Intensive Care Medicine最新文献

{"title":"Environmental sustainability in intensive care: the path forward. An ESICM Green Paper","authors":"Jan J. De Waele, Nicole Hunfeld, Heather Baid, Ricard Ferrer, Katerina Iliopoulou, Ana-Maria Ioan, Marc Leone, Marlies Ostermann, Gaetano Scaramuzzo, Maria Theodorakopoulou, Hugo Touw, Giuseppe Citerio, Lennie P. G. Derde, Katia Donadello, Nicole P. Juffermans, Laura Galarza, Giacomo Grasselli, Salvatore Maurizio Maggiore, Ignacio Martin-Loeches, Joel Alexandre, Maurizio Cecconi, Elie Azoulay","doi":"10.1007/s00134-024-07662-7","DOIUrl":"https://doi.org/10.1007/s00134-024-07662-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The European Society of Intensive Care Medicine (ESICM) Green Paper aims to address the challenge of environmental sustainability in intensive care and proposes actionable strategies for integrating sustainability into intensive care unit (ICU) stakeholder actions.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The ESICM Executive Committee appointed a task force of topic experts and ESICM committee representatives to develop the ESICM Green Paper. The task force convened biweekly from January to June 2024, identifying key domains for environmental sustainability and prioritizing actions. Drafts were iteratively refined and approved by the ESICM Executive Committee.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Climate change will impact activities in intensive care in many ways, but also the impact of ICU activities on the environment is considerable; drivers for this include extensive resource use and waste generation in ICUs from energy consumption, use of disposable items, and advanced therapies for critically ill patients. The ESICM Green Paper outlines a structured approach for ICUs to reduce their environmental impact, emphasizing energy efficiency, waste reduction, and sustainable procurement. Furthermore, it endorses the need for awareness and education among healthcare professionals, integration of sustainability into research, and sustainable policies within scientific societies.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The ESICM Green Paper reviewed the relevance of climate change to intensive care and provided suggestions for clinical practice, research, education, and ESICM organizational domains. It underscores that reducing intensive care's ecological footprint can coexist with high-quality patient care. Promoting a resilient, responsible healthcare system is a joint responsibility of all ICU stakeholders.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"1 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based medicine to solve the mysteries of citrate anticoagulation for continuous renal replacement therapy","authors":"Patrick M. Honoré, Thomas Rimmelé, Olivier Joannes-Boyau","doi":"10.1007/s00134-024-07668-1","DOIUrl":"https://doi.org/10.1007/s00134-024-07668-1","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"84 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adopting Code ICH in intensive care.","authors":"J Claude Hemphill, Giuseppe Citerio","doi":"10.1007/s00134-024-07655-6","DOIUrl":"https://doi.org/10.1007/s00134-024-07655-6","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black urine: what is happening and what should we do?","authors":"Lia Ginaldi, Massimo De Martinis","doi":"10.1007/s00134-024-07604-3","DOIUrl":"10.1007/s00134-024-07604-3","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1703-1704"},"PeriodicalIF":27.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond peer review: rethinking scientific publishing with AI. Author's reply.","authors":"Chiara Robba, Giuseppe Citerio, Samir Jaber","doi":"10.1007/s00134-024-07603-4","DOIUrl":"10.1007/s00134-024-07603-4","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1717-1718"},"PeriodicalIF":27.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effects of flexible visitation in the intensive care unit on family members' mental health: 12-month results from a randomized clinical trial.","authors":"Jennifer Menna Barreto de Souza, Aline Paula Miozzo, Rosa da Rosa Minho Dos Santos, Duane Mocellin, Gabriela Soares Rech, Geraldine Trott, Gabriel Pozza Müller Estivalete, Daniel Sganzerla, Denise de Souza, Regis Goulart Rosa, Cassiano Teixeira","doi":"10.1007/s00134-024-07577-3","DOIUrl":"10.1007/s00134-024-07577-3","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to assess the effects of flexible intensive care unit (ICU) visitation on the 1-year prevalence of post-traumatic stress, anxiety and depression symptoms among family members of critically ill patients.</p><p><strong>Methods: </strong>This is a long-term outcome analysis of a cluster-crossover randomized clinical trial that evaluated a flexible visitation model in the ICU (12 h/day) compared to a restrictive visitation model (median 1.5 h/day) in 36 Brazilian ICUs. In this analysis, family members were assessed 12 months after patient discharge from the ICU for the following outcomes: post-traumatic stress symptoms measured by the Impact Event Scale-6 and anxiety and depression symptoms measured by the Hospital Anxiety and Depression Scale.</p><p><strong>Results: </strong>A total of 519 family members were analyzed (288 in the flexible visitation group and 231 in the restrictive visitation group). Three-hundred sixty-nine (71.1%) were women, and the mean age was 46.6 years. Compared to family members in the restrictive visitation group, family members in the flexible visitation group had a significantly lower prevalence of post-traumatic stress symptoms (21% vs. 30.5%; adjusted prevalence ratio [aPR], 0.91; 95% confidence interval [CI] 0.85-0.98; p = 0.01). The prevalence of anxiety (28.9% vs. 33.2%; aPR 0.93; 95% CI 0.72-1.21; p = 0.59) and depression symptoms (19.2% vs. 25%; aPR, 0.78; 95% CI 0.60-1.02; p = 0.07) did not differ significantly between the groups.</p><p><strong>Conclusion: </strong>Flexible ICU visitation, compared to the restrictive visitation, was associated with a significant reduction in the 1-year prevalence of post-traumatic stress symptoms in family members.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1614-1621"},"PeriodicalIF":27.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publisher Correction: Effectiveness of fludrocortisone and hydrocortisone versus hydrocortisone alone in septic shock with and without pneumonia.","authors":"Bijan Teja, Tiago V Pereira, Anica C Law, C David Mazer, Nicholas A Bosch","doi":"10.1007/s00134-024-07571-9","DOIUrl":"10.1007/s00134-024-07571-9","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1727"},"PeriodicalIF":27.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terlipressin use in HRS-AKI and respiratory failure. Author's reply.","authors":"Mitra K Nadim, Lui G Forni, Marlies Ostermann","doi":"10.1007/s00134-024-07585-3","DOIUrl":"10.1007/s00134-024-07585-3","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1713-1714"},"PeriodicalIF":27.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NeuroWatch in acute respiratory distress syndrome: time to tune strategies.","authors":"Juliana Caldas, Rogério da Hora Passos","doi":"10.1007/s00134-024-07591-5","DOIUrl":"10.1007/s00134-024-07591-5","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1725-1726"},"PeriodicalIF":27.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It's all about setting the stage.\" The nurse facilitator trial: perceived outcomes and implementation issues. A qualitative study among ICU clinicians and nurse facilitators.","authors":"Anne Renet, Elie Azoulay, Jean Reignier, Alain Cariou, Anne Renault, Olivier Huet, Frédéric Pochard, Ruth A Engelberg, Nancy Kentish-Barnes","doi":"10.1007/s00134-024-07589-z","DOIUrl":"10.1007/s00134-024-07589-z","url":null,"abstract":"<p><strong>Purpose: </strong>For the first time in France, a randomised controlled trial was conducted to evaluate the impact of a nurse facilitator on family psychological symptoms. We sought to explore the implementation of the intervention, how it was experienced by clinicians, as well as the barriers and facilitators to implementing the change.</p><p><strong>Methods: </strong>We conducted qualitative semi-structured interviews with intensive care unit (ICU) clinicians and facilitators involved in the trial. Interview questions focused on participants' perceptions of the intervention and its outcomes, including the effect of the intervention on patients, families and the health care team, and barriers and facilitators to its implementation. Interviews were conducted by two social science researchers, audio recorded, transcribed, and analyzed using thematic content analysis.</p><p><strong>Results: </strong>Twenty-three clinicians were interviewed from the five participating ICUs. Three themes emerged, capturing clinicians' perspectives on implementing the intervention: (1) improved communication and enhanced care for families and the ICU team, albeit with some associated risks; (2) active listening and support, both for families and ICU clinicians but with certain limitations; (3) barriers to implementation including lack of organizational readiness, exclusion of under-represented groups, and facilitator challenges including role ambiguity and the need for role support.</p><p><strong>Conclusion: </strong>Participants believed the facilitator intervention potentially improved families' experience. However, they also highlighted emotional difficulties and tensions with some members of the participating teams, due to competing territories and ambiguous role definitions. Facilitators' failure to affect decision-making suggests their role in enhancing goal-concordant care was inadequate within the setting.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":"1657-1667"},"PeriodicalIF":27.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}