Critical Care Research and Practice最新文献

{"title":"Knowledge, Attitude, and Associated Factors towards Physical Assessment among Nurses Working in Intensive Care Units: A Multicenter Cross-Sectional Study.","authors":"Bikis Liyew, Ambaye Dejen Tilahun, Tilahun Kassew","doi":"10.1155/2020/9145105","DOIUrl":"10.1155/2020/9145105","url":null,"abstract":"<p><strong>Introduction: </strong>Nurses working in the intensive care unit play an essential role in detecting patients at risk of deterioration through ongoing assessment and action in response to changing health status.</p><p><strong>Objectives: </strong>To assess knowledge, attitude, and associated factors towards physical assessment on critically ill patients among nurses working in the intensive care unit at Amhara regional state referral hospitals, Northwest Ethiopia, 2019. The research hypothesis: there is poor physical assessment knowledge, poor physical assessment attitude, and there are factors that are likely to affect nurses' knowledge and attitude towards physical assessment providing this care to critically ill patients at Amhara regional state referral hospitals, Northwest Ethiopia, 2019.</p><p><strong>Methods: </strong>Institution-based cross-sectional study was conducted among 299 nurses from March to September 2019. A convenience sampling method was used. Data were entered by using Epi Info 7.2.2 and analyzed by using STATA 14. The result was computed by descriptive statistics and to explore predictors of knowledge, and attitude linear regression analysis models were fitted, and the adjusted unstandardized beta (<i>β</i>) coefficient at 95% CI was used. A <i>p</i>-value <0.05 was considered significant. Result and conclusion: the knowledge mean scores were 9.93 ± 2.99 [95% CI (9.59, 10.31)]. The proportion of nurse's knowledge who score above the mean was 167 (55.9%) [95% CI (50.2, 61.5)] and below the mean 132 (44.1%) [95% CI (38.5, 49.8)]. Attitude means scores were 36.85 ± 6.21 [(36.16, 37.51)]. The proportions of nurse's attitudes who score above the mean were 158 (52.8%) [95% CI (47.5, 58.5)] and below the mean 141 (47.2) [95% CI (41.5, 52.5)]. Regarding predictor variables, being male [<i>β</i> = 0.84, 95% CI (0.16, 1.52)] and taken training [<i>β</i> = 1.85, 95% CI (1.14, 2.56)] were factors positively associated with knowledge, whereas has taken training [<i>β</i> = 4.13, 95% CI (2.82, 5.44)], total years of experience [<i>β</i> = 0.59, 95% CI (0.25, 0.93)], and knowledge [<i>β</i> = 0.92, 95% CI (0.0.72, 1.12)] were factors positively associated with attitude towards physical assessment.</p><p><strong>Conclusion: </strong>Based on the result of this study, the knowledge and attitude towards physical assessment regarding critically ill patients among nurses working in intensive care units were good. Hence, training, educational support services, and awareness are recommended to encourage nurse's knowledge and attitude towards physical assessment.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"9145105"},"PeriodicalIF":1.7,"publicationDate":"2020-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38313254","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":"Intravenous Fluid of Choice in Major Abdominal Surgery: A Systematic Review.","authors":"Seechad Noonpradej,&nbsp;Osaree Akaraborworn","doi":"10.1155/2020/2170828","DOIUrl":"https://doi.org/10.1155/2020/2170828","url":null,"abstract":"<p><strong>Background: </strong>Intravenous fluid therapy plays a role in maintaining the hemodynamic status for tissue perfusion and electrolyte hemostasis during surgery. Recent trials in critically ill patients reported serious side effects of some types of fluids. Since the most suitable type of fluid is debatable, a consensus in perioperative patients has not been reached.</p><p><strong>Method: </strong>We performed a systematic review of randomized control trials (RCTs) that compared two or more types of fluids in major abdominal surgery. The outcomes were related to bleeding, hemodynamic status, length of hospital stay, and complications, such as kidney injury, electrolyte abnormality, major cardiac adverse event, nausea, vomiting, and mortality. A literature search was performed using Medline and EMBASE up to December 2019. The data were pooled to investigate the effect of fluid on macrocirculation and intravascular volume effect.</p><p><strong>Results: </strong>Forty-three RCTs were included. Eighteen fluids were compared: nine were crystalloids and nine were colloids. The results were categorized into macrocirculation and intravascular volume effect, microcirculation, anti-inflammatory parameters, vascular permeability, renal function (colloids), renal function and electrolytes (crystalloids), coagulation and bleeding, return of bowel function, and postoperative nausea vomiting (PONV). We found that no specific type of fluid led to mortality and every type of colloid was equivalent in volume expansion and did not cause kidney injury. However, hydroxyethyl starch and dextran may lead to increased bleeding. Normal saline can cause kidney injury which can lead to renal replacement therapy, and dextrose fluid can decrease PONV.</p><p><strong>Conclusion: </strong>In our opinion, it is safe to give a balanced crystalloid as the maintenance fluid and give a colloid, such as HES130/0.4, 4% gelatin, or human albumin, as a volume expander.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"2170828"},"PeriodicalIF":1.7,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2170828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38300561","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":"Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study.","authors":"Fernanda G de M Soares Pinheiro,&nbsp;Eduesley Santana Santos,&nbsp;Íkaro Daniel de C Barreto,&nbsp;Carleara Weiss,&nbsp;Andreia C Vaez,&nbsp;Jussiely C Oliveira,&nbsp;Matheus S Melo,&nbsp;Francilene A Silva","doi":"10.1155/2020/1483827","DOIUrl":"10.1155/2020/1483827","url":null,"abstract":"<p><strong>Background: </strong>Mortality in the intensive care unit (ICU) has been associated to an array of risk factors. Identification of risk factors potentially contribute to predict and reduce mortality rates in the ICU. The objectives of the study were to determine the prevalence and the factors associated with the mortality and to analyze the survival.</p><p><strong>Method: </strong>A cross-sectional study conducted in two clinical and surgical ICU in the state of Sergipe, northeastern Brazil. We enrolled 316 patients with at least 48 h of hospitalization, minimum age of 18 years old, sedated or weaned, with RASS ≥ -3, between July 2017 and April 2018. We categorized data in (1) age and gender, (2) clinical condition, and (3) prevalence of delirium. Data from enrolled patients were collected from enrollment until death or ICU discharge. Patients' outcomes were categorized in (1) death and (2) nondeath (discharge).</p><p><strong>Results: </strong>Twenty-one percent of participants died. Age (53 ± 17 years <i>vs</i>. 45 ± 18 years, <i>p</i> < 0.01), electrolyte disturbance (30.3% <i>vs</i> 18.1%, <i>p</i>=0.029), glycemic index (33.3% <i>vs</i> 18.2%, <i>p</i>=0.008), tube feeding (83.3% vs 67.1%, <i>p</i>=0.01), mechanical ventilation (50% <i>vs</i> 35.7%, <i>p</i>=0.035), sedation with fentanyl (24.2 <i>vs</i> 13.6, <i>p</i>=0.035), use of insulin (33.8% <i>vs</i> 21.7%, <i>p</i>=0.042), and higher Charlson score (2.61 <i>vs</i> 2.17, <i>p</i>=0.041) were significantly associated with death on the adjusted model. However, the regression model indicated that patients admitted from the emergency (HR = 0.40, <i>p</i>=0.006) and glycemic index alterations (HR = 1.68, <i>p</i>=0.047) were associated with mortality. There was no statistically significant difference (<i>p</i>=0.540) in survival between patients with and without delirium, based on the survival analysis and length of hospitalization.</p><p><strong>Conclusion: </strong>The prevalence of death was 21%, and age, electrolyte disturbance, glycemic index, tube feeding, mechanical ventilation, sedation with fentanyl, use of insulin, and higher Charlson score were associated with mortality.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"1483827"},"PeriodicalIF":1.7,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1483827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38269530","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":"Incidence, Risk Factors, and Outcome of Acute Kidney Injury in the Intensive Care Unit: A Single-Center Study from Jordan.","authors":"Ashraf O Oweis,&nbsp;Sameeha A Alshelleh,&nbsp;Suleiman M Momany,&nbsp;Shaher M Samrah,&nbsp;Basheer Y Khassawneh,&nbsp;Musa A K Al Ali","doi":"10.1155/2020/8753764","DOIUrl":"https://doi.org/10.1155/2020/8753764","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common serious problem affecting critically ill patients in intensive care unit (ICU). It increases their morbidity, mortality, length of ICU stay, and long-term risk of chronic kidney disease (CKD).</p><p><strong>Methods: </strong>A retrospective study was carried out in a tertiary hospital in Jordan. Medical records of patients admitted to the medical ICU between 2013 and 2015 were reviewed. We aimed to identify the incidence, risk factors, and outcomes of AKI. Acute kidney injury network (AKIN) classification was used to define and stage AKI.</p><p><strong>Results: </strong>2530 patients were admitted to medical ICU, and the incidence of AKI was 31.6%, mainly in stage 1 (59.4%). In multivariate analysis, increasing age (odds ratio (OR) = 1.2 (95% CI 1.1-1.3), <i>P</i> = 0.0001) and higher APACHE II score (OR = 1.5 (95% CI 1.2-1.7), <i>P</i> = 0.001) were predictors of AKI, with 20.4% of patients started on hemodialysis. At the time of discharge, 58% of patients with AKI died compared to 51.3% of patients without AKI (<i>P</i> = 0.05). 88% of patients with AKIN 3 died by the time of discharge compared to patients with AKIN 2 and 1 (75.3% and 61.2% respectively, <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>AKI is common in ICU patients, and it increases mortality and morbidity. Close attention for earlier detection and addressing risk factors for AKI is needed to decrease incidence, complications, and mortality.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"8753764"},"PeriodicalIF":1.7,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8753764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564129","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":"Continuous Estimation of Cardiac Output in Critical Care: A Noninvasive Method Based on Pulse Wave Transit Time Compared with Transpulmonary Thermodilution.","authors":"Ulrike Ehlers,&nbsp;Rolf Erlebach,&nbsp;Giovanna Brandi,&nbsp;Federica Stretti,&nbsp;Richard Valek,&nbsp;Stephanie Klinzing,&nbsp;Reto Schuepbach","doi":"10.1155/2020/8956372","DOIUrl":"https://doi.org/10.1155/2020/8956372","url":null,"abstract":"<p><strong>Purpose: </strong>Estimation of cardiac output (CO) and evaluation of change in CO as a result of therapeutic interventions are essential in critical care medicine. Whether noninvasive tools estimating CO, such as continuous cardiac output (esCCOTM) methods, are sufficiently accurate and precise to guide therapy needs further evaluation. We compared esCCOTM with an established method, namely, transpulmonary thermodilution (TPTD). <i>Patients and Methods</i>. In a single center mixed ICU, esCCOTM was compared with the TPTD method in 38 patients. The primary endpoint was accuracy and precision. The cardiac output was assessed by two investigators at baseline and after eight hours.</p><p><strong>Results: </strong>In 38 critically ill patients, the two methods correlated significantly (<i>r</i> = 0.742). The Bland-Altman analysis showed a bias of 1.6 l/min with limits of agreement of -1.76 l/min and +4.98 l/min. The percentage error for CO_esCCO was 47%. The correlation of trends in cardiac output after eight hours was significant (<i>r</i> = 0.442), with a concordance of 74%. The performance of CO_esCCO could not be linked to the patient's condition.</p><p><strong>Conclusion: </strong>The accuracy and precision of the esCCOTM method were not clinically acceptable for our critical patients. EsCCOTM also failed to reliably detect changes in cardiac output.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"8956372"},"PeriodicalIF":1.7,"publicationDate":"2020-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8956372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38240746","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":"Free Fatty Acids in CSF and Neurological Clinical Scores: Prognostic Value for Stroke Severity in ICU.","authors":"Sayed Gaber,&nbsp;Sherine Ibrahim ElGazzar,&nbsp;Mahmoud Qenawi,&nbsp;Nora Ismail Mohamed Abbas","doi":"10.1155/2020/5808129","DOIUrl":"https://doi.org/10.1155/2020/5808129","url":null,"abstract":"<p><strong>Introduction: </strong>Brain ischemia initiated significant increase in FFAs in animal studies. Accumulation of FFA can lead to liberation of inflammatory byproducts that contribute to neuronal death. Increased risk of systemic thromboembolism was seen in animal models after FFA infusion possibly through activation of factor XII by stearic acids. The clinical studies that examined the relation between stroke in humans and CSF biomarkers are infrequent. <i>Aim of Work</i>. We tried to evaluate the potential role of FFAs in CSF in the diagnosis and the prognosis of ICU patients with AIS while comparing the results to traditional neurological scoring systems. <i>Patients and Methods</i>. Our study included 80 patients who were admitted to ICU with acute ischemic stroke (AIS) within 24 hours of the onset of cerebral infarction. CSF samples were obtained at admission. The FFA levels were measured using the sensitive enzyme-based colorimetric method. The NIHSS, GCS, and mRS were evaluated at admission and at 30 days. Univariate and multivariate analysis were used to evaluate the stroke outcome according to FFA levels in CSF.</p><p><strong>Results: </strong>Worsening of the GCS (<7) at 30 days showed a significant correlation with FFA in CSF. The ROC curve showed a cutoff value of 0.27 nmol/<i>µ</i>l, sensitivity of 62.9%, and specificity of 72.2%. There was a significant correlation between FFA in CSF and the mRS >2 at 30 days. The ROC curve showed a cutoff value of 0.27 nmol/<i>µ</i>l, specificity of 69.2%, and sensitivity of 59.7%. There was a significant correlation between FFA in CSF and the NIHSS ≥ 16 at 30 days. The ROC curve showed a cutoff value of 0.27 nmol/<i>µ</i>l, specificity of 72.2%, and sensitivity of 62.9%. Our study subdivided patients according to infarction volume and compared the 2 subgroups with FFA in CSF. We found a significant difference between 2 subgroups. FFA levels showed a positive correlation with infarction volume ≥145 ml. The ROC curve showed a cutoff value of 0.25 nmol/<i>µ</i>l, sensitivity of 76.9%, and specificity of 71.4%. Our study showed that FFA in CSF was a significant predictor of all-cause mortality (0.37 + 0.26, <i>P</i> value 0.007). The ROC curve showed a cutoff value of 0.27, specificity of 72.2%, and sensitivity of 62.9%. There was a positive correlation between FFA in CSF and neurological causes of mortality (0.48 + 0.38, <i>P</i> value 0.037). The ROC curve showed a cutoff value of 0.37 nmol/<i>µ</i>l, specificity of 76.1%, and sensitivity of 61.5%.</p><p><strong>Conclusion: </strong>FFA in CSF may serve as an independent prognostic biomarker for assessing the prognosis of acute ischemic stroke and the clinical outcome. It might be a useful biomarker for early detection of high-risk patients for poor outcome and hence more aggressive treatment.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"5808129"},"PeriodicalIF":1.7,"publicationDate":"2020-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5808129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38212372","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":"Cardiopulmonary Resuscitation in Interfacility Transport: An International Report Using the Ground Air Medical Quality in Transport (GAMUT) Database.","authors":"Utpal S Bhalala,&nbsp;Neeraj Srivastava,&nbsp;M David Gothard,&nbsp;Michael T Bigham","doi":"10.1155/2020/4647958","DOIUrl":"https://doi.org/10.1155/2020/4647958","url":null,"abstract":"<p><strong>Background: </strong>With the regionalization of specialty care, there is an increasing need for interfacility transport from local to regional hospitals. There are very limited data on rates of cardiopulmonary resuscitation (CPR) during medical transport and relationship between transport-specific factors, such as transport program type and need of CPR during transport of critically ill patients. We present the first, multicenter, international report of CPR during medical transport using the large Ground and Air Medical qUality Transport (GAMUT) database.</p><p><strong>Methods: </strong>We retrospectively reviewed the GAMUT database from January 2014 to March 2017 for CPR during transport. We determined the overall CPR rate and CPR rates for adult, pediatric, and neonatal transport programs. The rate of CPR per total transports was expressed as percentage, and then, Spearman's rho nonparametric associations were determined between CPR and other quality metrics tracked in the GAMUT database. Examples include advanced airway presence, waveform capnography usage, average mobilization time from the start of referral until en route, 1^st attempt intubation success rate, and DASH1A intubation success (definitive airway sans hypoxia/hypotension on 1^st attempt). Data were analyzed using chi-square tests, and in the presence of overall significance, post hoc Bonferroni adjusted <i>z</i> tests were performed.</p><p><strong>Results: </strong>There were 72 programs that had at least one CPR event during the study period. The overall CPR rate was 0.42% (777 CPR episodes/184,272 patient contacts) from 115 programs reporting transport volume and CPR events from the GAMUT database during the study period. Adult, pediatric, and neonatal transport programs (<i>n</i> = 57, 40 and 16, respectively) had significantly different CPR rates (<i>P</i> < 0.001) i.e., 0.68% (555/82,094), 0.18% (138/76,430), and 0.33% (73/21,823), respectively. Presence of an advanced airway and mobilization time was significantly associated with CPR episodes (<i>P</i> < 0.001) (Rs = +0.41 and Rs  = -0.60, respectively). Other transport quality metrics such as waveform capnography, first attempt intubation, and DASH1A success rate were not significantly associated with CPR episodes.</p><p><strong>Conclusion: </strong>The overall CPR rate during medical transport is 0.42%. Adult, pediatric, and neonatal program types have significantly different overall rates of CPR. Presence of advanced airway and mobilization time had an association with the rate of CPR during transport.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"4647958"},"PeriodicalIF":1.7,"publicationDate":"2020-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4647958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38178369","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":"Effect of Early Mobilization on Respiratory and Limb Muscle Strength and Functionality of Nonintubated Patients in Critical Care: A Feasibility Trial","authors":"Maria Karoline Richtrmoc, W. Souza Leite, Anielle Martins Azevedo, Raissa Farias Correia, Rômulo de Aquino Coelho Lins, Wildberg Alencar Lima, C. A. Araújo Morais, Rodrigo Rios Pereira, M. Bandeira, Carlos Eduardo Santos Rego Barros, Amina Maria Soares de Lima, M. G. Rodrigues-Machado, D. Cunha Brandão, A. D. D. Dornelas de Andrade, M. I. Remígio de Aguiar, Shirley Lima Campos","doi":"10.1155/2020/3526730","DOIUrl":"https://doi.org/10.1155/2020/3526730","url":null,"abstract":"Purpose. To assess the potential effectiveness or efficacy of early mobilization on respiratory and peripheral muscle strengths and functionality in nonintubated patients. Methods. For 40 nonintubated patients over 18 years of age with over 24-hour intensive care unit (ICU) stay allocated to a single intervention, an incremental mobilization protocol was initiated. Maximal inspiratory and expiratory pressures (MIP and MEP), peripheral muscle strength (handgrip strength (HGS) and Medical Research Council scale (MRC-s)), and functionality (FIM, ICF-BMS, PFIT-s, and FSS-ICU scales) were evaluated at ICU admission and discharge. Results. All outcomes were significantly improved (pre vs. post values): MIP (43.93 ± 21.95 vs. 54.12 ± 21.68 cmH2O; ), MEP (50.32 ± 28.65 vs. 60.30 ± 21.23; ), HGS (25.5 (9.58) vs. 27.5 (9.48); ), MRC-s (58.52 ± 2.84 vs. 59.47 ± 1.81; ), FIM (54.4 ± 22.79 vs. 69.48 ± 12.74), ICF-BMS (28.63 ± 16.19 vs. 14.03 ± 11.15), PFIT-s (9.55 ± 2.34 vs. 11.18 ± 1.32) ( ), and FSS-ICU (28.7 ± 9.1 vs. 32.6 ± 5.0; ). The ceiling effect at admission/discharge was in MRC-s (60/82.5%), FSS-ICU (50/70%), and FIM (35/62.5%). The floor effect occurred at discharge in ICF-BMS (7.5/52.5%). Conclusions. The early mobilization protocol seemed effective at maintaining/increasing the respiratory muscle strength and functionality of nonintubated patients in critical care. Ceiling effect was high for MRC-s, FSS-ICU, and FIM scales.","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 1","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2020-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3526730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42366256","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":"Efficacy of Thiamine in the Treatment of Postcardiac Arrest Patients: A Randomized Controlled Study.","authors":"Suntornwit Pradita-Ukrit,&nbsp;Veerapong Vattanavanit","doi":"10.1155/2020/2981079","DOIUrl":"https://doi.org/10.1155/2020/2981079","url":null,"abstract":"<p><strong>Background: </strong>Thiamine administration has been shown to improve survival in a postcardiac arrest animal study. We aimed to evaluate the efficacy of thiamine in comatose out-of-hospital cardiac arrest (OHCA) patients following return of spontaneous circulation.</p><p><strong>Methods: </strong>A randomized, double-blinded, placebo-controlled study was conducted. Thirty-seven OHCA patients were randomly assigned to receive either thiamine 100 mg every 8 hours or a placebo. The primary outcome was 28-day all-cause mortality.</p><p><strong>Results: </strong>Over the course of 2 years, 37 patients were randomized to either receive thiamine (<i>n</i> = 20) or a placebo (<i>n</i> = 17). The primary outcome was not different between the groups: 10/20 (50%) in the thiamine group vs. 8/17 (47.1%) in the placebo group (<i>P</i>=0.93 by the log-rank test). There were no significant differences in secondary outcomes between the groups (good neurological outcome, lactate level, and S100B level).</p><p><strong>Conclusions: </strong>In this study, there were no significant differences in survival outcome. Further studies with a larger population are necessary to confirm these results.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"2981079"},"PeriodicalIF":1.7,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2981079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38086983","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":"Nurses' Knowledge, Attitude, and Influencing Factors regarding Physical Restraint Use in the Intensive Care Unit: A Multicenter Cross-Sectional Study.","authors":"Tilahun Kassew,&nbsp;Ambaye Dejen Tilahun,&nbsp;Bikis Liyew","doi":"10.1155/2020/4235683","DOIUrl":"https://doi.org/10.1155/2020/4235683","url":null,"abstract":"<p><strong>Background: </strong>Physical restraint is a common practice in the intensive care units which often result in frequent skin laceration at restraint site, limb edema, restricted circulation, and worsening of agitation that may even end in death. Despite the sensitivity of the problem, however, it is felt that there are nurses' evidence-based practice gaps in Ethiopia. To emphasize the importance of this subject, relevant evidence is required to develop protocols and to raise evidence-based practices of health professionals. So, this study aimed to assess the knowledge, attitude, and influencing factors of nurses regarding physical restraint use in the intensive care units in northwest Ethiopia.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was maintained from March to September 2019 at Amhara regional state referral hospitals, northwest Ethiopia. A total of 260 nurses in the intensive care units were invited to take part in the study by a convenience sampling technique. The Level of Knowledge, Attitudes, and Practices of Staff regarding Physical Restraints Questionnaire was used to assess the nurses' knowledge and attitude. Linear regression analysis was employed to examine the influencing factors of knowledge and attitude. Adjusted unstandardized beta (<i>β</i>) coefficient with a 95% confidence interval was used to report the result of association with a <i>p</i> value < 0.05 statistical significance level.</p><p><strong>Result: </strong>The mean scores of nurses' knowledge and attitude regarding physical restraint use among critically ill patients were 7.81 ± 1.89 and 33.75 ± 6.50, respectively. These mean scores are above the scale midpoint nearer to the higher ranges which imply a moderate level of knowledge and a good attitude regarding physical restraint. Lower academic qualification and short (<2 years) work experience were associated with lower-level of knowledge, and reading about restraint from any source and taken training regarding restraints were factors associated with a higher knowledge. Diploma and bachelor's in academic qualification were significantly associated with a negative attitude regarding restraint. Besides, there was a more positive attitude among nurses with a higher level of knowledge and who received training regarding physical restraint use.</p><p><strong>Conclusion: </strong>The nurses working in the intensive care unit had a moderate level of knowledge and a good attitude regarding physical restraint use. So, developing and providing educational and in-service training to the nurses regarding physical restraint are necessary to strengthen the quality of care for critically ill patients.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"4235683"},"PeriodicalIF":1.7,"publicationDate":"2020-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4235683","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38073452","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}