Introduction: The high transmissibility and lethality of the novel coronavirus SARS-CoV-2 (COVID-19) have been catastrophic. Acute kidney injury (AKI) is one of the frequent complications in patients with respiratory insufficiency caused by the virus. The pathogenic mechanism is based on the binding of its S-proteins to the angiotensin-converting enzyme (ACE) receptors, which will trigger a cellular damage. A podocyte and tubular compromise are found in the kidneys which can lead to tubular necrosis and the consequent AKI. Objectives: The objective of this report is to identify the main risk factor to develop AKI in patients infected with SARS-CoV-2 with critical acute respiratory distress. Patients and Methods: We performed this report study, collecting data from 48 ICU patients. Data from 13 of them who developed AKI and needed renal replacement therapy (RRT)were analyzed. Clinical characteristics and laboratory findings were reported using STATA 10.0. Results: AKI was present in 27.08% of patients, mostly male (92.3%) with a mean age of 63.8 years old. Hypertension, diabetes and obesity were the main comorbidities in those patients. Additionally, the meantime between admission and AKI diagnosis was 2.69 days. All patients showed fibrinogen, D-dimer, ALT and values above normal range. Mortality was seen in 61.5% of patients. Conclusion: This report tries to show AKI as an important clinical manifestation in critically ill patients infected with SARS-CoV-2, with high mortality. Further studies are needed to demonstrate if there are independent risk factors. / Revisión por pares

Bakgrund: Intrahospital transport [IHT] är ibland nödvändigt i vården av patienter i kritiska tillstånd. IHT innebär transport av patienter inom sjukhuset exempelvis från akutmottagningen till operationsavdelningen. Studier visar att ungefär hälften av transporterna riskerar patientsäkerheten. Patientens diagnos, utrustningsfel och kommunikationsbrist i transportteamet kan leda till negativa händelser under IHT. Specialistsjuksköterskor inom anestesi och intensivvård deltar i IHT av kritiskt sjuka patienter och har en nyckelroll för att säkerställa en patientsäker IHT. Syfte: Syftet var att jämföra specialistsjuksköterskans perspektiv på faktorer som påverkar IHT av en kritisktsjuk patient. Metod: En kvantitativ metod med webbenkäter valdes. Datamaterialet analyserades med beskrivande och analytisk statistik. T-test, ANOVA och Chi-square var lämpliga analyser för ändamålet. Öppna frågor analyserades med kvalitativ innehållsanalys. Resultat: Vid jämförelser av specialistsjuksköterskans perspektiv framkom det att specialistsjuksköterskor med båda utbildningar har mer kompentens och ett bättre helhetstänk kring IHT av kritiskt sjuka patienter. De specialistsjuksköterskor med >=5 års erfarenhet har bättre kunskap och känner sig mest bekväm med utrustningen som används. Hinder i arbetsmiljön var en aspekt som specialistsjuksköterskorna ansåg som en komplikation kring IHT. Sammanfattning Specialistsjuksköterskornas olika perspektiv på IHT visar på behovet av en checklista och simulatorträning för att kunna säkerställa en patientsäker IHT. / Background: Intrahospital transport [IHT] may be necessary in the care of the critically ill patient. IHT involves transport of the patient within the hospital, for instance from the emergency department to the operation theater. Studies show that approximately half of these transports endanger patient safety. The patients’ diagnosis, equipment failure and lack of communication within the transportteam can lead to adverse events. Specialist nurses within anaesthesia and intensive care participate in IHT of critically ill patients and have a key role in ensuring safety. Aim: The aim was to compare specialist nurses’ perspective on factors that affect safety during IHT of the critically ill patient. Method: A quantitative method using surveys was used. T-test, ANOVA and Chi-square were suitable analytical methods. Open-ended questions were analyzed qualitatively. Results: When comparing the perspectives of specialist nurses it emerged that nurses with qualifications from two specialities had more competence and better awareness of IHT of critically ill patients. Specialist nurses with >= 5 years work experience had more knowledge and felt more comfortable with IHT-equipment. Specialist nurses deemed environmental obstacles as complications during IHT. Conclusion: Specialist nurses different perspectives of IHT renders the need for checklists and training in order to ensure patient safety during IHT

Los profesionales de enfermería perciben problemas de carácter ético, ante las responsabilidades con el cuidado de las personas, ingresadas en las áreas de emergencia y de la unidad de vigilancia intensiva, ya que brindan cuidados a personas en estado de salud crítico, lo que conlleva a generarles diversos problemas de ámbito legales y éticos. Esta investigación tuvo como objetivos describir y analizar el afrontamiento de problemas éticos que realizan las enfermeras de emergencia y unidad de vigilancia intensiva con el paciente en estado crítico, Chiclayo, 2021. La investigación fue cualitativa, descriptiva-interpretativa. Participaron 15 enfermeras de las áreas de emergencia y unidad de vigilancia intensiva del Hospital Regional Policial de Chiclayo. La muestra se obtuvo por criterios de saturación y redundancia, y el muestreo fue por bola de nieve. Para la recogida de datos se utilizó la entrevista semiestructurada a profundidad, validada por expertos y estudio piloto. En modalidad virtual usando plataforma Zoom y/o WhatsApp. Para el proceso de los datos se utilizó el análisis de contenido. Avalado por principios éticos y de rigor científico. Se obtuvieron tres categorías: Deliberando la presencia de problemas éticos por las enfermeras de emergencia y unidades críticas, II. Problemas éticos con los pacientes hospitalizados, familiares, personal de salud y recursos y III. Decisiones de afrontamiento en problemas éticos desafiantes. Concluyendo que con los pacientes existe información incompleta sobre su diagnóstico, vulnerabilidad en el predominio de la autonomía, así como abandono familiar, encontrando / Nursing professionals perceive problems of an ethical nature, given the responsibilities with the care of people admitted to the emergency areas and the intensive surveillance unit, since they provide care to people in a critical state of health, which leads to generate various legal and ethical problems. The objectives of this research were to describe and analyze how emergency nurses and intensive care unit nurses deal with ethical problems with patients in critical condition, Chiclayo, 2021. The research was qualitative, descriptive-interpretive. 15 nurses from the emergency areas and intensive surveillance unit of the Regional Police Hospital of Chiclayo participated. The sample was obtained by saturation and redundancy criteria, and sampling was by snowball. An in-depth semi-structured interview, validated by experts, and a pilot study were used to collect data. In virtual mode using the Zoom and/or WhatsApp platform. Content analysis was used to process the data. Backed by ethical principles and scientific rigor. Three categories were obtained: Deliberating the presence of ethical problems by emergency nurses and critical units, II. Ethical problems with hospitalized patients, family members, health personnel and resources and III. Coping decisions in challenging ethical problems. Concluding that with patients there is incomplete information about their diagnosis, vulnerability in the predominance of autonomy, as well as family abandonment, finding resolutions to these problems in their code of ethics and adhered principles.