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Background: We aimed to examine whether using a high fraction of inspired oxygen (FIO 2 ) in the context of an individualised intra-and postoperative open-lung ventilation approach could decrease surgical site infection (SSI) in patients scheduled for abdominal surgery. Methods: We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO 2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality. Results: We enrolled 740 subjects: 371 in the high FIO 2 group and 369 in the low FIO 2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO 2 groups (relative risk [RR]: 0.94; 95% confidence interval [CI]: 0.59e1.50; P¼0.90]). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48e1.25; P¼0.38) and myocardial ischaemia (0.6% [n¼2] vs 0% [n¼0]; P¼0.47) did not differ between groups. Conclusions: An oxygenation strategy using high FIO 2 compared with conventional FIO 2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found. Clinical trial registration: NCT02776046.

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The intraoperative and postoperative use of modern hydroxyethyl starch 6% HES 130/0.4 was not associated with increased risks of AKI and dialysis after cardiac surgery in our multicentre cohort.

Campiño-Valderrama SM, Duque PA. Afrontamiento y adaptación de cuidadores de niños y niñas con cáncer. Univ. Salud. 2016;18(2):302-311. DOI: http://dx.doi.org/10.22267/rus.161802.40 Resumen Objetivo: Identificar la capacidad de afrontamiento y adaptación de cuidadores de niños y niñas con cáncer teniendo como referente el modelo de adaptación de Callista Roy. Materiales y métodos: Estudio con enfoque cuantitativo de tipo descriptivo y de corte transversal, cuya muestra estuvo constituida por 23 cuidadoras principales de niños y niñas con cáncer que se encontraban hospitalizados o asistían a quimioterapia ambulatoria. Para la recolección de la información se utilizó la Escala de Medición del Proceso de Afrontamiento y Adaptación de Callista Roy versión abreviada en español. Resultados: El 100% de los cuidadores principales eran madres y abuelas. El 56,5% de ellas se presentaba en un afrontamiento alto y el 43,5% afrontamiento medio. Las cuidadoras que demostraron afrontamiento alto se ubican en el grupo de las que se encontraban solteras y casadas, pertenecientes al estrato uno, con nivel de escolaridad bachiller completo y llevaban menos de un año a cargo del cuidado. Los resultados por factores de afrontamiento demuestran reacciones, comportamientos y estrategias utilizadas para hacer frente a los problemas difíciles mediante un afrontamiento activo. Conclusión: Las características del cuidador y las estrategias utilizadas para conseguir respuestas adaptativas, deben ser aprovechadas por enfermería para promover un modelo de cuidado integral donde se aborde no solamente al niño o niña, sino también a su familia y entorno, con el fin de posibilitar un afrontamiento integrado.Palabras clave: Cuidadores; estrategias de afrontamiento; adaptación psicológica. (Fuente: DeCS, Bireme). AbstractObjective: To identify the coping capacity and adaptation of caregivers of children with cancer taking as reference the adaptation model of Callista Roy. Materials and methods: A descriptive and cross-sectional study with a quantitative approach, whose sample consisted of 23 primary caregivers of children with cancer, who were hospitalized or attending outpatient chemotherapy. The Measurement Scale of Coping and Adaptation Process of Callista Roy abridged version in Spanish was used for data collection. Results: 100% of primary caregivers were mothers and grandmothers. 56.5% of them presented high coping and 43.5% an average one. Carers who demonstrated high coping were single and married, belonging to strata 1, with full high school education level and were in charge of care for less than a year. The results by factors of coping demonstrate reactions, behaviors and strategies used to address difficult problems through an active coping. Conclusion: The characteristics of the caregiver and the strategies used to achieve Universidad y Salud SECCIÓN DE ARTÍCULOS ORIGINALES