometidos a canalización de arteria femoral o radial.</p> <span class="elsevierStyleSectionTitle">Medidas</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">La incidencia de ACR por 100 días de catéter entre grupos fue comparada mediante la regresión de Poisson. Se consideró ACR cuando se producía la retirada no programada del catéter por parte del propio paciente o por el personal.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se insertaron 2.419 catéteres en arteria radial que permanecieron durante 14.742 días, y 1.085 catéteres en arteria femoral que permanecieron durante 6.497 días. Se detectaron 45 casos de ACR en el sitio femoral y 162 casos en el sitio radial. Hubo una menor tasa de ACR en el sitio femoral que en el radial (4,1% vs 6,7%; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,003). La regresión de Poisson mostró una menor incidencia de ACR en el sitio femoral que en el radial (0,69 vs 1,10 eventos de ACR por 100 días de catéter; OR 0,6, p = 0,006, IC95% 0,01-0,83).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Encontramos una menor incidencia de ACR en el sitio femoral que en el radial. Pensamos, que para mejorar la seguridad de los pacientes podría ser interesante monitorizar exhaustivamente la incidencia de ACR e implementar medidas preventivas, debido a que la ACR puede conllevar complicaciones graves.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Arterial catheter site \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Femoral (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1085) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Radial (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2419) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Age – years median (25th–75th percentiles)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 (45–70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61 (47–70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.31 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sex female – no. (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">452 (41.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1001 (41.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.88 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Diabetes mellitus – no. (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">349 (32.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">695 (33.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.56 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">APACHE-II – score median (25th–75th percentiles)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (10–17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (10–17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Diagnosis group – no. (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.26 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiologic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">233 (21.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">516 (21.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Respiratory \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">181 (16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">429 (17.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Digestive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 (6.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">118 (4.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neurological \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">253 (23.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">587 (24.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Traumatology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">294 (27.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">675 (27.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intoxication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54 (5.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94 (3.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Duration of the catheter – days median (25th–75th percentiles)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (4–8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (4–8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">ACR – no. (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (4.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">162 (6.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab284778.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Characteristics of femoral and radial arterial catheters.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arterial catheter-related bloodstream infections: results of an 8-year survey in a surgical intensive care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Pirracchio" 1 => "M. Legrand" 2 => "M.R. Rigon" 3 => "J. Mateo" 4 => "A.C. Lukaszewicz" 5 => "A. Mebazaa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0b013e3182120cf7" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2011" "volumen" => "39" "paginaInicial" => "1372" "paginaFinal" => "1376" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21336106" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infectious risk associated with arterial catheters compared with central venous catheters" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.C. Lucet" 1 => "L. Bouadma" 2 => "J.R. Zahar" 3 => "C. Schwebel" 4 => "A. Geffroy" 5 => "S. Pease" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0b013e3181d4502e" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2010" "volumen" => "38" "paginaInicial" => "1030" "paginaFinal" => "1035" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20154601" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective study of peripheral arterial catheter infection and comparison with concurrently sited central venous catheters" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.B. Koh" 1 => "J.R. Gowardman" 2 => "C.M. Rickard" 3 => "I.K. Robertson" 4 => "A. Brown" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0b013e318161f74b" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2008" "volumen" => "36" "paginaInicial" => "397" "paginaFinal" => "402" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18216598" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prevalence of nosocomial infection in Intensive Care Units in Europe" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "the EPIC International Advisory Committee" "etal" => false "autores" => array:6 [ 0 => "J.L. Vincent" 1 => "D.J. Bihari" 2 => "P.M. Suter" 3 => "H.A. Bruining" 4 => "J. White" 5 => "M.H. Nicolas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "1995" "volumen" => "274" "paginaInicial" => "639" "paginaFinal" => "644" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7637145" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of the efficacy of the implementation of an arterial cannulation protocol as quality assurance method" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.D. Amo Priego" 1 => "F.J. Carmona Monge" 2 => "I. Gómez Nieves" 3 => "G. Bonilla Zafra" 4 => "F. Gordo Vidal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Enferm Intensiva" "fecha" => "2004" "volumen" => "15" "paginaInicial" => "159" "paginaFinal" => "164" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15498399" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accidental removal of endotracheal and nasogastric tubes and intravascular catheters" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Carrión" 1 => "D. Ayuso" 2 => "M. Marcos" 3 => "P. Robles" 4 => "M.A. de la Cal" 5 => "I. Alía" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2000" "volumen" => "28" "paginaInicial" => "63" "paginaFinal" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10667500" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of the accidental withdrawal of tubes, probes and catheters as a part of the program of quality control" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Marcos" 1 => "D. Ayuso" 2 => "B. González" 3 => "M. Carrión" 4 => "P. Robles" 5 => "M. Muñoz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Enferm Intensiva" "fecha" => "1994" "volumen" => "5" "paginaInicial" => "115" "paginaFinal" => "120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7600388" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quality of care in intensive care units. Retrospective study on long-term patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.P. García" 1 => "P. López" 2 => "C. Eseverri" 3 => "C. Zazpe" 4 => "M.C. Asiain" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Enferm Intensiva" "fecha" => "1998" "volumen" => "9" "paginaInicial" => "102" "paginaFinal" => "108" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9934057" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of care quality in the ICU through a computerized nursing care plan" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Goñi Viguria" 1 => "M.P. García Santolaya" 2 => "M. Vázquez Calatayud" 3 => "M.A. Margall Coscojuela" 4 => "M.C. Asiaín Erro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Enferm Intensiva" "fecha" => "2004" "volumen" => "15" "paginaInicial" => "76" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15207188" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Accidental catheter removal in critically ill patients: a prospective and observational study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Lorente" 1 => "M.S. Huidobro" 2 => "M.M. Martín" 3 => "A. Jiménez" 4 => "M.L. Mora" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/cc2887" "Revista" => array:6 [ "tituloSerie" => "Crit Care" "fecha" => "2004" "volumen" => "8" "paginaInicial" => "229" "paginaFinal" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15312203" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias. Indicadores de calidad en el enfermo crítico. Available from: <a class="elsevierStyleInterRef" href="http://www.semicyuc.org/sites/default/files/esp_indicadores_calidad.pdf">http://www.semicyuc.org/sites/default/files/esp_indicadores_calidad.pdf</a>" ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias. Indicadores de calidad en el enfermo crítico. Actualización 2011. Available from: <a class="elsevierStyleInterRef" href="http://www.semicyuc.org/sites/default/files/actualizacion_indicadores_calidad_2011.pdf">http://www.semicyuc.org/sites/default/files/actualizacion_indicadores_calidad_2011.pdf</a>" ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arterial catheter-related infection of 2949 catheters" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Lorente" 1 => "R. Santacreu" 2 => "M.M. Martín" 3 => "A. Jiménez" 4 => "M.L. Mora" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/cc3934" "Revista" => array:5 [ "tituloSerie" => "Crit Care" "fecha" => "2006" "volumen" => "10" "paginaInicial" => "R8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16420641" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Scheer" 1 => "A. Perel" 2 => "U.J. Pfeiffer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Crit Care" "fecha" => "2002" "volumen" => "6" "paginaInicial" => "199" "paginaFinal" => "204" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12133178" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "identificador" => "xack47882" "titulo" => "Acknowledgments" "texto" => "<p id="par0095" class="elsevierStylePara elsevierViewall">This study was supported, in part, by a grant from <span class="elsevierStyleGrantSponsor" id="gs0010">Instituto de Salud Carlos III</span> (<span class="elsevierStyleGrantNumber" refid="gs0010">I3SNS-INT-11-063</span>) (Madrid, Spain).</p>" ] ] ] "idiomaDefecto" => "en" "url" => "/02105691/0000003700000005/v1_201306031649/S0210569112002057/v1_201306031649/en/main.assets" "Apartado" => array:4 [ "identificador" => "434" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02105691/0000003700000005/v1_201306031649/S0210569112002057/v1_201306031649/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569112002057?idApp=WMIE" ]
año/Mes | Html | Total | |
---|---|---|---|
2024 Noviembre | 11 | 13 | 24 |
2024 Octubre | 75 | 49 | 124 |
2024 Septiembre | 81 | 44 | 125 |
2024 Agosto | 110 | 49 | 159 |
2024 Julio | 73 | 35 | 108 |
2024 Junio | 98 | 55 | 153 |
2024 Mayo | 59 | 33 | 92 |
2024 Abril | 59 | 40 | 99 |
2024 Marzo | 55 | 34 | 89 |
2024 Febrero | 49 | 40 | 89 |
2024 Enero | 40 | 30 | 70 |
2023 Diciembre | 41 | 47 | 88 |
2023 Noviembre | 59 | 45 | 104 |
2023 Octubre | 49 | 28 | 77 |
2023 Septiembre | 35 | 36 | 71 |
2023 Agosto | 33 | 20 | 53 |
2023 Julio | 32 | 37 | 69 |
2023 Junio | 26 | 17 | 43 |
2023 Mayo | 55 | 38 | 93 |
2023 Abril | 52 | 30 | 82 |
2023 Marzo | 48 | 30 | 78 |
2023 Febrero | 60 | 39 | 99 |
2023 Enero | 23 | 25 | 48 |
2022 Diciembre | 65 | 49 | 114 |
2022 Noviembre | 67 | 46 | 113 |
2022 Octubre | 81 | 47 | 128 |
2022 Septiembre | 104 | 45 | 149 |
2022 Agosto | 48 | 49 | 97 |
2022 Julio | 43 | 49 | 92 |
2022 Junio | 53 | 43 | 96 |
2022 Mayo | 50 | 56 | 106 |
2022 Abril | 52 | 38 | 90 |
2022 Marzo | 55 | 84 | 139 |
2022 Febrero | 42 | 42 | 84 |
2022 Enero | 42 | 39 | 81 |
2021 Diciembre | 47 | 47 | 94 |
2021 Noviembre | 69 | 40 | 109 |
2021 Octubre | 69 | 93 | 162 |
2021 Septiembre | 45 | 42 | 87 |
2021 Agosto | 59 | 50 | 109 |
2021 Julio | 42 | 47 | 89 |
2021 Junio | 38 | 27 | 65 |
2021 Mayo | 52 | 57 | 109 |
2021 Abril | 78 | 97 | 175 |
2021 Marzo | 89 | 40 | 129 |
2021 Febrero | 74 | 33 | 107 |
2021 Enero | 59 | 33 | 92 |
2020 Diciembre | 56 | 26 | 82 |
2020 Noviembre | 40 | 18 | 58 |
2020 Octubre | 37 | 31 | 68 |
2020 Septiembre | 33 | 14 | 47 |
2020 Agosto | 50 | 30 | 80 |
2020 Julio | 32 | 27 | 59 |
2020 Junio | 26 | 19 | 45 |
2020 Mayo | 30 | 22 | 52 |
2020 Abril | 24 | 11 | 35 |
2020 Marzo | 25 | 13 | 38 |
2020 Febrero | 75 | 30 | 105 |
2020 Enero | 32 | 26 | 58 |
2019 Diciembre | 38 | 21 | 59 |
2019 Noviembre | 33 | 16 | 49 |
2019 Octubre | 34 | 18 | 52 |
2019 Septiembre | 29 | 20 | 49 |
2019 Agosto | 45 | 24 | 69 |
2019 Julio | 43 | 21 | 64 |
2019 Junio | 19 | 16 | 35 |
2019 Mayo | 67 | 24 | 91 |
2019 Abril | 23 | 16 | 39 |
2019 Marzo | 39 | 28 | 67 |
2019 Febrero | 34 | 30 | 64 |
2019 Enero | 32 | 23 | 55 |
2018 Diciembre | 47 | 32 | 79 |
2018 Noviembre | 68 | 40 | 108 |
2018 Octubre | 39 | 27 | 66 |
2018 Septiembre | 28 | 13 | 41 |
2018 Agosto | 28 | 9 | 37 |
2018 Julio | 24 | 8 | 32 |
2018 Junio | 31 | 11 | 42 |
2018 Mayo | 19 | 5 | 24 |
2018 Abril | 30 | 11 | 41 |
2018 Marzo | 18 | 4 | 22 |
2018 Febrero | 19 | 9 | 28 |
2018 Enero | 43 | 20 | 63 |
2017 Diciembre | 23 | 6 | 29 |
2017 Noviembre | 30 | 13 | 43 |
2017 Octubre | 38 | 8 | 46 |
2017 Septiembre | 18 | 15 | 33 |
2017 Agosto | 22 | 9 | 31 |
2017 Julio | 31 | 8 | 39 |
2017 Junio | 64 | 11 | 75 |
2017 Mayo | 31 | 12 | 43 |
2017 Abril | 41 | 12 | 53 |
2017 Marzo | 23 | 6 | 29 |
2017 Febrero | 19 | 2 | 21 |
2017 Enero | 31 | 5 | 36 |
2016 Diciembre | 43 | 20 | 63 |
2016 Noviembre | 36 | 22 | 58 |
2016 Octubre | 48 | 25 | 73 |
2016 Septiembre | 35 | 8 | 43 |
2016 Agosto | 29 | 9 | 38 |
2016 Julio | 27 | 9 | 36 |
2016 Marzo | 1 | 3 | 4 |
2015 Diciembre | 3 | 0 | 3 |
2015 Noviembre | 1 | 0 | 1 |
2015 Octubre | 0 | 12 | 12 |
2015 Julio | 1 | 14 | 15 |
2015 Junio | 4 | 0 | 4 |
2015 Enero | 1 | 0 | 1 |
2014 Octubre | 1 | 0 | 1 |
2014 Agosto | 1 | 0 | 1 |
2014 Junio | 4 | 0 | 4 |
2014 Mayo | 2 | 0 | 2 |
2014 Abril | 3 | 0 | 3 |
2014 Marzo | 29 | 7 | 36 |
2014 Febrero | 24 | 6 | 30 |
2014 Enero | 19 | 4 | 23 |
2013 Diciembre | 23 | 10 | 33 |
2013 Noviembre | 21 | 2 | 23 |
2013 Octubre | 19 | 3 | 22 |
2013 Septiembre | 29 | 6 | 35 |
2013 Agosto | 28 | 4 | 32 |
2013 Julio | 21 | 5 | 26 |
2013 Junio | 8 | 6 | 14 |