Proyecto ASCyDValoración de la analgesia, sedación, contenciones y delirio en los pacientes ingresados en unidades de cuidados intensivos españolas. Proyecto ASCyD

Aims: Main aim: To determine the Spanish intensive care units (ICU) that assess and record pain levels, sedation/agitation, delirium and the use of physical restraint (PR) as standard practice. Secondary aims: To determine the use of validated assessment tools and to explore patients' levels of pain and sedation/agitation, the prevalence of delirium, and the use of PR. Method: An observational, descriptive, cross-sectional, prospective and multicentre study using an ad hoc survey with online access that consisted of 2 blocks. Block I: with questions on the unit's characteristics and routine practice; Block II: aspects of direct care and direct assessments of patients admitted to participating units. Results: One hundred and fifty-eight units and 1574 patients participated. The pain of communicative patients (CP) was assessed and recorded as standard in 109 units (69%), the pain of non-communicative patients (NCP) in 84 (53%), sedation/agitation in 111 (70%), and delirium in 39 units (25%). There was recorded use of PR in 39 units (25%). Validated scales were used to assess the pain of CP in 139 units (88%), of NCP in 102 (65%), sedation/agitation in 145 (92%), delirium in 53 units (34%). In 33 units (21%) pain, sedation/agitation and delirium of PC and NPC was assessed, and in 8 of these units there was a specific PR protocol and register. Among the patients who could be assessed, an absence of pain was reported in 57%, moderate pain in 27%; 48% were calm and collaborative, and 10% agitated; 21% had PR, and 12.6% of the patients had delirium. Conclusions: The assessment of pain, sedation and delirium is demonstrated, and low percentages of agitation and delirium achieved. We observed a high percentage of patients with pain, and moderate use of PC. We should generalise the use of protocols to assess, prevent and treat pain and delirium by appropriately managing analgesia, sedation, and individual and well-considered use of PC. (ClinicalTrials.gov Identifier: NCT03773874).Objetivos Objetivo principal: Conocer qué unidades de cuidados intensivos (UCI) españolas valoran y registran, de forma normalizada, niveles de dolor, sedación/agitación, delirio y uso de contenciones mecánicas (CM). Objetivos secundarios: Determinar la utilización de herramientas validadas de valoración y explorar los niveles de dolor y sedación/agitación de los pacientes, la prevalencia de deliro y el uso de CM. Método Estudio observacional, descriptivo, transversal, prospectivo y multicéntrico mediante una encuesta ad hoc con acceso on line, de 2 bloques: bloque 1, enfocado a preguntas sobre características de las unidades y práctica habitual, y bloque 2, sobre aspectos de asistencia directa y evaluaciones directas de pacientes ingresados en unidades participantes. Resultados Participaron 158 unidades y 1.574 pacientes. La valoración normalizada y el registro del dolor de pacientes comunicativos (PC) se realizaba en 109 unidades (69%), el dolor de pacientes no comunicativos (PNC) en 84 (53%), la sedación/agitación en 111 (70%), el delirio en 39 unidades (25%). Registrado el uso de CM en 39 unidades (25%). Se utilizaban escalas validadas para valorar el dolor en PC en 139 unidades (88%), en PNC en 102 (65%), sedación/agitación en 145 (92%), delirio en 53 unidades (34%). En 33 unidades (21%) se valoraba dolor a PC y PNC, sedación/agitación y delirio, y en 8 de estas unidades existía protocolo específico de CM y registro. Entre los pacientes que pudieron ser evaluados, se reportó ausencia de dolor en el 57%, dolor moderado en el 27%; tranquilos y colaboradores el 48%, y el 10% agitados; tenían CM el 21% y delirio el 12,6% de los pacientes. Conclusiones La valoración del dolor, sedación y delirio está acreditada, obteniéndose bajos porcentajes de pacientes con agitación y delirio. Observamos un elevado porcentaje de pacientes con dolor y moderado uso de la CM. Hay que generalizar el uso de protocolos para valorar, prevenir y tratar el dolor y el delirio mediante un adecuado manejo de la analgesia, de la sedación y un uso individual y reflexivo de las CM. (ClinicalTrials.gov Identifier: NCT03773874)Sin financiaciónNo data JCR 2020No data IDR 20200.239 SJR (2020) Q3, 31/61 Advanced and Specialized NursingUE

The K2-OjOS Project*New and revisited planets and candidates in K2 campaigns 5, 16, & 18

We present the first results of K2-OjOS, a collaborative project between professional and amateur astronomers primarily aimed to detect, characterize, and validate new extrasolar planets. For this work, 10 amateur astronomers looked for planetary signals by visually inspecting the 20 427 light curves of K2 campaign 18 (C18). They found 42 planet candidates, of which 18 are new detections and 24 had been detected in the overlapping C5 by previous works. We used archival photometric and spectroscopic observations, as well as new high-spatial resolution images in order to carry out a complete analysis of the candidates found, including a homogeneous characterization of the host stars, transit modelling, search for transit timing variations and statistical validation. As a result, we report four new planets (K2-355 b, K2-356 b, K2-357 b, and K2-358 b) and 14 planet candidates. Besides, we refine the transit ephemeris of the previously published planets and candidates by modelling C5, C16 (when available) and C18 photometric data jointly, largely improving the period and mid-transit time precision. Regarding individual systems, we highlight the new planet K2-356 b and candidate EPIC 211537087.02 being near a 2:1 period commensurability, the detection of significant TTVs in the bright star K2-184 (V = 10.35), the location of K2-103 b inside the habitable zone according to optimistic models, the detection of a new single transit in the known system K2-274, and the disposition reassignment of K2-120 b, which we consider as a planet candidate as the origin of the signal cannot be ascertained