RESUMO: Objetivo: identificar os pacientes e os fatores de risco associados à ocorrência de infecções relacionadas à assistência à saúde em unidades de terapia intensiva. Método: estudo transversal realizado com 155 pacientes internados entre 2012 e 2014 em duas unidades de terapia intensiva de dois hospitais públicos do Distrito Federal. Os dados foram coletados em prontuário e registrados em planilha no programa Microsoft Excel®. Foram considerados significativos resultados com p-value<0,05. Resultados: do total de 155 pacientes, 55 (35,5%) pacientes foram acometidos por infecções relacionadas à assistência à saúde durante a internação na unidade de terapia intensiva. Tempo de internação (p=0,001), internação por causas clínicas (p=0,017), diabetes mellitus (p=0,002) e cirurgia eletiva (p=0,011), foram fatores de risco, independentes para essas infecções. Conclusão: as complicações infecciosas acometeram cerca de um terço dos pacientes no cenário de terapia intensiva. A vigilância dessas complicações pode orientar ações para melhoria da segurança do paciente crítico. DESCRITORES: Infecção hospitalar; Unidades de terapia intensiva; Fatores de risco; Hospitais públicos; Pacientes. RISK FACTORS FOR HEALTHCARE-ASSOCIATED INFECTIONS IN INTENSIVE CARE UNITSABSTRACT: Objective: to identify patients and risk factors related to the occurrence of healthcare-associated infections in intensive care units. Method: cross-sectional study with 155 hospitalized patients between 2012 and 2014 in two intensive care units of two public hospitals of the Federal District. Data were collected from the medical records and recorded in a spreadsheet using the Microsoft Excel® program. Results with p-value <0.05 were considered significant. Results: of the total of 155 patients, 55 (35.5%) patients were affected by healthcare-associated infections during hospitalization in the intensive care unit. Length of stay (p=0.001), hospitalization due to clinical causes (p=0.017), diabetes mellitus (p=0.002) and elective surgery (p=0.011) were independent risk factors for these infections. Conclusion: infectious complications affected approximately one third of the patients in the intensive care setting. Surveillance of these complications may guide actions to improve the safety of critical patients. KEYWORDS: Cross Infection; Intensive care units; Risk factors; Hospitals, public; Patients. FACTORES DE RIESGO A INFECCIONES ASOCIADAS A LA ASISTENCIA EN UNIDADES DE TERAPIA INTENSIVA*RESUMEN: Objetivo: identificar los pacientes y los factores de riesgo asociados a la ocurrencia de infecciones relacionadas a la asistencia a la salud en unidades de terapia intensiva. Método: estudio transversal realizado con 155 pacientes internados entre 2012 y 2014 en dos unidades de terapia intensiva de dos hospitales públicos de Distrito Federal. Se recogieron los datos por medio de prontuario y se los registraron en programa Microsoft Excel®. Se consideraron significativos resultados con p-value<0,05. Resultados: del total de 155 pacientes, 55 (35,5%) pacientes ...
Objective: to verify whether the use of invasive mechanical ventilation (IMV) with positive pressure predisposes to the appearance of acute kidney injury (AKI) in critically ill patients. Method: prospective cohort of quantitative approach developed in intensive care unit (ICU) of a public hospital. Eligible patients were selected by convenience sampling. For data collection, a questionnaire consisting of items on clinical and laboratory variables was applied. The information was extracted from the medical records during a period of 15 days. Data analysis was descriptive and inferential. Significant results with p≤0.05 were considered significant. Results: hypertension was among the most incident comorbidities (29. 1%) of the 79 patients evaluated. Among the patients analyzed, 59.5% required IMV with PEEP ≥10 cmH 2 O. Of the total number of patients, 91. 1% evolved with renal dysfunction, according to the KDIGO classification. As an outcome, 34.2% of patients died. Patients who used PEEP >5 cmH 2 0 showed significant predisposition to renal dysfunction (p≤0.05). Conclusion: invasive mechanical ventilation with positive pressure (PEEP) was a factor that contributed to aggravate renal function in different gradations. It was found that patients receiving IMV with PEEP >5 cmH 2 O are more predisposed to the onset of AKI in the ICU, due to the tendency to advanced age, overweight, long time of mechanical ventilation and also hypertension.
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