Mitzy Tannia Reichembach Danski

Ensaio clínico controlado sobre o curativo de cateter venoso central

Objective: To evaluate the effectiveness of gauze and tape as compared to transparent polyurethane film for dressing central venous catheters. Methods: A randomized controlled clinical trial was conducted. Results: No significant difference was identified in catheterrelated infection (p = 1) or the stability of the dressing (p = 0.670). There was no statistically significant difference with respect to the absorption of exudate (p <0.001). The likelihood of local reaction in the control group (gauze and tape) was different from the study group (p = 0.024). Conclusion: The type of dressing does not decrease the incidence of catheter-related infection, the binding capacity is similar, and the gauze dressing has the capacity to absorb exudate. However, the gauze dressing resulted in a higher probability of developing a local reaction. Record WHO: ACTRN12609000951257.

Uso da Calendula officinalis na prevenção e tratamento de radiodermatite: ensaio clínico randomizado duplo cego

OBJETIVO Avaliar a eficacia da Calendula officinalis em relacao aos Acidos Graxos Essenciais na prevencao e tratamento de radiodermatite. METODO Trata-se de ensaio clinico randomizado duplo cego realizado com 51 pacientes com câncer de cabeca e pescoco em tratamento radioterapico divididos em dois grupos: controle (27) e experimental (24). RESULTADOS Ha evidencia estatistica significativa (p-valor = 0,0120) de que a proporcao de radiodermatite grau 2 no Grupo Acidos Graxos Essenciais e superior ao Grupo Calendula. Por meio da curva de Kaplan-Meier observa-se que a sobrevida do Grupo Acidos Graxos Essenciais manteve-se sempre abaixo da curva de sobrevida do Grupo Calendula, devido ao menor risco de desenvolver radiodermatite grau 1, o que torna a utilizacao da Calendula mais eficaz, com significância estatistica (p-valor = 0,00402). CONCLUSAO A Calendula exibiu melhor resposta terapeutica do que o Acidos Graxos Essenciais na prevencao e tratamento da radiodermatite. Registro Brasileiro de Ensaios Clinicos: RBR-237v4b.OBJECTIVE To evaluate the efficacy of Calendula officinalis in relation to Essential Fatty Acids for the prevention and treatment of radiodermatitis. METHOD This is a randomized double-blind controlled clinical trial with 51 patients with head and neck cancer in radiotherapy treatment divided into two groups: control (27) and experimental (24). RESULTS There is statistically significant evidence (p-value = 0.0120) that the proportion of radiodermatitis grade 2 in Essential Fatty Acids group is higher than Calendula group. Through the Kaplan-Meier survival curve we observed that Essential Fatty Acids group has always remained below the Calendula group survival curve, due to the lower risk of developing radiodermatitis grade 1, which makes the usage of Calendula more effective, with statistical significance (p-value = 0.00402). CONCLUSION Calendula showed better therapeutic response than the Essential Fatty Acids in the prevention and treatment of radiodermatitis. Brazilian Registry of Clinical Trials: RBR-237v4b.

Uso De La Calendula Officinalis En La Prevención Y Tratamiento De Radiodermatitis: Ensayo Clínico Randomizado Doble Ciego

OBJETIVO Avaliar a eficacia da Calendula officinalis em relacao aos Acidos Graxos Essenciais na prevencao e tratamento de radiodermatite. METODO Trata-se de ensaio clinico randomizado duplo cego realizado com 51 pacientes com câncer de cabeca e pescoco em tratamento radioterapico divididos em dois grupos: controle (27) e experimental (24). RESULTADOS Ha evidencia estatistica significativa (p-valor = 0,0120) de que a proporcao de radiodermatite grau 2 no Grupo Acidos Graxos Essenciais e superior ao Grupo Calendula. Por meio da curva de Kaplan-Meier observa-se que a sobrevida do Grupo Acidos Graxos Essenciais manteve-se sempre abaixo da curva de sobrevida do Grupo Calendula, devido ao menor risco de desenvolver radiodermatite grau 1, o que torna a utilizacao da Calendula mais eficaz, com significância estatistica (p-valor = 0,00402). CONCLUSAO A Calendula exibiu melhor resposta terapeutica do que o Acidos Graxos Essenciais na prevencao e tratamento da radiodermatite. Registro Brasileiro de Ensaios Clinicos: RBR-237v4b.OBJECTIVE To evaluate the efficacy of Calendula officinalis in relation to Essential Fatty Acids for the prevention and treatment of radiodermatitis. METHOD This is a randomized double-blind controlled clinical trial with 51 patients with head and neck cancer in radiotherapy treatment divided into two groups: control (27) and experimental (24). RESULTS There is statistically significant evidence (p-value = 0.0120) that the proportion of radiodermatitis grade 2 in Essential Fatty Acids group is higher than Calendula group. Through the Kaplan-Meier survival curve we observed that Essential Fatty Acids group has always remained below the Calendula group survival curve, due to the lower risk of developing radiodermatitis grade 1, which makes the usage of Calendula more effective, with statistical significance (p-value = 0.00402). CONCLUSION Calendula showed better therapeutic response than the Essential Fatty Acids in the prevention and treatment of radiodermatitis. Brazilian Registry of Clinical Trials: RBR-237v4b.

Clinical controlled trial on central venous catheter dressings

Objective: To evaluate the effectiveness of gauze and tape as compared to transparent polyurethane film for dressing central venous catheters. Methods: A randomized controlled clinical trial was conducted. Results: No significant difference was identified in catheterrelated infection (p = 1) or the stability of the dressing (p = 0.670). There was no statistically significant difference with respect to the absorption of exudate (p <0.001). The likelihood of local reaction in the control group (gauze and tape) was different from the study group (p = 0.024). Conclusion: The type of dressing does not decrease the incidence of catheter-related infection, the binding capacity is similar, and the gauze dressing has the capacity to absorb exudate. However, the gauze dressing resulted in a higher probability of developing a local reaction. Record WHO: ACTRN12609000951257.

[Peripherally inserted central catheter care in neonates: an integrative literature review].

O cateter central de insercao periferica e tecnologia comum empregada na terapia intravenosa de neonatos. Trata-se de revisao integrativa, cujo objetivo foi investigar e analisar as evidencias disponiveis na literatura acerca da tematica. As bases de dados pesquisadas foram Literatura Latino-Americana e do Caribe em Ciencias da Saude (LILACS) e Biblioteca Nacional de Medicina dos Estados Unidos (PubMed). Resultados apontam lacunas no que tange a populacao neonatal; conhecimento insuficiente dos profissionais quanto indicacoes (n=1); e variados temas sobre uso de anticoagulantes (n=6), comparacao com outros cateteres (n=4), diagnostico por imagem (n=2), dor (n=2), infeccao relacionada a cateter e sua prevencao (n=7), entre outros fatores. Conclui-se que ha necessidade de atualizacao profissional, evidencias cientificas de facil acesso e publicacoes nacionais.The peripherally inserted central catheter is a common technology employed in the intravenous therapy of neonates. This integrative review was performed with the objective to investigate and analyze the evidence available in the literature regarding this technology. The databases searched included the Latin American and Caribbean Health Sciences Literature (LILACS) and the United States National Library of Medicine (PubMed). Results point at gaps in relation to their use in the neonatal population (n=1); various themes regarding the use of anticoagulants (n=6), comparison with other catheters (n=4), diagnostic imaging (n=2), pain (n=2), and catheter-relation infection and its prevention (n=7), among others. There is a need for staff education regarding their use; scientific evidence with easy access; and national publications regarding their use.

Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates

OBJETIVO Avaliar a incidencia de complicacoes relacionadas ao uso do cateter intravenoso periferico em neonatos e identificar fatores de risco associados. METODO Coorte prospectiva, realizada em Unidade de Terapia Intensiva Neonatal. Os participantes foram os neonatos internados submetidos a puncao intravenosa periferica, no periodo de fevereiro a junho de 2013. RESULTADOS A incidencia de complicacoes foi de 63,15%, sendo infiltracao/extravasamento (69,89%), flebite (17,84%) e obstrucao (12,27%). Os fatores de risco foram: presenca de infeccao (p=0,0192) e peso no dia da puncao (p=0,0093), tipo de infusao intermitente associada a continua (p<0,0001), intubacao orotraqueal (p=0,0008), infusao de plano basico (p=0,0027), nutricao parenteral total (p=0,0002), hemotransfusao associada a outras infusoes (p=0,0003) e outros medicamentos (p=0,0004). Maior risco de desenvolver complicacao nas primeiras 48 horas pos-puncao. CONCLUSAO Uma taxa elevada de complicacoes relacionadas ao uso do cateter intravenoso periferico e fatores de risco associados a infeccao, peso, drogas e solucoes infundidas e tipo de infusao.OBJECTIVE To evaluate the incidence of complications related to the use of peripheral intravenous catheter in neonates and identify the associated risk factors. METHOD Prospective cohort study conducted in a Neonatal Intensive Care Unit. Participants were the hospitalized neonates undergoing peripheral intravenous puncture in the period from February to June 2013. RESULTS The incidence of complications was 63.15%, being infiltration/extravasation (69.89%), phlebitis (17.84%) and obstruction (12.27%). The risk factors were the presence of infection (p = 0.0192) and weight at the puncture day (p = 0.0093), type of intermittent infusion associated with continuous infusion (p <0.0001), endotracheal intubation (p = 0.0008), infusion of basic plan (p = 0.0027), total parenteral nutrition (P = 0.0002), blood transfusion associated with other infusions (p = 0.0003) and other drugs (p = 0.0004). Higher risk of developing complications in the first 48 hours after puncture. CONCLUSION A high rate of complications related to the use of peripheral intravenous catheter, and risk factors associated with infection, weight, drugs and infused solutions, and type of infusion.

Chlorhexidine and gauze and tape dressings for central venous catheters: a randomized clinical trial

OBJECTIVE: to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters. METHOD: a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing) or control (gauze and micro porous tape) groups. RESULTS: a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170); local reactions to the dressing (p-value = 0.3774); and dressing fixation (p-value = 0.2739). CONCLUSION: both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.OBJECTIVE: to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters. METHOD: a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing) or control (gauze and micro porous tape) groups. RESULTS: a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170); local reactions to the dressing (p-value = 0.3774); and dressing fixation (p-value = 0.2739). CONCLUSION: both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.

Prevenção de úlceras por pressão no calcanhar com filme transparente de poliuretano

OBJECTIVE: Evaluate the effectiveness of transparent polyurethane film in prevention of pressure ulcer of the calcaneus. Methods: A sample of 100 patients enrolled in a non-randomized controlled trialreceived a paired analysis of both calcaneus areas; each received the experimental intervention on the left heel and the control intervention on the right heel (clinical guideline only), constituting a total of 200 heel sites for analysis. RESULTS: The incidence of pressure ulcers was 32%, with 6% occurring in the experimental intervention, 18% in the control intervention, and 8% bilaterally, with significant incidence in the first 15 days of hospitalization. The length of time without pressure ulcers occurrence with the experimental intervention was 19.2 days, with a 95% confidence interval. CONCLUSION: It was concluded that the transparent polyurethane film associated with the pressure ulcers clinical guideline was effective in the prevention of heel pressure ulcer.

Incidência de complicações locais no cateterismo venoso periférico e fatores de risco associados

Objective To estimate the incidence of local complications associated with peripheral catheters and identify risk factors for the development of most common complications. Methods This prospective cohort study included 92 adult inpatients at clinical and surgical units who had peripheral catheterization. By daily observance of the catheters we determined time of permanence and local complications due to the use of a complete safety catheter. All actions began after training of nursing teams. Statistical tests used were the Fisher exact test, G test (Williams), chi-square, Mann-Whitney U test, and relative risk. Results Local complications occurred in 56.2% of cases. Time of catheter permanence over 72 hours increased the risk for phlebitis development in 2.34% of cases (RR; p=0.0483; CI [0.91; 6.07]). Conclusion Incidence of local complications was high. Phlebitis was the predominant complication and the time of catheter permanence over 72 hours was a considered risk factor for this complication.

Infection, local reaction and poor fixation of dressings for central venous catheter

OBJECTIVE: To identify factors related to the occurrence of infection, local reaction and poor fixation of dressings for central venous catheters.METHODS: Randomized clinical trial conducted with adult patients using central venous catheter for short periods, hospitalized in intensive and semi-intensive care units of a university hospital.RESULTS: 85 patients (43 chlorhexidine dressings; 42 gauze and tape). Use of blood component increases the chance of catheter-related infection; use of dressings for more than three days increases the chance of local reaction; catheter in the jugular vein increases the chance of poor fixation of the dressing. Catheter permanence for more than five days increases the chance of infection, local reaction and poor fixation.CONCLUSION: Both dressings are effective to cover central venous catheters and can be used for this purpose.