Journal of the Intensive Care Society最新文献_第6页

Re: Socioeconomic status and critical care outcomes: Time for ICNARC to reconsider? 社会经济地位与重症监护结果：ICNARC是时候重新考虑了？

IF 1.9

Journal of the Intensive Care Society Pub Date : 2026-02-27 DOI: 10.1177/17511437261415836

David A Harrison, Paul Mouncey

引用次数: 0

Targeting and monitoring mean arterial pressure in critical illness: A mixed-methods service evaluation. 危重病人平均动脉压定位与监测：一种混合方法服务评价。

IF 1.9

Journal of the Intensive Care Society Pub Date : 2026-02-14 eCollection Date: 2026-05-01 DOI: 10.1177/17511437261415835

Isla MacKay, Ian Piper, Annemarie B Docherty

{"title":"Targeting and monitoring mean arterial pressure in critical illness: A mixed-methods service evaluation.","authors":"Isla MacKay, Ian Piper, Annemarie B Docherty","doi":"10.1177/17511437261415835","DOIUrl":"10.1177/17511437261415835","url":null,"abstract":"Background: In sepsis and cardiac arrest, arterial hypotension is associated with poorer outcomes, including renal injury and mortality. Guidelines recommend a mean arterial pressure (MAP) target of ⩾65 mmHg, but supporting evidence is limited. We undertook a service evaluation which aimed to: (1) assess clinical opinion regarding the optimal MAP target in intensive care (ICU); and (2) evaluate MAP target adherence at the Royal Infirmary Edinburgh ICU, quantifying levels of hypotension.Methods: We utilised a concurrent triangulation mixed-methods approach, integrating semi-structured consultant interviews and quantitative analysis of patient-level blood pressure data. Blood pressure data were collected at 1-min intervals for the first 72 h of arterial monitoring. We defined hypotensive insults by five sequential minutes below MAP target.Results: We interviewed 18 consultants. Twelve (67%) reported a standard target of 65 mmHg. The importance of evidence-based, individualised, and flexible targets was emphasised. We included 208,570 min of monitoring time across 66 patients. At admission, 53 (80%) patients received a target of 65 mmHg. Mean (SD) MAP was lower in patients on vasopressors than those not on vasopressors (77.6 (14.2) vs 86.9 (17.3) mmHg, p = 0.0001). Hypotension affected 55 (83%) patients and accounted for >10% of monitoring time in thirteen (20%). Median pressure-time index (PTI) was 3.4 mmHg * h; 24 (36%) patients had a PTI >10 mmHg * h.Conclusions: The optimal MAP target varied by patient, yet target personalisation remained limited in practice. Target adherence varied, with observed MAP both exceeding and undershooting set targets. Future research will explore the feasibility and implications of achieving tighter blood pressure control.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"187-197"},"PeriodicalIF":1.9,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207998","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 impact of early physical mobilisation for the management and prevention of intensive care unit delirium: A qualitative study exploring patients' perspectives. 早期身体活动对重症监护病房谵妄管理和预防的影响：一项探索患者观点的定性研究。

IF 1.9

Journal of the Intensive Care Society Pub Date : 2026-01-29 eCollection Date: 2026-08-01 DOI: 10.1177/17511437261416698

Jacqueline Bennion, Roger Garrett, Duncan Barron, Daniel Martin, Gill Mein

{"title":"The impact of early physical mobilisation for the management and prevention of intensive care unit delirium: A qualitative study exploring patients' perspectives.","authors":"Jacqueline Bennion, Roger Garrett, Duncan Barron, Daniel Martin, Gill Mein","doi":"10.1177/17511437261416698","DOIUrl":"10.1177/17511437261416698","url":null,"abstract":"Background: The intensive care unit (ICU) may be described as a 'deliriogenic' environment. Critically ill patients diagnosed with delirium are at increased risk of long-term cognitive impairment and hospital mortality. Best practice guidelines recommend early mobilisation interventions to manage and prevent delirium in ICUs. However, evidence evaluating the impact and role of early mobilisation upon delirium in ICUs from the patient perspective is lacking. The aim of this study was to understand the experience of early mobilisation from the perspective of patients diagnosed with delirium in the ICU.Methods: This qualitative study adopted a phenomenological approach. One focus group including three participants and seven semi-structured one-to-one interviews were conducted with patients previously diagnosed with delirium in the ICU. Data were analysed using Braun and Clarke's thematic analysis. Face validity of findings was reviewed by a public representative on the research team.Results: Six main themes were identified: (1). The vivid reality and isolation of delirium, (2). Loss of control, (3). Delirium as a barrier to mobilisation, (4). The role of different methods of mobilisation (5). Facilitating mobilisation and recovery of self, and (6). Grounded back into reality.Conclusion: This qualitative study demonstrated the impact and role of mobilisation interventions going beyond the patients' physical recovery from critical illness. These findings support current best practice recommendations for the implementation of early mobilisation interventions in ICUs.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"294-301"},"PeriodicalIF":1.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107788","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

What is the best way to secure a chest drain? A scoping review. 确保胸腔引流的最佳方法是什么？范围审查。

IF 1.9

Journal of the Intensive Care Society Pub Date : 2026-01-29 eCollection Date: 2026-05-01 DOI: 10.1177/17511437251412171

Chit Wong, Joshua Wright, Francesco Luke Siena, Philip Breedon, David W Hewson, Martin Beed

{"title":"What is the best way to secure a chest drain? A scoping review.","authors":"Chit Wong, Joshua Wright, Francesco Luke Siena, Philip Breedon, David W Hewson, Martin Beed","doi":"10.1177/17511437251412171","DOIUrl":"10.1177/17511437251412171","url":null,"abstract":"Each year, around 30,000 intercostal chest drains (ICDs) are inserted in the UK, with complications like displacement being a common concern. Various fixation techniques have been proposed to secure ICDs, but there is no consensus on a gold standard. A scoping review was conducted to identify publications describing ICD fixation methods and frequency with which they become dislodged. Three databases were reviewed: MEDLINE from 1946 to 17th October 2024 through the Ovid® website portal, PubMed®, and the Cochrane Central Register of Controlled Trials (CENTRAL). Appropriate search terms and synonyms were applied with Boolean operators and from 5275 identified records 63 were included for review. Nine ICD fixation principles were identified to classify fixation methods: kinking; Poisson-effect (\"Roman Sandal\"); suture \"through\" the tube; tube fixation points (cuffs or wings); friction/adhesion (from ties or dressings); external coiling/locking/flattening; internal balloons; internal coiling (pigtails); subcutaneous tunnelling. Many fixation methods combined more than one principle. Although no definitive conclusions on the best fixation method can be drawn from this review, trends suggest that incorporating sutures or using combined techniques, such as sutures paired with dressings, cable ties or balloon catheters, may enhance ICD security. In laboratory conditions, the highest pull force was associated with the modified Jo'berg knot. Further robust studies are needed to compare the effectiveness of different fixation methods superior in terms of displacement rate, but also taking into account pain, skin integrity, wound leakage/infection, or ease of use.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"198-212"},"PeriodicalIF":1.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107751","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

A national benchmarking survey to explore the use of dose error reduction software in adult intensive care units (ICUs). 一项旨在探讨在成人重症监护病房（icu）使用剂量误差减少软件的全国性基准调查。

IF 1.9

Journal of the Intensive Care Society Pub Date : 2026-01-27 eCollection Date: 2026-05-01 DOI: 10.1177/17511437261415832

Shaun Morgan, Scott Lamont

{"title":"A national benchmarking survey to explore the use of dose error reduction software in adult intensive care units (ICUs).","authors":"Shaun Morgan, Scott Lamont","doi":"10.1177/17511437261415832","DOIUrl":"10.1177/17511437261415832","url":null,"abstract":"Background: Dose Error Reduction Software (DERS) are downloaded onto Smart Pumps with minimum and maximum infusion rate settings to reduce the risk of medication errors when administering intravenous medicines. There are no current national standards for the application of this technology on Adult Intensive Care Units (ICU), and clinical application and governance of this technology is currently unknown.Method: A multicentre, cross-sectional survey was conducted using a self-administered questionnaire to explore practical aspects of Smart Pump containing DERS use, such as whether a DERS library was present, how it was managed, how propofol was administered, what kind of error reporting processes were in place, as well as nursing qualifications and competencies on ICUs in England.Results: A response rate of 50.7% (136/268 responses) ICUs units in England was achieved and indicated that 63.2% (86/136 responses) of responding units had a Smart Pump containing a DERS library. Three administration strategies were used, mg/kg/h, mL/h and 'Other' (which most responses stated as mg/h) for propofol for continuous sedation in ICU Smart Pump containing DERS libraries. In 68.6% (49/86 responses) of ICUs, DERS use and DERS error rates are not reported through local operational and governance structures. DERS use was significantly associated with units having a Clinical Nurse Educator with a postgraduate education certificate (p = 0.005).Conclusions: There are no standardised DERS settings for the anaesthetic agent propofol and inconsistent approaches to Smart Pump containing DERS governance oversight across ICUs in England. Further research is required to understand the clinical significance of identified variability.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"179-186"},"PeriodicalIF":1.9,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12846906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087562","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

Exploring the training, implementation and utilisation experiences of lung ultrasound accredited physiotherapists in the United Kingdom: A national survey. 探索英国肺超声认证物理治疗师的培训、实施和利用经验：一项全国性调查。

IF 1.9

Journal of the Intensive Care Society Pub Date : 2026-01-26 eCollection Date: 2026-05-01 DOI: 10.1177/17511437251408630

Simon Hayward, David McWilliams, Chloe Kendrick, Ellis Porter

{"title":"Exploring the training, implementation and utilisation experiences of lung ultrasound accredited physiotherapists in the United Kingdom: A national survey.","authors":"Simon Hayward, David McWilliams, Chloe Kendrick, Ellis Porter","doi":"10.1177/17511437251408630","DOIUrl":"10.1177/17511437251408630","url":null,"abstract":"Background: With 10-years' worth of growth in the use of LUS by physiotherapists within the U.K., this survey explores their training, implementation and clinical practice experiences.Methods: A cross-sectional survey was delivered to U.K. Physiotherapists accredited in LUS. The 50-question survey was administered via JISC online and was open for 4-weeks in January 2025. Closed questions were presented descriptively; open questions underwent inductive conceptual content analysis and descriptive coding.Results: Of the 223 invitations, 168 surveys were returned (75% response rate). Responses were highest from four U.K. regions which correlated with a higher number of regional mentors. Most respondents were in band 7 static roles, accredited via FUSIC® and worked on the ICU with respiratory or surgical patients. The primary indication to perform a LUS was an increase in the fraction of inspired oxygen, average scanning frequency was 1-2 per week and common pathological findings were consolidation (pneumonia and atelectasis) plus pleural effusion (transudative and exudative). The most common negative factors experienced overall were limited time to scan and access to an US machine. Additional negative factors were limited access to a mentor during training, limited support from other professions during implementation, limited access to an appropriate patient population to scan during clinical practice.Conclusion: This is the largest survey to investigate the experiences of physiotherapists using lung ultrasound in the U.K. and provides important insights during training, implementation and clinical use. The specific details of these findings will support both current and future LUS users to plan and develop robust physiotherapy LUS service.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"213-223"},"PeriodicalIF":1.9,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12846904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087541","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

Surrogate patient and relative communication feedback for senior ICU doctors. ICU高级医师代理患者及相关沟通反馈。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2026-01-21 eCollection Date: 2026-05-01 DOI: 10.1177/17511437261415834

Sam Waddy

引用次数: 0

Socioeconomic status and critical care outcomes: Time for ICNARC to reconsider? 社会经济地位与重症监护结果：ICNARC是时候重新考虑了？

IF 1.9

Journal of the Intensive Care Society Pub Date : 2026-01-14 DOI: 10.1177/17511437261415831

Ned Gilbert-Kawai, Tom Syratt

引用次数: 0

Discharging people home editorial: Article against-Should patients be discharged directly home (DDH) from critical care? 让病人出院回家社论：文章反对——病人应该从重症监护中直接出院回家吗？