{"title":"Frailty and the Risk of Delirium: A Mendelian Randomization Study.","authors":"Miao Yu, Baohua Li","doi":"10.1097/CNQ.0000000000000565","DOIUrl":"10.1097/CNQ.0000000000000565","url":null,"abstract":"<p><p>Observational studies have explored associations between frailty and delirium, but conclusions have been controversial. We aimed to identify the potential causality effect between these 2 traits using Mendelian randomization (MR). The genetics instrument related with frailty index (FI) was taken from a summary-level genome-wide association study (GWAS), and the GWAS of delirium was obtained from the FinnGen Study. The inverse variance weighted method (IVW) was performed. MR analysis found a causal association between genetically predicted FI and an elevated risk of delirium in IVW (odds ratio [OR]: 2.85; 95% CI: 1.03-7.90; P= .04). This study encouraged early identification of the baseline frailty in intensive care units. Critical care nurses are advised to use multidimensional tools to identify frailty. Then, individualized care plans should be made according to frailty degrees, like nutrition and pre-rehabilitation for pre-frail patients. Nurses can optimize medical resources and apply cluster interventions for delirium high-risk groups.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 3","pages":"316-324"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Systematic Review of the Neurological Benefits Associated With the Use of Targeted Hypothermia Temperature Management Versus Targeted Normothermia in Out-of-Hospital Cardiac Arrest Patients.","authors":"Hue Truong, Catherine Han","doi":"10.1097/CNQ.0000000000000564","DOIUrl":"10.1097/CNQ.0000000000000564","url":null,"abstract":"<p><p>Cardiac arrest, a condition in which the heart ceases to function and oxygen delivery to the brain and other vital organs is interrupted, affects 700 000 Americans annually. One of the most devastating consequences of cardiac arrest is the lack of oxygen delivery to the brain, resulting in anoxic brain injury and severe neurological dysfunction. The pivotal trial published in 2002 by Dr. Stephen Bernard and his team, touted the positive benefits of therapeutic temperature management on the neurological recovery of post-cardiac arrest patients and changed the way the scientific and medical communities viewed the use of hypothermia. Since then, research has seemingly confirmed the apparent benefits of hypothermia on neurological recovery but the question remains as to what temperature patients should be cooled to, and more recently, if patients should actively be cooled at all or if the medical team should strive to maintain normothermia. A thorough literature review identified 6 studies comparing the neurological benefits of targeted temperature management and targeted normothermia, and concluded that a change in clinical practice cannot be made based on the current literature.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 3","pages":"302-315"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Gutierrez, Abhinandan Chittal, Tiffany DuMont, Bridget Smith, William Thewes, Ahmad AlhajHusain, Eric Bihler
{"title":"Pulmonary Manifestations of Sepsis.","authors":"Laura Gutierrez, Abhinandan Chittal, Tiffany DuMont, Bridget Smith, William Thewes, Ahmad AlhajHusain, Eric Bihler","doi":"10.1097/CNQ.0000000000000556","DOIUrl":"10.1097/CNQ.0000000000000556","url":null,"abstract":"<p><p>Sepsis is an inflammatory response to severe infection, which can affect any organ system. This inflammatory response can lead to life-threatening end organ dysfunction. In this article, we review pulmonary complications of sepsis including hypoxemia and acute respiratory distress syndrome. We also discuss pulmonary sources of sepsis including the management of community- and hospital-acquired pneumonia and ventilator-associated pneumonia.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 3","pages":"206-213"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gastrointestinal and Nutritional Support, Endocrine, and Hematological Considerations in Sepsis.","authors":"Arshpal Gill, Nikolas Touloumes, Justin Dorman, Kayla Flanigan, Tiffany DuMont, Khalid Malik, Patricia Bononi, Akash Gadani, Billie Barker","doi":"10.1097/CNQ.0000000000000559","DOIUrl":"10.1097/CNQ.0000000000000559","url":null,"abstract":"<p><p>The gastrointestinal system alongside nutritional support, the endocrine system, and the hematological system has integral roles in sepsis. Understanding these systems can help clinicians better manage patients with sepsis and potentially improve outcomes. This chapter details these 3 important organ systems and, in particular, the clinical impact on each organ system in sepsis.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 3","pages":"214-222"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rahul Prakash Rane, Sheahahn Soundranayagam, Daniel A Shade, Kevin Nauer, Tiffany DuMont, Khaled Nashar, Marvin R Balaan
{"title":"Renal Involvement in Sepsis: Acute Kidney Injury.","authors":"Rahul Prakash Rane, Sheahahn Soundranayagam, Daniel A Shade, Kevin Nauer, Tiffany DuMont, Khaled Nashar, Marvin R Balaan","doi":"10.1097/CNQ.0000000000000553","DOIUrl":"10.1097/CNQ.0000000000000553","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a common complication of sepsis due to a myriad of contributing factors and leads to significant morbidity and mortality in critically ill patients. Prompt identification and management are vital to reverse and/or prevent the worsening of AKI. When renal function is severely compromised, there may be a need for dialytic therapy to meet the metabolic needs of patients. This article will review the definition of AKI, epidemiology, risk factors, and pathophysiology of AKI in sepsis, along with both non-dialytic and dialytic treatment strategies. We will also review landmark trials in fluid resuscitation in sepsis.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 2","pages":"100-108"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antimicrobials in the Management of Sepsis in the Intensive Care Unit (ICU).","authors":"Adriana Betancourth, Salman Bangash, Yousaf Bajwa, Ashley Garbinski, Tiffany DuMont, Omer Bajwa, Nitin Bhanot","doi":"10.1097/CNQ.0000000000000545","DOIUrl":"10.1097/CNQ.0000000000000545","url":null,"abstract":"<p><p>Sepsis is a severe and often life-threatening condition which can lead to widespread organ dysfunction, septic shock, and even death. Antimicrobials are critical in improving outcomes for patients with sepsis. This chapter details the general principles of antimicrobial therapy, appropriate selection and de-escalation of antimicrobials, and challenges in antimicrobial stewardship.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 2","pages":"80-87"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nurses' Knowledge, Attitude, Practice, and Perceived Barriers of Infection Control Measures in the Intensive Care Units at Northwest Bank Hospitals.","authors":"Khaled Ali Bawaqneh, Ahmad Ayed, Basma Salameh","doi":"10.1097/CNQ.0000000000000538","DOIUrl":"10.1097/CNQ.0000000000000538","url":null,"abstract":"<p><p>The foremost challenge encountered by patients in intensive care units is nosocomial infections impacting their prognosis. Nurses play a vital role in infection control, necessitating adequate knowledge and adherence to protocols. Therefore, the study aims to assess nurses' knowledge, attitude, practice, and perceived barriers of infection control measures in the Intensive care units at the Northwest Bank Hospitals. The study employed a quantitative cross-sectional and observational design, utilizing a self-administration questionnaire and checklist distributed among 115 ICU nurse working in governmental hospitals in the Northwest Bank. The study revealed that the majority of nurses demonstrated a moderate to low knowledge level. However, 63.5% exhibited a positive attitude toward infection control measures, and 72.9% demonstrated good practice levels. Among the sociodemographic determinants, gender was the only significant factor in relation to practice, where male nurses demonstrated better practices than female nurses (P < .05). Nursing staff identified several barriers to achieving infection standards, including lack of equipment, inadequate training courses on infection control, challenges posed by visitors, absence of infection control policies and standards, insufficient isolation rooms, and heavy workload. The majority of nurses displayed good practice levels and positive attitudes toward infection prevention. Additionally, male nurses practiced infection control measures significantly more effectively than female nurses. The major barriers were lack of equipment, lack of training courses, and challenges related to visitors. Addressing these barriers is essential to improving infection control measures in critical care units.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 2","pages":"160-171"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pathophysiology of Sepsis.","authors":"Tanya Marshall, Karen Dysert, Meilin Young, Tiffany DuMont","doi":"10.1097/CNQ.0000000000000552","DOIUrl":"10.1097/CNQ.0000000000000552","url":null,"abstract":"<p><p>Sepsis is a condition of life-threatening organ dysfunction caused by a dysregulated host response to infection. It is the result of a series of exaggerated physiologic responses that lead to simultaneous hyper- and hypoinflammatory states. In the hyperinflammatory phase, there is an exuberant release of cytokines, commonly referred to as a cytokine storm. The immune-suppressive phase is characterized by counterregulatory attempts to achieve homeostasis that sometimes \"overshoot\", leaving the host in a state of immunosuppression, thus predisposing to recurrent nosocomial and secondary infections. The aging population with comorbidities faces higher risks of immune dysfunction and inflammation. Thus, the number of sepsis survivors that develop subsequent infections is predicted to rise substantially in the next few decades. Understanding sepsis-induced immune dysregulation may enhance surveillance and outcomes. This review is intended to describe the pathophysiology of sepsis and its effects on the immune system.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 2","pages":"88-92"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Effect of Prior Use of Statins on the Severity of COVID-19 Disease: A Retrospective Study.","authors":"Hadi Hasani, Farzaneh Hamidi, Fatemeh Ahmadi-Forg, Pardis Panahi, Fatemeh Tofighi Khelejan","doi":"10.1097/CNQ.0000000000000544","DOIUrl":"10.1097/CNQ.0000000000000544","url":null,"abstract":"<p><p>It has been suggested that the use of statin pills beforehand could potentially influence the outcomes when individuals are hospitalized with COVID-19. In this study, we investigated how the prior use of statin medication could influence the COVID-19 severity parameters. In this retrospective cohort study, we categorized COVID-19 patients into 2 groups: statin users and non-users. Then, various data including age, gender, the patient's need for ventilation support, the lowest oxygen blood saturation level, the length of hospitalization, receiving remdesivir treatment, and their COVID-19 vaccination status were collected. Out of 168 patients, 62 had taken statin medication before being admitted. Using statins decreased the patient's need for ventilation support, length of hospitalization, ventilation duration, and oxygen saturation level (P < .001). Interaction effect analysis showed that receiving remdesivir statically affected the length of hospitalization, ventilation duration, and oxygen saturation level but did not significantly affect the association between statins and needing to ventilator. The use of statin pills before COVID-19 admission reduced the requirement for ventilator support.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"48 2","pages":"143-150"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}