Handover in Intensive Care.

Handover is a frequent and complex task that also implies the transfer of the responsibility of the care. The deficiencies in this process are associated with important gaps in clinical safety and also in patient and professional dissatisfaction, as well as increasing health cost. Efforts to standardize this process have increased in recent years, appearing numerous mnemonic tools.

Non-Invasive Mechanical Ventilation Versus Continuous Positive Airway Pressure Relating to Cardiogenic Pulmonary Edema in an Intensive Care Unit.

Background: To compare the application of non-invasive ventilation (NIV) versus continuous positive airway pressure (CPAP) in the treatment of patients with cardiogenic pulmonary edema (CPE) admitted to an intensive care unit (ICU).

Methods: In a prospective, randomized, controlled study performed in an ICU, patients with CPE were assigned to NIV (n=56) or CPAP (n=54). Primary outcome was intubation rate.

[Ten-year evolution of mechanical ventilation in acute respiratory failure in the hematogical patient admitted to the intensive care unit].

Objective: A comparison was made between invasive mechanical ventilation (IMV) and noninvasive positive pressure ventilation (NPPV) in haematological patients with acute respiratory failure.

Design: A retrospective observational study was made from 2001 to December 2011.

Setting: A clinical-surgical intensive care unit (ICU) in a tertiary hospital.

[Techniques available for hemodynamic monitoring. Advantages and limitations].

The pulmonary artery catheter has been a key tool for monitoring hemodynamic status in the intensive care unit for nearly 40 years. During this period of time, it has been the hemodynamic monitoring technique most commonly used for the diagnosis of many clinical situations, allowing clinicians to understand the underlying cardiovascular physiopathology, and helping to guide treatment interventions. However, in recent years, the usefulness of pulmonary artery catheterization has been questioned.

[Noninvasive mechanical ventilation in severe pneumonia due to H1N1 virus].

Objective: The use of noninvasive mechanical ventilation was evaluated in our series of patients admitted to our ICU with pneumonia due to influenza A virus H1N1, assessing the need for intubation, arterial blood gases and clinical improvement, the development of complications and ICU and hospital stay.

Design: Retrospective and observational study.

Setting: ICU of Castellón University General Hospital (Castellón, Spain).

[Study of post-ICU mortality during 4 years (2006-2009). Analysis of the factors related to death in the ward after discharge from the ICU].

Objective: To detect possible reasons for mortality of critical patients transferred from the ICU to the hospital wards and to analyze the possible attributable causes for such mortality.

Design: An observational study of prospectively collected data, analyzed retrospectively.

Population: Cohort analysis of 5328 with consecutive admissions to our ICU, whose evolution was followed up to hospital discharge or death.

[Patient data management systems or unit data management systems. Two clinical management perspectives in Intensive Medicine].

The need of availability of information able to describe the activity performed in ICU has two different sides. The first related with the monitoring of the patient himself, his clinical situation changes and the checking of attitudes and reactions of the clinical team related to these changes. The other one focused on the possibility to describe appropriately the general activity of the unit, the epidemiological characteristics of the attended population and the indicators of efectitivity and efficiency that could be used for a continous quality improving.