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Signa Vitae

Journal of Intensive Care and Emergency Medicine

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Lung replacement therapies for acute respiratory failure

Abstract

Acute respiratory failure is one of the critical conditions with an increased mortality. In order to reverse lung injury and reduce the mortality rate, several lung replacement therapies have been developed, including the extracorporeal membrane oxygenation, the intravascular oxygenator and carbon dioxide removal device, the intravenous membrane oxygenator and the thoracic artificial lung. This article aims to present the properties, indications and advantages of these devices.

Key words: artificial organs, extracorporeal membrane oxygenation, respiratory insufficiency

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Nursing and Implementation of Modern Technology

Abstract

Introduction. Implementation of technology in health care has become a global trend. The society modernization has led to the increasing development of technology and information systems. Nurses in everyday work encounter with the application of communications and information technologies. The implementation of modern technology in nursing increases nurses efficiency, but it is also changing the way of care for patients. Implementation of modern technology in nursing is the result of interactions between technical skills, culture and social acceptance in the working environment.

Aim. The aim of this article was to investigate the application of modern technology in nursing and how it affects the nursing profession, what competencies are required for the introduction of technology and the role of nurses in the process.

Materials and methods. PubMed database, OJIN base (Online Journal of Issues in Nursing), HCA (Hospital Corporation of America) were searched with the aim of finding appropriate studies and articles. Keywords which were used: nursing, modern technology, nursing challenges, education.

Results. During a search of the databases, we found seven articles of which according to the inclusion criteria for this study we used three. Data from the literature that was used showed that the application of modern technology in nursing is still in the initial process of adaptation.

Conclusion. Modern technology in the nursing profession is in its infancy, a lot of factors are contributing to slower development such as high cost, a shortage of nurses and training of medical staff to work with the new technology.

Key words: nursing, modern technology, nursing challenges, education

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Genetic determinants of survival

Abstract

The human genome comprises some 20,000 genes, or 3 billion base pairs. Variation in this genetic sequence is common and some of these variants affect gene function or the protein transcribed from it. Human characteristics are determined by the interaction of the genome with environmental challenges, and differences between us thus result from variation in those challenges and in the genome itself. This is true of human susceptibility to disease, and survival from it. Genetic variation influences human behaviours which may predispose to health or disease; the risk of contracting an infectious disease, or of suffering diseases such as cancer or myocardial infarction; the development of complications; the response to any treatment administered; and thus the outcome of the disease state. Genetic studies can help shed light on the mechanisms which underpin disease processes, whilst perhaps suggesting ways in which treatment might be ‘personalised’, and novel therapeutic targets for drug development.

More sophisticated approaches to such endeavours are required, given the failure to identify the bulk of gene variants of influence using conventional strategies.

Key words: gene, polymorphism, survival, genome

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Inhalation sedation with the ‘Anaesthetic Conserving Device’ for patients in intensive care units: A literature review

Abstract

Background. The Anaesthetic Conserving Device is a modified heat and moisture exchanger that enables the application of inhalation sedation with existing ventilators in intensive care units. The following review describes the advantages of inhalation sedation using the Anaesthetic Conserving Device in comparison to standard intravenous sedation for patients in intensive care units and highlights the technical aspects of its functioning.

Methods. The literature search was limited to PubMed, Sage Journals and CINAHL databases, using the terms »anaesthetic conserving device«, »volatile anaesthetic reflection filter«, »AnaConDa« independently and in connection with the terms »sedation« and »intensive care unit«. Included are articles published up until December 2014.

Results. Use of inhalation sedation with the Anaesthetic Conserving Device enables faster transition to spontaneous breathing and a shorter awakening time than with intravenous sedation. Even short-term inhalation sedation of patients after open heart procedures has a cardioprotective effect and reduces troponin T values. Despite increased concentrations of inorganic fluoride in serum after sevoflurane exposure, no clinical studies to date have shown its nephrotoxic effect, even after long-term (48 h) sedation. The Anaesthetic Conserving Device is accurate in maintaining target values of volatile anaesthetics. However, increased dead space volume was found in several studies, exceeding the internal volume of the Anaesthetic Conserving Device.

Conclusion. Results to date show that inhalation sedation with the Anaesthetic Conserving Device may be an effective and safe alternative to existing protocols of intravenous sedation for patients requiring intensive treatment.

Key words: anaesthetic conserving device, inhalational sedation, intravenous sedation, intensive care unit

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History of professional education on podiatry emergencies and disasters: a Spanish point of view

Abstract

Mainstreaming between podiatry practice and podiatry studies is needed. Podiatry practice evolution in Spain has allowed this medical discipline to obtain its own academic, institutional and legislative framework to increase and improve professional decisions in the podiatric medical practice. For that reason, there is a great interest and relevancy on emergencies and urgencies education in podiatry clinical and welfare activity. It is an essential component, the different and inherent risk conditions of welfare activity require to give an immediate, accurate and sure response that protects people life. Podiatry faculties could and should establish joint actions that integrate on an effective way the complexity and multiplicity of vital situations that the podiatric activity involves, as well as to establish strategic plans in the activity of professional podiatrists that come together in an improvement of graduates.

Key words: education, Emergency medicine, podiatry, disasters

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