INTENSIVE CARE

Author: de la Chica Ruiz-Ruano Rafael.
Year: 2005.
University: GRANADA [More theses of this university] [www.ugr.es].
Place of defense: Facultad de Medicina.
Place of preparation: Facultad de Medicina.

Summary: INTRODUCTION: The techniques of cardiopulmonary resuscitation (CPR) were introduced at the beginning of the sixties. Its use spread rapidly in the middle as intra extrahospitalario view of the evidence of their effectiveness in saving lives of sick suffered a stop cardiorespiratory (PCR). However, both internationally and in a particularly acute at the national level, the data available PCR intrahospital are very scarce and incomplete. In addition the results of the PCR attention to depend on a multitude of factors associated with the type of patient and the system of organizing the response, so it is difficult to make comparisons between different areas and centers. Therefore it is recommended that reports be made a pattern standardized and universal: the style Utstein.

Author: DOMÍNGUEZ BERROT ANA MARÍA.
Year: 2005.
University: VALLADOLID [More theses of this university] [www.uva.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: UNIVERSIDAD DE VALLADOLID.

Summary: It tries to find out whether the analysis of the variability of respiratory pattern of patients undergoing Weaning from mechanical ventilation may have prognostic value, which allows us to know in advance which patients can be freed from the artificial respiratory support and which are not. It also has interest from the point of view pathophysiologic, find differences or similarities with the variability of respiratory pattern in healthy volunteers.

Author: Badia Castelló Maria.
Year: 2006.
University: LLEIDA [More theses of this university] [www.udl.es].
Place of defense: Facultat de Medicina. Universitat de Lleida.
Place of preparation: Facultat de Medicina. Universitat de Lleida.

Summary: INTRODUCTION: The admission to the ICU, critical illness, the environment and the ICU intensive treatment involving a variation on the usual conditions of life with consequences for the patient, his family and society. Classically evaluation of the ICU was done through analysis of survival and physiological deterioration. It is now considered a priority assessment results through knowledge of the related quality of life (HRQOL) health beyond discharge. Furthermore it is interesting to know the impact of critical illness and its treatment on the patient's memory. OBJECTIVE: Analysis of changes in HRQOL pre-admission to the ICU and the 12 months of his high using two measuring instruments, the Short Form 36 (SF-36) and EuroQoL 5D (EQ-5D) and the relationship between the two instruments. It also assesses the emotional impact on the patient of UCI and the influence of treatment received. MATERIALS AND METHODS: Prospective study, consecutive patients admitted to the ICU in a period of 19 months. Measuring instruments HRQL: SF-36 and EQ-5D. Instrument measurement of memory through the tool ICUM (Intensive Care Unit Memory) and the scale of impact of the stressor (EIE) for the evaluation of the symptoms of post-traumatic stress disorder. RESULTS: During the time period from December 2001 to June 2003 were included 189 patients. The global quality of life showed a significant deterioration in the 12 months of discharge. Patients with brain impairment (traumatic origin or vascular) were the group of patients who were associated with poorer quality of life. The patient presented traumatic head trauma without severe physical limitations but unchanged your emotional state prior. Patients with respiratory disease accounted for only group improved on their HRQL. The comparison between the two instruments showed a strong correlation to the level of physical dimensions. The factorial analysis shows similarities between the two instruments, gaining 3 factors include physical function, and emotional pain. The 77.6% of the patients had any memory of their stay in ICU. The 41 patients who spoke memory illusory had a share of symptoms of post-traumatic stress significantly higher. The multiple logistic regression model showed as predictive factors of memory illusory treatment with propofol, dopamine and prolonged hospital stay. CONCLUSION: The quality of life must be assessed taking into account the diagnostic category that includes the patient in a few defined by age, sex and comorbidity. The SF-36 and EQ-5D are capable of detecting changes in the patient's HRQOL critical and despite some differences in structure and content measured similar aspects complementing one another. The evaluation results must include the measurement of psychological impact subjected. Knowledge of HRQOL (including the psychological impact) long-term critic of the patient allows patients to identify potential physical, mental and emotional health and channel efforts to improve their care. Keywords: Quality of life related to health, SF-36, EQ-5D, memory, post-traumatic stress, ICU