Acute and Critical Care最新文献

{"title":"Implementation of a partnership involving parents in the care of critically ill children: an integrative review.","authors":"Tuti Seniwati, Nani Nurhaeni, Dessie Wanda","doi":"10.4266/acc.001896","DOIUrl":"10.4266/acc.001896","url":null,"abstract":"<p><p>The admission of a child to an intensive care unit, such as pediatric or neonatal intensive care units, serves as a significant stressor for parents. This condition is exacerbated when the child undergoes treatment in isolation from their parents. One strategy to address this challenge involves positioning parents at the bedside during the child's care. This study aimed to identify and synthesize qualitative and quantitative research evidence on partnerships involving parents in the care of critically ill children. This research employed an integrative review method, and it was registered with the International Prospective Register of Systematic Reviews as a research-implementation protocol (ID no. CRD42023414924t). Six databases were searched for relevant literature, including ScienceDirect, Scopus, ProQuest, Sage Journals, PubMed, and Google Scholar. The evaluation of article quality used the 2018 version of the Mixed Methods Appraisal Tool, while content analysis was employed for data analysis. The results indicated that 18 articles fulfilled the inclusion requirements, out of the 5,435 articles found during the search phase. The analysis resulted in the discovery of three primary themes: partnership components, partnership outcomes and factors influencing partnerships. These three themes collectively constitute the conceptual model of partnerships in treating children with critical illness. It can be concluded that the active participation of parents in a child's critical care will yield positive outcomes for both the child and the parents. Existing empirical data underscore the significance of comprehending the factors influencing this specific situation.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"521-537"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726739","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}

{"title":"Correction and clarification on reported percentage error of estimated continuous cardiac output.","authors":"Ryoichi Ochiai","doi":"10.4266/acc.005225","DOIUrl":"10.4266/acc.005225","url":null,"abstract":"","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"638-639"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726697","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}

{"title":"Association between nutritional risk scores and timing of endotracheal intubation in COVID-19-associated acute respiratory distress syndrome: a single-center cohort study in South Korea.","authors":"Hyojin Jang, Wanho Yoo, Kwangha Lee","doi":"10.4266/acc.003900","DOIUrl":"10.4266/acc.003900","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing of endotracheal intubation in patients with coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome (ARDS) remains uncertain, and delayed intubation is associated with worse outcomes. Nutritional status, known to affect respiratory function and immune response, may help identify patients at risk of rapid deterioration. This study aimed to evaluate whether nutritional risk scores can predict early intubation in COVID-19-associated ARDS.</p><p><strong>Methods: </strong>We retrospectively analyzed 247 patients with COVID-19-associated ARDS admitted to a tertiary hospital intensive care unit. Nutritional status at admission was assessed using the modified Nutrition Risk in the Critically Ill (mNUTRIC) score and the Prognostic Nutritional Index (PNI). Early intubation was defined as occurring within 24 hours of hospital admission. Receiver operating characteristic curves and multivariate logistic regression were used to evaluate predictive performance.</p><p><strong>Results: </strong>Of 247 patients, 193 (78.1%) required mechanical ventilation, and 133 (68.9%) underwent early intubation. The mNUTRIC score showed moderate discriminatory performance (area under the curve [AUC], 0.705), while PNI performed poorly (AUC, 0.401). In a multivariate analysis adjusted for illness severity, only Acute Physiology and Chronic Health Evaluation II (OR, 1.206, P<0.001) and SOFA scores (OR, 1.270, P=0.028) were independent predictors of early intubation. The mNUTRIC score was not independently associated (P>0.05), suggesting its value is derived from component severity.</p><p><strong>Conclusions: </strong>The predictive power of the mNUTRIC score for early intubation in COVID-19 ARDS was primarily driven by its embedded illness severity components. Nevertheless, the score demonstrated practical utility as a single, composite marker for rapid, holistic evaluation of patient risk.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"538-547"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726733","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}

{"title":"Autonomy versus paternalism: what is the physician's responsibility in a life-threatening situation?","authors":"Sunil Kumar Garg, Ahmed Altigany Fadlallah","doi":"10.4266/acc.001650","DOIUrl":"10.4266/acc.001650","url":null,"abstract":"","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"635-637"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726736","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}

{"title":"The role of catecholamines in aneurysmal subarachnoid hemorrhage: a narrative review.","authors":"Samantha Nalliah, Tariq Janjua, Luis Rafael Moscote-Salazar, Md Yunus, Amit Agrawal","doi":"10.4266/acc.001525","DOIUrl":"10.4266/acc.001525","url":null,"abstract":"<p><p>The marked release of catecholamines during subarachnoid hemorrhage is an important aspect of the pathobiology following aneurysmal rupture. This narrative review aims to identify how catecholamines influence aneurysmal subarachnoid hemorrhage (aSAH) outcomes. aSAH is a critical neurological condition characterized by hemorrhage into the subarachnoid space, leading to severe neurological deficits and mortality. Catecholamines, including epinephrine, norepinephrine, and dopamine, are the body's stress responses, which can lead to secondary injuries following aSAH. This review was conducted through a targeted literature search of relevant studies examining the relationship between aSAH, catecholamines, and clinical outcomes. Searches were performed in PubMed, Scopus, The Cochrane Library, Medline (Ovid), Embase (Ovid), and CINAHL, including publications up to July 2024. Search terms combined keywords and subject headings related to \"subarachnoid hemorrhage\" or \"aSAH,\" \"catecholamines,\" \"epinephrine,\" \"norepinephrine,\" \"dopamine,\" and outcome-related terms such as \"prognosis,\" \"mortality,\" and \"neurological outcome.\" Articles were selected based on relevance, and key findings were synthesized descriptively to provide a comprehensive overview of current knowledge in this area. Elevated levels of catecholamines are observed following aSAH and are associated with increased sympathetic nervous system activity. This catecholamine surge contributes to pathological processes, including vasospasm, blood-brain barrier disruption, cerebral edema, and neuronal damage. The review highlights the implications of catecholamine levels; where higher concentrations correlate with poorer outcomes and higher mortality rates. Understanding the mechanisms responsible for secondary injury due to catecholamines surge following aSAH shall facilitate the development of therapeutic approaches to prevent secondary brain injury and improve outcomes.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"513-520"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725902","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}

{"title":"Early postoperative 6-minute walk test in cardiac surgery patients: an observational study assessing safety, feasibility, and predictors of completion in India.","authors":"Prasanth Jayaraman, Puvaneswari Kanagaraj, Shrinivas Hittalamani","doi":"10.4266/acc.000050","DOIUrl":"10.4266/acc.000050","url":null,"abstract":"<p><strong>Background: </strong>Early mobilization after cardiac surgery is crucial for enhancing recovery, minimizing complications, and promoting timely discharge. The 6-minute walk test (6MWT) is a validated measure of functional capacity; however, its use during the early postoperative period-particularly in Intensive care Unit (ICU) settings in India-remains underexplored. This study assesses the safety, feasibility, and functional performance outcomes of the 6MWT administered on postoperative days (PODs) 2 to 4 and identifies factors associated with test completion.</p><p><strong>Methods: </strong>A cohort-based observational study was conducted in a tertiary care ICU between June and September 2021. In total, 150 cardiac surgery patients aged 30-70 years were enrolled. Inclusion required hemodynamic stability, no vasopressor/inotropic support, and ambulation from POD 2. The 6MWT was administered per the American Thoracic Society guidelines. Clinical, demographic, and physiological parameters were recorded and analyzed using descriptive statistics, paired t-tests, and regression analyses.</p><p><strong>Results: </strong>Of the 150 patients, 140 completed the test. The mean age was 52±14 years, and 75% of participants were male. Mean walking distances improved from 78.14 m (21.7% of predicted) on POD 2 to 193.51 m (53.75%) on POD 4. Completion rates increased from 40.0% to 99.2%. Physiological responses remained within safe limits, and no serious adverse events occurred. The regression analyses identified education, diet, and oxygen saturation as positive predictors and comorbidities, being female, oxygen use, and physical occupation as negative predictors.</p><p><strong>Conclusions: </strong>The 6MWT is a safe, feasible, and informative tool for assessing early functional recovery in stable post-cardiac surgery ICU patients to aid individualized rehabilitation and discharge planning.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"614-626"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726755","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}

{"title":"Correction: Estimating resting energy expenditure in critically ill patients: a retrospective exploratory comparison of predictive equations and Fick-derived Weir estimates in Italy.","authors":"Antonio Romanelli, Alessandro Calicchio, Salvatore Palmese, Sabato Pascarella, Bruna Pisapia, Renato Gammaldi","doi":"10.4266/acc.001300.e1","DOIUrl":"10.4266/acc.001300.e1","url":null,"abstract":"","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"642"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726742","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}

{"title":"The 6-hour window: is the sepsis transfer guideline enough?","authors":"Kyeongman Jeon","doi":"10.4266/acc.006000","DOIUrl":"10.4266/acc.006000","url":null,"abstract":"","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"627-629"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725917","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}

{"title":"Utility of procalcitonin in diagnosing early postoperative sepsis after pediatric cardiac surgery in Malaysia.","authors":"Muhammad Yusoff Mohd Ramdzan, Kah Kee Tan, Kok Wai Soo","doi":"10.4266/acc.005016","DOIUrl":"10.4266/acc.005016","url":null,"abstract":"<p><strong>Background: </strong>Systemic inflammation following cardiopulmonary bypass (CPB) can interfere with analysis of routine clinical and biochemical parameters. Procalcitonin (PCT) is a potential biomarker for diagnosing early postoperative sepsis in pediatric patients following cardiac surgery utilizing CPB. This study aimed to evaluate the diagnostic accuracy of PCT compared to other biomarkers, especially C-reactive protein (CRP), in this clinical setting.</p><p><strong>Methods: </strong>A prospective single-center study was conducted over a 10-month period during the coronavirus disease 2019 (COVID-19) pandemic (2021-2022), enrolling 89 pediatric patients postcardiac surgery. PCT, CRP, and complete blood count were analyzed, and area under the curve (AUC) was employed for statistical analysis.</p><p><strong>Results: </strong>PCT and CRP demonstrated moderate discriminatory ability with AUCs of 0.678 and 0.635, respectively. White cell count exhibited fair discriminatory power, and platelet count performed poorly in distinguishing septic from nonseptic cases (AUC: white cell count, 0.545; platelet, 0.486).</p><p><strong>Conclusions: </strong>PCT and CRP hold promise as diagnostic markers for early postoperative sepsis in pediatric cardiac surgery patients. However, these biomarkers are not adequate standalone indicators, emphasizing the continued need for clinical judgment supported by multiple diagnostic parameters.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"567-573"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726541","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}

{"title":"Ultrasound-guided supraclavicular internal jugular vein compression to increase internal jugular vein cross-sectional area in hospitalized patients: a prospective observational study in Japan.","authors":"Masataka Hiruma, Hiroyuki Honda, Shuichiro Kurita, Shunsuke Nukaga, Mitsuhiro Watanabe, Kei Nishiyama","doi":"10.4266/acc.002025","DOIUrl":"10.4266/acc.002025","url":null,"abstract":"<p><strong>Background: </strong>Real-time ultrasound-guided catheterization of the internal jugular vein (IJV) is widely used for its safety and high success rate. However, it becomes difficult when the IJV's cross-sectional area (CSA) is reduced. A reported technique applies manual pressure (with fingers) to the supraclavicular IJV to impede venous return and enlarge the distal CSA. While effective in previous studies, its clinical utility remains unclear, as those studies involved only healthy volunteers and used blind technique. Therefore, this study aimed to evaluate the efficacy of our novel ultrasound-guided compression of the proximal IJV.</p><p><strong>Methods: </strong>In this prospective observational study, 25 hospitalized patients were included. Two ultrasound machines were used: one to visualize the CSA of the distal IJV, and the other to apply and guide compression of the supraclavicular IJV, ensuring real-time confirmation of venous occlusion. Patients were asked about pain during the compression procedure. The primary outcome was the degree of dilation at the puncture site of the IJV.</p><p><strong>Results: </strong>All 25 patients (mean Sequential Organ Failure Assessment score: 5.2±3.6) completed the study. Supraclavicular IJV compression resulted in a significant increase in the CSA of the distal IJV by approximately 150%, from 0.4±0.3 cm² to 1.0±0.3 cm² (P<0.001). No patient reported any pain during the procedure.</p><p><strong>Conclusions: </strong>Ultrasound-guided supraclavicular IJV compression significantly increased the CSA of the distal IJV in hospitalized patients. This method enhances vein visibility by increasing IJV volume, potentially improving the success and safety of central venous catheterization.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 4","pages":"574-581"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726584","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}