ABSTRACT
ANTECEDENTES Y OBJETIVO: Los objetivos de la Sección de Cuidados Intensivos de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SCI-SEDAR) con el presente trabajo son: establecer nuevas recomendaciones adaptando los estándares publicados por el Ministerio de Sanidad y Política Social, y alineadas con las principales guías internacionales, y desarrollar una herramienta de mejora de la calidad y la eficiencia. MATERIALES Y MÉTODO: A lo largo de 2018, 3 miembros de la SCI-SEDAR definieron la metodología, desarrollaron las recomendaciones y seleccionaron al panel de expertos. Debido a la limitada evidencia de buena parte de las recomendaciones y a la importante variabilidad estructural de las unidades de cuidados intensivos de anestesia actuales, se optó por un abordaje Delphi modificado para determinar el grado de consenso. RESULTADOS: Un total de 24 expertos de 21 instituciones constituyeron el grupo de expertos del presente trabajo. Se establecieron 175 recomendaciones sobre 8 apartados, incluyendo 129 con consenso fuerte y 46 con consenso débil. CONCLUSIONES: La SCI-SEDAR estableció las recomendaciones estructurales de las unidades de cuidados intensivos de anestesia que deberán guiar la renovación o la creación de nuevas unidades
BACKGROUND AND OBJECTIVE: In this article, the Intensive Care Section of the Spanish Society of Anesthesiology (SCI-SEDAR) establishes new recommendations based on the standards published by the Ministry of Health, Consumer Affairs and Social Welfare and aligned with the principle international guidelines, and develops a tool to improve quality and efficiency. MATERIALS AND METHOD: Over a 12-month period (2018), 3 members of the SCI-SEDAR defined the methodology, developed the recommendations and selected the panel of experts. Due to the limited evidence available for many of the recommendations and the significant structural differences between existing anesthesia intensive care units, we chose a modified Delphi approach to determine the degree of consensus. RESULTS: The panel consisted of 24 experts from 21 institutions. The group put forward 175 recommendations on 8 sections, including 129 with strong consensus and 46 with weak consensus. CONCLUSIONS: The SCI-SEDAR has established a series of structural recommendations that should be used when renovating or creating new anesthesia intensive care units
Subject(s)
Humans , Anesthesiology/standards , Consensus , Facility Design and Construction/standards , Intensive Care Units/standards , Anesthesia , Anesthesiology/legislation & jurisprudence , Architectural Accessibility/legislation & jurisprudence , Architectural Accessibility/standards , Delphi Technique , Facility Design and Construction/legislation & jurisprudence , Hospital Bed Capacity/standards , Household Work , Housekeeping, Hospital/standards , Intensive Care Units/legislation & jurisprudence , Interior Design and Furnishings/standards , Laundry Service, Hospital/standards , Lighting/standards , Patients' Rooms/legislation & jurisprudence , Patients' Rooms/standards , Quality Improvement , Societies, Medical , SpainABSTRACT
BACKGROUND AND OBJECTIVE: In this article, the Intensive Care Section of the Spanish Society of Anesthesiology (SCI-SEDAR) establishes new recommendations based on the standards published by the Ministry of Health, Consumer Affairs and Social Welfare and aligned with the principle international guidelines, and develops a tool to improve quality and efficiency. MATERIALS AND METHOD: Over a 12-month period (2018), 3 members of the SCI-SEDAR defined the methodology, developed the recommendations and selected the panel of experts. Due to the limited evidence available for many of the recommendations and the significant structural differences between existing anesthesia intensive care units, we chose a modified Delphi approach to determine the degree of consensus. RESULTS: The panel consisted of 24 experts from 21 institutions. The group put forward 175 recommendations on 8 sections, including 129 with strong consensus and 46 with weak consensus. CONCLUSIONS: The SCI-SEDAR has established a series of structural recommendations that should be used when renovating or creating new anesthesia intensive care units.
Subject(s)
Anesthesiology/standards , Consensus , Facility Design and Construction/standards , Intensive Care Units/standards , Anesthesia , Anesthesiology/legislation & jurisprudence , Architectural Accessibility/legislation & jurisprudence , Architectural Accessibility/standards , Delphi Technique , Facility Design and Construction/legislation & jurisprudence , Hospital Bed Capacity/standards , Household Work , Housekeeping, Hospital/standards , Humans , Intensive Care Units/legislation & jurisprudence , Interior Design and Furnishings/standards , Laundry Service, Hospital/standards , Lighting/standards , Patients' Rooms/legislation & jurisprudence , Patients' Rooms/standards , Quality Improvement , Societies, Medical , SpainABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Critical Care , Consensus , Societies, Medical/standards , Anesthesiology/methods , Anesthesiology/standards , Quality Assurance, Health Care/standards , Quality of Health Care/standardsSubject(s)
Anesthesia/standards , Critical Care/standards , Anesthesiology , Humans , Practice Guidelines as Topic , Societies, Medical , SpainABSTRACT
La recientemente publicada Declaración de Helsinki para la seguridad del paciente en anestesiología establece que la seguridad y calidad de los cuidados que recibe el paciente relacionado con su situación perioperatoria es responsabilidad directa del anestesiólogo. Esta declaración de seguridad del paciente, avalada por la totalidad de las sociedades europeas de anestesiología, propugna la necesidad de elaboración de protocolos que faciliten el manejo del paciente durante sus cuidados perioperatorios. Uno de los temas propuestos en la Declaración es el manejo preoperatorio y la preparación del paciente quirúrgico. En este artículo se pretende hacer una revisión bibliográfica basada en la evidencia acerca del cuidado preoperatorio del paciente, así como proponer un protocolo sobre los aspectos más importantes del tema, que permita a cada hospital adaptarlo a sus necesidades e incorporarlo a su rutina de trabajo. Se destaca la importancia que tiene la realización de una correcta evaluación preoperatoria, reduciendo la morbimortalidad del paciente quirúrgico. El empleo de cuestionarios preoperatorios y la solicitud dirigida de pruebas complementarias preoperatorias facilita esta labor y reduce costes innecesarios. Finalmente se revisan las recomendaciones más aceptadas sobre normas de ayuno preoperatorio y el manejo de la medicación crónica preoperatoria (AU)
The recently published Helsinki Declaration on Patient Safety in Anesthesiology establishes that the safety and quality of the perioperative care received by patients is the responsibility of anesthesiologists. This declaration has been accepted by all the European societies of anesthesiology and stipulates that all institutions providing perioperative anesthesia care to patients should design protocols to guide perioperative patient management. The present article aims to provide an evidenced-based review of preoperative assessment and preparation and to propose a protocol that can be adapted to the needs of each hospital and be incorporated into their routine practice. Emphasis is placed on the importance of correct preoperative evaluation in reducing morbidity and mortality in the surgical patient. This task can be aided by the use of preoperative questionnaires and the rational use of preoperative tests, which will also reduce unnecessary costs. Finally, the most widely accepted recommendations on preoperative fasting and the perioperative management of chronic medication are discussed (AU)
Subject(s)
Female , Humans , Male , Patient Safety/standards , Preoperative Care/instrumentation , Helsinki Declaration , Anesthesia/standards , Fasting/physiology , Anesthesiology/instrumentation , Anesthesiology/standards , Surveys and Questionnaires , Medical History Taking/standards , Electrocardiography/methods , Electrocardiography , Radiography, Thoracic , Blood CoagulationABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Anesthesiology/methods , Anesthesiology/statistics & numerical data , Societies, Medical/statistics & numerical data , Societies, Medical/trends , Intensive Care Units/statistics & numerical data , Intensive Care Units/trends , Critical Care/methods , Critical Care/organization & administration , Critical Care/statistics & numerical data , Anesthesiology/trendsSubject(s)
Critical Care , Education, Medical , Specialization , Humans , Medicine/standards , SpainABSTRACT
No disponible
Subject(s)
Humans , Critical Care/trends , Education, Medical, Graduate/trends , Medicine/education , Specialization/trendsSubject(s)
Anesthesiology , Critical Care , Anesthesiology/trends , Critical Care/methods , Critical Care/trends , Europe , Humans , Spain , United StatesABSTRACT
No disponible
Subject(s)
Humans , Anesthesiology , Critical Care , Spain , United States , EuropeABSTRACT
A program that performs simulation of the kinetics of enzyme-catalyzed reactions with up to 32 species is described. The program is written in C++ for MS Windows 95/98/NT and uses a simple text file to define the kinetic model. The use of the program is illustrated with some examples. WES is available free of charge on request from the authors (e-mail: fgarcia@iele-ab.uclm.es).
Subject(s)
Computer Simulation , Enzymes/chemistry , Models, Chemical , Software , Catalysis , KineticsABSTRACT
The aim of this study was to know the prevalence of cholelithiasis (C) in the El Real-Gandia (Spain) as well as the degree of the response of the population. Health examinations were performed in 1,803 adults from El Real (2,000 inhabitants) and Gandia (54,000 inhabitants) using abdominal echography as the screening technique. Cholelithiasis was defined as the presence of biliary lithiasis (BL) or previous cholecystectomy (PC). Of 1,268 (70.3%) participants in the study, C was found in 126 cases (BL in 102 and P in 24) representing a standardized prevalence of around 15% in women and 5% in men. Cholelithiasis was more frequent in females (13.8%) than in males (5.7%) (p < 0.001) increasing linearly with age (p < 0.005). The proportion of PC was significantly higher in women (23.9%) than in men (5.9%) (p < 0.05) and in Gandia (34.4%) than in El Real (13.8%) (p < 0.02). The prevalence of biliary mud and polyps was of 0.3% and 1.1%, respectively. Working obligations (35.4%) and fear of hospitals (22.4%) were the most frequent causes for no response (NR). Males with more than primary a school education originating from outside the Valencian community (VC) were significantly associated with NR in multivariant analysis.
Subject(s)
Cholelithiasis/epidemiology , Abdomen/diagnostic imaging , Adult , Age Factors , Aged , Cholecystectomy , Cholecystography , Cholelithiasis/diagnostic imaging , Cross-Sectional Studies , Data Interpretation, Statistical , Female , Humans , Logistic Models , Male , Middle Aged , Sex Factors , Spain/epidemiology , Surveys and Questionnaires , UltrasonographyABSTRACT
MOTIVATION: The derivation of steady-state equations is frequently carried out in enzyme kinetic studies. Done manually, this becomes tedious and prone to human error. The computer programs now available which are able to accept reaction mechanisms of some complexity are focused only on the strict steady-state approach. RESULTS: Here we present a computer program called REFERASS, with a short computation time and a user-friendly format for the input and output files, able to derive the strict steady-state equations and/or those corresponding to the usual assumption that one ore more of the reversible steps are in rapid equilibrium. This program handles enzyme-catalysed reactions with mechanisms involving up to 255 enzyme species connected by up to 255 reaction steps, subject to limits imposed by the memory and disk space available.
