Journal of the Intensive Care Society最新文献

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Longitudinal trend in post-discharge estimated glomerular filtration rate in intensive care survivors. 重症监护幸存者出院后估计肾小球滤过率的纵向趋势。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-12-26 DOI: 10.1177/17511437241308673
Rebecca M Glendell, Kathryn A Puxty, Martin Shaw, Malcolm Ab Sim, Jamie P Traynor, Patrick B Mark, Mark Andonovic
{"title":"Longitudinal trend in post-discharge estimated glomerular filtration rate in intensive care survivors.","authors":"Rebecca M Glendell, Kathryn A Puxty, Martin Shaw, Malcolm Ab Sim, Jamie P Traynor, Patrick B Mark, Mark Andonovic","doi":"10.1177/17511437241308673","DOIUrl":"10.1177/17511437241308673","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) within the intensive care unit (ICU) is common but evidence is limited on longer-term renal outcomes. We aimed to model the trend of kidney function in ICU survivors using estimated glomerular filtration rate (eGFR), comparing those with and without AKI, and investigate potential risk factors associated with eGFR decline.</p><p><strong>Methods: </strong>This observational cohort study included all patients aged 16 or older admitted to two general adult ICUs in Scotland between 1st July 2015 and 30th June 2018 who survived to 30 days following hospital discharge. Baseline serum creatinine and subsequent values were used to identify patients with AKI and calculate eGFR following hospital discharge. Mixed effects modelling was used to control for repeated measures and to allow inclusion of several exploratory variables.</p><p><strong>Results: </strong>3649 patients were included, with 1252 (34%) experiencing in-ICU AKI. Patients were followed up for up to 2000 days with a median 21 eGFR measurements. eGFR declined at a rate of -1.9 ml/min/1.73m<sup>2</sup>/year (<i>p-</i>value < 0.001) in the overall ICU survivor cohort. Patients with AKI experienced an accelerated rate of post-ICU eGFR decline of -2.0 ml/min/1.73m<sup>2</sup>/year compared to a rate of -1.83 ml/min/1.73m<sup>2</sup>/year in patients who did not experience AKI (<i>p-</i>value 0.007). Pre-existing diabetes or liver disease and in-ICU vasopressor support were associated with accelerated eGFR decline regardless of AKI experience.</p><p><strong>Conclusions: </strong>ICU survivors experienced a decline in kidney function beyond that which would be expected regardless of in-ICU AKI. Long-term follow-up is warranted in ICU survivors to monitor kidney function and reduce morbidity and mortality.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241308673"},"PeriodicalIF":2.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The legacy of the COVID-19 pandemic on critical care research: A descriptive interview study. COVID-19大流行对重症监护研究的影响:一项描述性访谈研究
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-12-08 DOI: 10.1177/17511437241301921
Natalie A Pattison, Geraldine O'Gara, Brian H Cuthbertson, Louise Rose
{"title":"The legacy of the COVID-19 pandemic on critical care research: A descriptive interview study.","authors":"Natalie A Pattison, Geraldine O'Gara, Brian H Cuthbertson, Louise Rose","doi":"10.1177/17511437241301921","DOIUrl":"10.1177/17511437241301921","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic challenged both research and clinical teams in critical care to collaborate on research solutions to new clinical problems. Although an effective, nationally coordinated response helped facilitate critical care research, reprioritisation of research efforts towards COVID-19 studies had significant consequences for existing and planned research activity in critical care.</p><p><strong>Aims: </strong>Our aim was to explore the impact of the COVID-19 pandemic research prioritisation policies and practices on critical care research funded prior to the pandemic, the conduct of pandemic research, and implications for ongoing and future critical care research.</p><p><strong>Methods: </strong>We undertook a descriptive qualitative study recruiting research-active clinician researchers and research delivery team members working in critical care. We conducted digitally recorded, semi-structured interviews in 2021-2022. Framework Analysis was used to analyse the data.</p><p><strong>Results: </strong>We interviewed 22 participants comprising principal investigators, senior trial coordinators and research delivery nurses from across the UK. Six themes were identified: <i>Unit, organisational and national factors; Study specific factors; Resources; Individual/clinician factors; Family/patient factors; Contextual factors.</i> These themes explained how a nationally coordinated response during the pandemic affected individuals, studies and wider organisations in managing the research response in critical care, highlighting future implications for critical care research.</p><p><strong>Conclusion: </strong>Harnessing the collective response seen in the COVID-19 pandemic in critical care could better support integration of research activity into routine critical care activities. Future endeavours should focus on workforce preparations, contingency planning, strategies for study prioritisation and integration of research as part of the continuum of clinical care.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241301921"},"PeriodicalIF":2.1,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Animal-assisted intervention services across UK intensive care units: A national service evaluation. 英国重症监护病房的动物辅助干预服务:一项国家服务评估。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-12-06 DOI: 10.1177/17511437241301000
Sam Wright, Holly McAree, Megan Hosey, Kate Tantam, Bronwen Connolly
{"title":"Animal-assisted intervention services across UK intensive care units: A national service evaluation.","authors":"Sam Wright, Holly McAree, Megan Hosey, Kate Tantam, Bronwen Connolly","doi":"10.1177/17511437241301000","DOIUrl":"10.1177/17511437241301000","url":null,"abstract":"<p><strong>Background: </strong>Animal-assisted interventions (AAI) can provide psychological support to critical care patients during their intensive care unit (ICU) admission. However, there are currently no data on AAI services across UK ICUs. The current study therefore aims to (i) determine how many ICUs in the UK offer services, (ii) characterise available services and (iii) explore and review local documentation for service oversight.</p><p><strong>Methods: </strong>A service evaluation comprising two parts; a national survey of UK ICU's, analysed using descriptive statistics, and review of local service oversight documents, analysed using a framework approach.</p><p><strong>Results: </strong>Responses from 74 sites (/242, 30.6%) were included in survey analysis. AAI services were present at 32 sites (/74, 43.2%), of which 30 offered animal-assisted activity services alone and 2 offered both animal-assisted activity and animal-assisted therapy services. Animal-assisted activity services were typically delivered on a weekly basis, lasting 30-60 min and with dogs the sole animal employed. Concern over infection prevention and control was the most common barrier to service provision, as well as a lack of supporting evidence. Sixteen sites provided 27 oversight documents for analysis, that highlighted unique and shared responsibilities between critical care staff and animal therapy handlers, including aspects of administration, welfare and infection control.</p><p><strong>Conclusion: </strong>From a small sample, AAI services were available in less than half of ICUs. Empirical value of interventions is countered by current lack of definitive evidence of effectiveness, which should be addressed before wider implementation of AAI services and the associated resource requirements, is undertaken.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241301000"},"PeriodicalIF":2.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes for older patients with subarachnoid haemorrhage who require admission to an Australian intensive care unit. 高龄蛛网膜下腔出血患者需要入住澳大利亚重症监护病房的结局。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-12-02 DOI: 10.1177/17511437241301916
Jeremy Sharman, Natasha Turner, Amalia Karahalios, Ben Sansom, Adam M Deane, Mark P Plummer
{"title":"Outcomes for older patients with subarachnoid haemorrhage who require admission to an Australian intensive care unit.","authors":"Jeremy Sharman, Natasha Turner, Amalia Karahalios, Ben Sansom, Adam M Deane, Mark P Plummer","doi":"10.1177/17511437241301916","DOIUrl":"10.1177/17511437241301916","url":null,"abstract":"<p><strong>Background: </strong>Advanced age is an independent risk factor for poor outcomes following aneurysmal subarachnoid haemorrhage (SAH). However, Australian data are lacking. Our aim was to evaluate outcomes for older patients admitted to an Australian intensive care unit for management of aneurysmal SAH.</p><p><strong>Methods: </strong>We conducted a single centre retrospective observational study looking at adult patients admitted with aneurysmal SAH to an Intensive Care Unit (ICU) over a 10-year period. Patients were grouped by age; <70 years, 70-79 years, ⩾80 years, and were of sufficient complexity to be unsuitable for our neurosurgical high-dependency unit. The primary outcome was in-hospital mortality. Secondary outcomes were ICU and hospital length of stay, and discharge destination.</p><p><strong>Results: </strong>Of 372 patients admitted to ICU with aneurysmal SAH, 302 (82%) were younger (<70 years), 46 (12%) were septuagenarians and 24 (6%) were octogenarians. There were no differences between clinical or radiological grade of aneurysmal SAH between age cohorts. When compared to the patients younger than 70 years, there was increased odds of dying for those 70-79 and ⩾80 years (70-79: OR 1.98, 95% CI 0.93, 4.20 <i>p</i> = 0.077; ⩾80: OR 4.01, 95% CI 1.55, 10.35 <i>p</i> = 0.004). There were no associations between age and duration of admission. Only 6% of patients aged ⩾70 years were discharged home alive.</p><p><strong>Conclusion: </strong>It was uncommon for patients over 70 years of age who present with a SAH to be discharged home from hospital, and those aged ⩾80 are four times more likely to die in hospital than younger patients.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241301916"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes after critical care admission in people with a learning disability. 学习障碍患者重症监护入院后的结局。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-12-02 DOI: 10.1177/17511437241301922
Ben Messer, Emily Harrison, Alison Carter, Ian Clement, Holly Gillott, Ching Khai Ho, Thomas Ross, Nicholas Lane, Hilary Tedd
{"title":"Outcomes after critical care admission in people with a learning disability.","authors":"Ben Messer, Emily Harrison, Alison Carter, Ian Clement, Holly Gillott, Ching Khai Ho, Thomas Ross, Nicholas Lane, Hilary Tedd","doi":"10.1177/17511437241301922","DOIUrl":"10.1177/17511437241301922","url":null,"abstract":"<p><strong>Introduction: </strong>People with learning disabilities experience worse healthcare outcomes than the general population. There is evidence that they are more likely to experience avoidable mortality and less likely to receive critical care interventions during an acute illness. Decisions regarding critical care admission or intervention must be based on evidence of whether a patient will receive lasting benefit from a critical care admission. We therefore investigated outcomes from critical care admissions in people with learning disabilities and compared them to general critical care patients.</p><p><strong>Methods: </strong>People with learning disabilities who were admitted to our critical care unit were identified via our coding department, from the Intensive Care National Audit and Research Centre (ICNARC) database and from our local electronic patient record. Mortality and length of stay outcomes for people with learning disabilities were recorded following critical care admission over a 5 years period and compared with the general critical care cohort over the same 5 years period. Longer term survival of patients with learning disabilities was also recorded.</p><p><strong>Results: </strong>297 critical care admissions in 176 people with learning disabilities were identified. The general critical care cohort included 6224 admissions in 4976 patients. The standardised mortality rate in people with learning disabilities admitted to critical care was 0.59 compared to the general critical care cohort which was 0.98. Mortality outcomes remained better in patients with learning disabilities compared to the general critical care cohort in invasively ventilated patients and in people with profound and multiple learning disability. Critical care length of stay was longer in people with learning disabilities. 12 month mortality was 14.8% in the learning disability cohort. By the end of the study, 23.9% of people with learning disabilities had died after a mean of 482 days following their first critical care admission. Patients who are currently still alive after having survived to hospital discharge following critical care admission have lived an average of 1129 days. After only 7.4% of critical care admissions in people with learning disabilities was there an increase in dependence on assistance in activities of daily living.</p><p><strong>Discussion: </strong>We have shown that people with learning disabilities are more likely to survive following a critical care admission than general critical care patients. This is regardless of whether they were invasively ventilated or whether they had profound and multiple learning disabilities. Critical care admission and invasive ventilation are associated with good short and longer term mortality.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241301922"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antibiotic prophylaxis reduced broad-spectrum antibiotics and length of stay in ICU patients with alcohol withdrawal induced refractory delirium tremens. 抗生素预防可减少酒精戒断诱发难治性震颤性谵妄的重症监护病房患者使用广谱抗生素的次数和住院时间。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-11-25 DOI: 10.1177/17511437241298518
Dunia Al-Hashimi, Martin Kåberg, Anders Krifors, Michael Wanecek, Ola Blennow
{"title":"Antibiotic prophylaxis reduced broad-spectrum antibiotics and length of stay in ICU patients with alcohol withdrawal induced refractory delirium tremens.","authors":"Dunia Al-Hashimi, Martin Kåberg, Anders Krifors, Michael Wanecek, Ola Blennow","doi":"10.1177/17511437241298518","DOIUrl":"10.1177/17511437241298518","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia is a well-known complication in patients with severe alcohol withdrawal syndrome (SAWS). Antibiotic prophylaxis in ICU treated SAWS patients may be beneficial but data is lacking. The aims of this study were to investigate the effect of introduction of trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis, on use of broad-spectrum antibiotics and ICU length of stay (LOS) in SAWS patients with refractory delirium tremens (rDT).</p><p><strong>Methods: </strong>Retrospective observational cohort study comparing before (control group) and after the introduction of TMP-SMX prophylaxis in patients admitted to a single center ICU because of alcohol withdrawal induced rDT.</p><p><strong>Results: </strong>A total of 108 patients were included, 53 patients in the control group and 55 patients in the TMP-SMX group. Baseline characteristics did not differ between the groups (89% male, median age 52 years). The use of broad-spectrum antibiotics was significantly lower in the TMP-SMX group than in the control group (11 vs 70%, <i>p</i> < 0.001). The only variable associated with decreased use of broad-spectrum antibiotics in multiple logistic regression analysis was receiving TMP-SMX (0.06, 95% CI 0.02, 0.19, <i>p</i>-value: <0.001). Median LOS was shorter in the TMP-SMX group than in the control group (61 vs 72 h, <i>p</i> = 0.004). In multiple linear regression analysis receiving TMP-SMX SMX was associated with shorter LOS (-22.7, 95% CI: -41.3, -4.1, <i>p</i>-value: 0.02) and having one or more comorbidities with longer LOS (37.4, 95% CI: 10.4, 64.5, <i>p</i>-value: <0.01).</p><p><strong>Conclusion: </strong>Prophylaxis with TMP-SMX in ICU-treated rDT patients was associated with reduced use of broad-spectrum antibiotics and reduced ICU LOS.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241298518"},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of hemodynamic parameters by PiCCO and PAC in patients treated with the Impella CP. 通过 PiCCO 和 PAC 评估接受 Impella CP 治疗的患者的血液动力学参数。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-11-25 DOI: 10.1177/17511437241300909
Dominik Schmitt, Andreas Schneider, Björn Lengenfelder, Martin Wagner, Daniel Patschan, Benjamin Sasko, Georg Ertl, Stefan Frantz, Oliver Ritter, Dirk Weismann
{"title":"Assessment of hemodynamic parameters by PiCCO and PAC in patients treated with the Impella CP.","authors":"Dominik Schmitt, Andreas Schneider, Björn Lengenfelder, Martin Wagner, Daniel Patschan, Benjamin Sasko, Georg Ertl, Stefan Frantz, Oliver Ritter, Dirk Weismann","doi":"10.1177/17511437241300909","DOIUrl":"10.1177/17511437241300909","url":null,"abstract":"<p><p>In 28 patients supported by an Impella pump (Impella CP, Abiomed Inc.<sup>®</sup>, Danvers, MA), hemodynamic measurements by PiCCO (PULSION Medical Systems SE<sup>®</sup>, Feldkirchen, Germany) and pulmonary artery catheter (PAC or Swan-Ganz Catheter; Edwards Lifescience<sup>®</sup>, Unterschleissheim, Germany) were compared. There was a significant positive correlation of cardiac output (CO; <i>r</i> <sup>2</sup> = 0.917, <i>p</i> < 0.001), systemic vascular resistance index (SVRI; <i>r</i> <sup>2</sup> = 0.904, <i>p</i> < 0.001), stroke volume index (SI; <i>r</i> <sup>2</sup> = 0.909, <i>p</i> < 0.001) and left ventricular work index (LCWI; <i>r</i> <sup>2</sup> = 0.689, <i>p</i> < 0.001) in PiCCO and PAC measurements under Impella CP support. We conclude, that in patients with left-ventricular Impella support, hemodynamics may be assessentd by PiCCO or PAC.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241300909"},"PeriodicalIF":2.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Delivery of evidence-based critical care practices across the United Kingdom: A UK-wide multi-site service evaluation in adult units. 在英国各地开展循证重症监护实践:英国范围内成人病房的多站点服务评估。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-11-22 DOI: 10.1177/17511437241293917
William R Thomson, Zudin Puthucheary, Panayiotis Stavrinou, Dalia Barghouthy, Shreekant Champanerkar, Douglas Findlay, Sarah Gordon, David McWilliams, Kate Tantam, Helen Woodward, Timothy J Stephens
{"title":"Delivery of evidence-based critical care practices across the United Kingdom: A UK-wide multi-site service evaluation in adult units.","authors":"William R Thomson, Zudin Puthucheary, Panayiotis Stavrinou, Dalia Barghouthy, Shreekant Champanerkar, Douglas Findlay, Sarah Gordon, David McWilliams, Kate Tantam, Helen Woodward, Timothy J Stephens","doi":"10.1177/17511437241293917","DOIUrl":"10.1177/17511437241293917","url":null,"abstract":"<p><strong>Background: </strong>The ICU Liberation Bundle was developed to improve outcomes for patients admitted to critical care. Despite a lack of Bundle adoption in the UK, the individual evidence-based practices (EBPs) within the bundle are defined as standards of care by the UK Intensive Care Society. There are limited data on the delivery of these EBPs.</p><p><strong>Objective: </strong>To evaluate current delivery of the EBPs of the ICU Liberation bundle in a sample of hospitals in the UK National Health Service (NHS) presenting delivery of EBP's between hospitals, their stability of delivery across multiple weeks and in comparison to US hospitals in the original ICU Liberation Bundle study.</p><p><strong>Methods: </strong>Multi-centre service evaluation, using modified definitions of compliance from the ICU Liberation Bundle study. We sampled six representative units from across the UK; data collection totalled 1116 patient days. Data were analysed using descriptive statistics.</p><p><strong>Results: </strong>Across all six units, patients received a median of 42.9% (IQR 40%-60%) of all possible bundle EBPs. Unit bundle proportional compliance (number of components completed/eligible number of components) ranged from 40.0% (IQR 28.6%-50.0%) to 71.4% (IQR 57.1%-80.0%). Units completed spontaneous awakening trials most regularly in 80.1% of eligible patients (149/186). Delirium assessments were the least adhered to EBP with only 32.2% (359/1116) of patients receiving at least two validated delirium assessments per day. Full bundle compliance was lower in the UK cohort in comparison to the original trial (4% vs 8%).</p><p><strong>Discussion: </strong>We identified substantial variation in the delivery of seven evidence-based practices that are considered standards of care in the UK. Variation existed between hospitals and within each hospital over time. These data begin to describe the current state of EBP adherence in a selection of critical care units.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241293917"},"PeriodicalIF":2.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In vivo assessment of a modification of a domiciliary ventilator which reduces oxygen consumption in mechanically ventilated patients. 对可减少机械通气患者耗氧量的家用呼吸机改型进行体内评估。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-11-04 DOI: 10.1177/17511437241296685
Timothy O Jenkins, Thomas M Sutton, Peter Griffen, Yoseph Mebrate, Michael I Polkey
{"title":"In vivo assessment of a modification of a domiciliary ventilator which reduces oxygen consumption in mechanically ventilated patients.","authors":"Timothy O Jenkins, Thomas M Sutton, Peter Griffen, Yoseph Mebrate, Michael I Polkey","doi":"10.1177/17511437241296685","DOIUrl":"10.1177/17511437241296685","url":null,"abstract":"<p><p>There are instances where hospitals may experience a relative shortage of oxygen, for example, future pandemics, natural disasters or wartime. We developed a modification to a domiciliary ventilator that captures oxygen normally vented during expiration into the atmosphere, delivering it to the patient. The modification significantly increases PaO<sub>2</sub> in mechanically ventilated patients at their baseline FiO<sub>2</sub> and baseline FiO<sub>2</sub> +1, +2 and +3 L/min compared to no modification. The modification reduces walled oxygen consumption by median (IQR) -1.0 (-1.25 to -1.00) L/min whilst maintaining PaO<sub>2</sub>. This modification may be a valuable in circumstances where there is a relative shortage of oxygen.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241296685"},"PeriodicalIF":2.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of adult mechanically ventilated patients: A UK-wide survey. 成人机械通气患者的管理:英国范围内的调查。
IF 2.1
Journal of the Intensive Care Society Pub Date : 2024-10-20 DOI: 10.1177/17511437241292190
James Ward, Isis Terrington, Katie Preston, Alexander Smith, Thomas Roe, Jonathan Barnes, Emma Allen, Sandra Lima, Rebecca Cusack, Michael P W Grocott, Ahilanandan Dushianthan
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