8 research outputs found
Perioperative oxygen fraction – effect on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial. Rationale and design of the PROXI-Trial
<p>Abstract</p> <p>Background</p> <p>A high perioperative inspiratory oxygen fraction may reduce the risk of surgical site infections, as bacterial eradication by neutrophils depends on wound oxygen tension. Two trials have shown that a high perioperative inspiratory oxygen fraction (Fi<smcaps>O</smcaps><sub>2 </sub>= 0.80) significantly reduced risk of surgical site infections after elective colorectal surgery, but a third trial was stopped early because the frequency of surgical site infections was more than doubled in the group receiving Fi<smcaps>O</smcaps><sub>2 </sub>= 0.80. It has not been settled if a high inspiratory oxygen fraction increases the risk of pulmonary complications, such as atelectasis, pneumonia and respiratory failure. The aim of our trial is to assess the potential benefits and harms of a high perioperative oxygen fraction in patients undergoing abdominal surgery.</p> <p>Methods and design</p> <p>The PROXI-Trial is a randomized, patient- and assessor blinded trial of perioperative supplemental oxygen in 1400 patients undergoing acute or elective laparotomy in 14 Danish hospitals. Patients are randomized to receive either 80% oxygen (Fi<smcaps>O</smcaps><sub>2 </sub>= 0.80) or 30% oxygen (Fi<smcaps>O</smcaps><sub>2 </sub>= 0.30) during surgery and for the first 2 postoperative hours. The primary outcome is surgical site infection within 14 days. The secondary outcomes are: atelectasis, pneumonia, respiratory failure, re-operation, mortality, duration of postoperative hospitalization, and admission to intensive care unit. The sample size allows detection of a 33% relative risk reduction in the primary outcome with 80% power.</p> <p>Discussion</p> <p>This trial assesses benefits and harms of a high inspiratory oxygen fraction, and the trial may be generalizable to a general surgical population undergoing laparotomy.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier: NCT00364741.</p
Hand hygiene technique quality evaluation in nursing and medicine students of two academic courses
Evaluation of training on the programs to optimize antimicrobial use in medical residents of the province of Las Palmas.
[ES] Introducción. La resistencia a los antibióticos es una amenaza para la salud pública mundial. Esta situación hace
imprescindible el establecimiento de programas de optimización
del uso de antimicrobianos (PROA). Se identificaron las
necesidades formativas en el PROA de los médicos residentes y
se analizaron las asociaciones entre las variables de estudio y la
formación en el uso racional y prudente de antibióticos.
Métodos. Estudio transversal y analítico a través de un
cuestionario auto administrado a un colectivo de 506 médicos
residentes de la provincia de Las Palmas. Se calculó la asociación
entre las características de los residentes y la formación
en el PROA mediante una regresión logística.
Resultados. Las asociaciones entre la varianza de las respuestas
y el tipo de especialidad se observaron en la mayoría
de los análisis de los componentes principales (oportunidad
p=0,003, entrenamiento p=0,007, motivación p=0,055 e higiene
de manos p=0,044), seguidas de la varianza según el sexo
(capacidad p=0,028, conocimientos teóricos p=0,013, higiene
de manos p=0,002). Muy pocas diferencias se asociaron con
la edad (capacidad p=0,051 e higiene de manos p=0,054) o el
año de especialidad (higiene de manos p=0,032).
Conclusiones. Las principales necesidades formativas de
los médicos residentes incluyen salud integral, motivación,
entrenamiento, higiene de manos e información. El tipo de
especialidad seguido del sexo son los determinantes más importantes
de las perspectivas sobre el uso y la resistencia a los
antibióticos.
[EN] Background. Antibiotic resistance is a threat to global public health. This situation makes essential to establish programs
to optimize antimicrobial use (PROA). Training needs are
identified in the PROA of resident physicians and the results of
the analysis of the associations between study variables and
training in the rational and prudent use of antibiotics are presented
in this analysis.
Methods. Cross-sectional and analytical study through a
self-administered questionnaire to a group of 506 medical residents
of the province of Las Palmas. The association between
resident’s characteristics and PROA training was calculated
through logistic regression.
Results. The associations between response variance
and speciality were observed in most of the core component
analysis (opportunity p=0.003, training p=0.007, motivation
p=0.055 and hand hygiene p=0.044), followed by
variance according to sex (capacity p=0.028, theoretical
knowledge p=0.013, hand hygiene p=0.002). Very few differences
were associated with age (capacity p=0,051 and
hand hygiene p=0,054) or the year of expertise (hand hygiene
p=0,032).
Conclusions. The main training needs of resident physicians
include one health, motivation, training, hand hygiene
and information. The type of speciality followed by sex are the
most important determinants on antibiotic use and resistance
for resident physicians.S