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Activity of an Intermediate Respiratory Care Unit Attached to a Respiratory Medicine Department
Actividad de una unidad de cuidados respiratorios intermedios dependiente de un servicio de neumología
Ernest Sala
, Catalina Balaguer, Miguel Carrera, Alexandre Palou, Juana Bover, Àlvar Agustí
Servei de Pneumologia, Hospital Universitari Son Dureta, Fundació Caubet-Cimera, Palma de Mallorca, Islas Baleares, CIBER (Centro de Investigación Biomédica en Red) de Enfermedades Respiratorias (CibeRes), Spain
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"nombre" => "Miguel" "apellidos" => "Carrera" ] 3 => array:2 [ "nombre" => "Alexandre" "apellidos" => "Palou" ] 4 => array:2 [ "nombre" => "Juana" "apellidos" => "Bover" ] 5 => array:2 [ "nombre" => "Àlvar" "apellidos" => "Agustí" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servei de Pneumologia, Hospital Universitari Son Dureta, Fundació Caubet-Cimera, Palma de Mallorca, Islas Baleares, CIBER (Centro de Investigación Biomédica en Red) de Enfermedades Respiratorias (CibeRes), Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Actividad de una unidad de cuidados respiratorios intermedios dependiente de un servicio de neumología" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-12-21" "fechaAceptado" => "2008-09-15" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec155658" "palabras" => array:3 [ 0 => "Respiratory intermediate care units" 1 => "Noninvasive ventilation" 2 => "COPD" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155659" "palabras" => array:3 [ 0 => "Unidad de cuidados respiratorios intermedios" 1 => "Ventilación no invasiva" 2 => "EPOC" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background and objective</span><p class="elsevierStyleSimplePara elsevierViewall">With the development of noninvasive ventilation (NIV), patients with increasingly complex needs have been admitted to respiratory medicine departments. For this reason, such departments in Spain and throughout Europe have been adding specialized respiratory intermediate care units (RICUs) for monitoring and treating patients with severe respiratory diseases. The aim of the present study was to describe the activity of such a RICU. The description may be of use in facilitating the setting up of RICUs in other hospitals of the Spanish National Health Service.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">A systematic record of activity carried out in the RICU of the Hospital Universitario Son Dureta between January and December 2006 was kept prospectively.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of 206 patients with a mean (SD) age of 65 (14) years admitted to the unit, 67% came from the emergency department, 14% from the respiratory medicine department, and 12% from the intensive care unit (ICU). The most common admission diagnoses were exacerbated chronic obstructive pulmonary disease (COPD) (n= 97, 47.1%), pneumonia (n=39, 18.9%), heart failure (n=17, 8.2%), and pulmonary vascular diseases (n=18, 8.7%). One hundred twenty-one patients (59%) required NIV. Mean length of stay in the RICU was 5 (5) days. Patients were discharged to the conventional respiratory ward in 79.1% of the cases; 7.8% required subsequent admission to the ICU, and 9.7% died. Of the patients with exacerbated COPD (mean age, 66.5 [10] years; mean length of stay, 4.6 [4.5] days), 67% required NIV, 7.2% required subsequent admission to the ICU, and 8.2% died.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The creation of a RICU by a respiratory medicine department is viable in Spain. Such units make it possible to treat a large number of patients with a low rate of therapeutic failures. Exacerbated COPD was the most common diagnosis on admission to our RICU, and the need for NIV the most common criterion for admission.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">El desarrollo de la ventilación no invasiva (VNI) ha aumentado la complejidad de los pacientes ingresados en los servicios de neumología. Por ello, en España y Europa se están incorporando unidades especiales para el seguimiento y tratamiento de pacientes con enfermedades respiratorias graves: las unidades de cuidados respiratorios intermedios (UCRI). El objetivo del presente estudio ha sido describir la actividad de una UCRI dependiente de un servicio de neumología. Esta información puede ser un punto de referencia útil que facilite la implementación de las UCRI en otros hospitales del Sistema Nacional de Salud español.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">De enero a diciembre de 2006, ambos inclusive, se recogió de forma prospectiva y sistemática la actividad realizada en la UCRI del Hospital Universitario Son Dureta.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Ingresaron 206 pacientes, cuya edad media (± desviación estándar) era de 65 ± 14 años. Los Servicios de Urgencias y Neumología y la Unidad de Cuidados Intensivos (UCI) aportaron, respectivamente, el 67, el 14 y el 12% de todos los ingresos. Los principales diagnósticos de ingreso fueron: agudización de la enfermedad pulmonar obstructiva crónica (EPOC, con 97 casos; 47%), neumonía (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>39; 19%), insuficiencia cardíaca (n = 17; 8,2%) y enfermedades vasculares pulmonares (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>18; 8,7%). Del total de pacientes, 121 (59%) precisaron VNI. La estancia media fue de 5 ± 5 días. El 79% recibió el alta a camas de hospitalización convencional del propio Servicio de Neumología, el 8% requirió ingreso posterior en la UCI y el 9,7% falleció. De los pacientes con agudización de la EPOC (edad media: 66,5 ± 10 años; estancia media: 4,6 ± 4,5 días), el 67% precisó VNI, el 7,2% requirió un ingreso posterior en la UCI y el 8,2% falleció.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">En nuestro país es viable la creación de una UCRI dependiente del Servicio de Neumología. Estas unidades permiten desarrollar una alta actividad asistencial con un bajo porcentaje de fracasos terapéuticos. La agudización de la EPOC fue el diagnóstico de ingreso más habitual en nuestra UCRI, y la necesidad de tratamiento con VNI, el criterio de ingreso más frecuente.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Funding for the purchase of some of the ventilation and monitoring equipment for the Respiratory Intermediate Care Unit was provided by ABEMAR.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intermediate respiratory intensive care units: definitions and characteristics" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Torres" 1 => "M. Ferrer" 2 => "J.B. Blanquer" 3 => "M. Calle" 4 => "V. Casolive" 5 => "J.M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 1 | 1 | 2 |
| 2024 October | 29 | 18 | 47 |
| 2024 September | 35 | 13 | 48 |
| 2024 August | 47 | 34 | 81 |
| 2024 July | 31 | 22 | 53 |
| 2024 June | 43 | 21 | 64 |
| 2024 May | 27 | 21 | 48 |
| 2024 April | 17 | 21 | 38 |
| 2024 March | 27 | 20 | 47 |
| 2024 February | 16 | 13 | 29 |
| 2023 March | 2 | 0 | 2 |
| 2023 February | 20 | 17 | 37 |
| 2023 January | 20 | 34 | 54 |
| 2022 December | 23 | 24 | 47 |
| 2022 November | 23 | 11 | 34 |
| 2022 October | 19 | 50 | 69 |
| 2022 September | 18 | 27 | 45 |
| 2022 August | 15 | 27 | 42 |
| 2022 July | 19 | 43 | 62 |
| 2022 June | 13 | 20 | 33 |
| 2022 May | 21 | 17 | 38 |
| 2022 April | 19 | 26 | 45 |
| 2022 March | 15 | 36 | 51 |
| 2022 February | 19 | 19 | 38 |
| 2022 January | 15 | 29 | 44 |
| 2021 December | 20 | 63 | 83 |
| 2021 November | 23 | 55 | 78 |
| 2021 October | 18 | 50 | 68 |
| 2021 September | 16 | 76 | 92 |
| 2021 August | 19 | 27 | 46 |
| 2021 July | 15 | 38 | 53 |
| 2021 June | 22 | 43 | 65 |
| 2021 May | 6 | 31 | 37 |
| 2021 April | 26 | 67 | 93 |
| 2021 March | 27 | 25 | 52 |
| 2021 February | 10 | 27 | 37 |
| 2021 January | 13 | 19 | 32 |
| 2020 December | 11 | 18 | 29 |
| 2020 November | 5 | 12 | 17 |
| 2020 October | 13 | 10 | 23 |
| 2020 September | 5 | 5 | 10 |
| 2020 August | 15 | 19 | 34 |
| 2020 July | 16 | 21 | 37 |
| 2020 June | 6 | 4 | 10 |
| 2020 May | 12 | 20 | 32 |
| 2020 April | 13 | 17 | 30 |
| 2020 March | 14 | 11 | 25 |
| 2020 February | 15 | 18 | 33 |
| 2020 January | 19 | 21 | 40 |
| 2019 December | 13 | 15 | 28 |
| 2019 November | 13 | 13 | 26 |
| 2019 October | 10 | 6 | 16 |
| 2019 September | 5 | 7 | 12 |
| 2019 August | 14 | 8 | 22 |
| 2019 July | 23 | 14 | 37 |
| 2019 June | 5 | 9 | 14 |
| 2019 May | 18 | 11 | 29 |
| 2019 April | 44 | 12 | 56 |
| 2019 March | 19 | 21 | 40 |
| 2019 February | 8 | 10 | 18 |
| 2019 January | 4 | 6 | 10 |
| 2018 December | 9 | 6 | 15 |
| 2018 November | 19 | 13 | 32 |
| 2018 October | 19 | 14 | 33 |
| 2018 September | 9 | 6 | 15 |
| 2018 May | 5 | 1 | 6 |
| 2018 April | 12 | 11 | 23 |
| 2018 March | 3 | 2 | 5 |
| 2018 February | 6 | 8 | 14 |
| 2018 January | 9 | 8 | 17 |
| 2017 December | 4 | 6 | 10 |
| 2017 November | 6 | 4 | 10 |
| 2017 October | 10 | 12 | 22 |
| 2017 September | 3 | 4 | 7 |
| 2017 August | 10 | 14 | 24 |
| 2017 July | 8 | 7 | 15 |
| 2017 June | 14 | 26 | 40 |
| 2017 May | 15 | 14 | 29 |
| 2017 April | 2 | 2 | 4 |
| 2017 March | 6 | 8 | 14 |
| 2017 February | 7 | 8 | 15 |
| 2017 January | 2 | 7 | 9 |
| 2016 December | 2 | 7 | 9 |
| 2016 November | 5 | 5 | 10 |
| 2016 October | 5 | 11 | 16 |
| 2016 September | 6 | 5 | 11 |
| 2016 August | 7 | 4 | 11 |
| 2016 July | 3 | 2 | 5 |
| 2016 March | 4 | 0 | 4 |
| 2015 December | 1 | 0 | 1 |
| 2015 October | 43 | 6 | 49 |
| 2015 September | 42 | 6 | 48 |
| 2015 August | 45 | 8 | 53 |
| 2015 July | 47 | 7 | 54 |
| 2015 June | 52 | 5 | 57 |
| 2015 May | 47 | 9 | 56 |
| 2015 April | 43 | 5 | 48 |
| 2015 March | 35 | 8 | 43 |
| 2015 February | 32 | 6 | 38 |
| 2015 January | 32 | 4 | 36 |
| 2014 December | 29 | 8 | 37 |
| 2014 November | 20 | 8 | 28 |
| 2014 October | 35 | 9 | 44 |
| 2014 September | 35 | 8 | 43 |
| 2014 August | 38 | 10 | 48 |
| 2014 July | 34 | 9 | 43 |
| 2014 June | 37 | 9 | 46 |
| 2014 May | 39 | 13 | 52 |
| 2014 April | 51 | 9 | 60 |
| 2014 March | 57 | 14 | 71 |
| 2014 February | 55 | 10 | 65 |
| 2014 January | 35 | 14 | 49 |
| 2013 December | 40 | 9 | 49 |
| 2013 November | 42 | 5 | 47 |
| 2013 October | 81 | 11 | 92 |
| 2013 September | 68 | 8 | 76 |
| 2013 August | 44 | 7 | 51 |
| 2013 July | 84 | 10 | 94 |
| 2013 June | 158 | 5 | 163 |
| 2013 May | 40 | 6 | 46 |
| 2013 April | 26 | 3 | 29 |
| 2013 March | 8 | 3 | 11 |
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