[Prone position: postural treatment for patients with adult respiratory distress syndrome. The nurse's point of view]. / Decúbito prono: tratamiento postural en pacientes con SDRA. Punto de vista de enfermería.

The prone position is a therapeutic strategy that can be beneficial in the treatment of adult respiratory distress syndrome (ARDS). In order to evaluate the advantages and possible complications associated with this postural change within the context of nursing, we analyzed retrospectively 71 turns carried out in 32 patients who met criteria for ARDS. The patient was turned by a team of 4 or 5 persons following a strict protocol. The PaO2/FIO2 ratio and SatO2 significantly increased in prone position, without any hemodynamic repercussions. No extubation or loss of vascular accesses or drainage tubes occurred. Complications included: facial edema, low-pressure lesions, and regurgitation of enteral nutrition.

[Quality of life and mortality of patients in intensive care. Indices of quality of life]. / Calidad de vida y mortalidad a largo plazo de pacientes en medicina intensiva. Indice de calidad de vida (ICV).

INTRODUCTION: At present there is no single practical standardized scale for measuring quality of life (QL). Any proposal should include the patient's physical impairment, level of independence, and subjective perception of happiness. We combined three previously published scales to define a quality of life index (QLI) that we propose as a standard quantitative instrument. The applicability and usefulness of QLI for the measurement of the level of deterioration of patients after admission to an intensive care unit (ICU) was examined. We prospectively evaluated QL before patient admission to determine if it influences mortality, as well as long-term changes in the QL and the factors conditioning te deterioration of patients released from the UCI as evaluated by QL indicators. MATERIAL AND METHODS: To calculate QLI, we combined the Karnofsky scale, daily life activities index, and the perception of quality of life scale. The resulting percentage (QLI) was used to evaluate 536 patients after admission to the ICU and 6 and 12 months after release. QLI was compared with the severity of disease (Apache II), probability of death (MPM), diagnostic group, and socioeconomic variables. RESULTS: Using multivariate methods, four significant variables related with mortality were identified: Apache II--MPM, duration of the stay in the unit, age, and QLI. Our analysis of long-term deterioration showed that advanced age, high QLI before admission, and the patient's diagnostic group explained the degree of deterioration. DISCUSSION: QLI was a useful instrument for obtaining a quantitative estimate of the QL of critically ill patients.