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Association of oxygenation levels after successful mechanical thrombectomy under general anesthesia and 3-month functional outcome in patients with acute ischemic stroke: A prospective observational study 全麻下机械取栓成功后氧合水平与急性缺血性卒中患者3个月功能结局的关系:一项前瞻性观察研究
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.accpm.2025.101494
Manuel Taboada , Ana Estany-Gestal , Laura Barreiro , Kora Williams , Jorge Fernández , Marta Méndez , Fátima García , Borja Cardalda-Serantes , Carmen López , Manuel Rodríguez-Yáñez , Susana Arias-Rivas , María Santamaría-Cadavid , Emilio Rodríguez-Castro , Miguel Blanco , Antonio Mosqueira , Jose Antonio Castiñeiras , Esteban Ferreiroa , Pablo Otero , Alberto Naveira , Eva San Luis , Teresa Seoane-Pillado
{"title":"Association of oxygenation levels after successful mechanical thrombectomy under general anesthesia and 3-month functional outcome in patients with acute ischemic stroke: A prospective observational study","authors":"Manuel Taboada ,&nbsp;Ana Estany-Gestal ,&nbsp;Laura Barreiro ,&nbsp;Kora Williams ,&nbsp;Jorge Fernández ,&nbsp;Marta Méndez ,&nbsp;Fátima García ,&nbsp;Borja Cardalda-Serantes ,&nbsp;Carmen López ,&nbsp;Manuel Rodríguez-Yáñez ,&nbsp;Susana Arias-Rivas ,&nbsp;María Santamaría-Cadavid ,&nbsp;Emilio Rodríguez-Castro ,&nbsp;Miguel Blanco ,&nbsp;Antonio Mosqueira ,&nbsp;Jose Antonio Castiñeiras ,&nbsp;Esteban Ferreiroa ,&nbsp;Pablo Otero ,&nbsp;Alberto Naveira ,&nbsp;Eva San Luis ,&nbsp;Teresa Seoane-Pillado","doi":"10.1016/j.accpm.2025.101494","DOIUrl":"10.1016/j.accpm.2025.101494","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate whether oxygenation levels (PaO<sub>2</sub> &lt;150 mmHg <em>vs</em>. PaO<sub>2</sub> ≥150 mmHg) in mechanically ventilated patients with acute ischemic stroke (AIS) after successful endovascular treatment (EVT) under general anesthesia are associated with functional outcomes at three months.</div></div><div><h3>Methods</h3><div>We prospectively collected data over 30 mo from patients with proximal occlusion of the anterior circulation treated with successful EVT under general anesthesia. After the procedure, patients were admitted to the ICU for delayed extubation. Two groups were established based on the partial pressure of oxygen (PaO<sub>2</sub> &lt;150 mmHg <em>vs</em>. PaO<sub>2</sub> ≥150 mmHg), measured in arterial blood gas analysis within the first hour of ICU admission. Demographics, clinical factors, and neurological status were compared. The primary outcome was the proportion of patients achieving a favorable functional outcome (mRS ≤ 2) at 3 mo.</div></div><div><h3>Results</h3><div>During the study period, 271 patients were admitted to our ICU after EVT for AIS. Of these, 210 patients met the inclusion criteria. No significant differences were found between the groups in demographics, clinical factors, neurological status, or functional outcomes at 3 mo. The primary outcome showed no significant difference: 48 of 100 patients (48%) in the PaO<sub>2</sub> &lt;150 mmHg group achieved a favorable functional outcome (mRS 0–2) compared to 56 of 108 patients (51.9%) in the PaO<sub>2</sub> ≥150 mmHg group (p = 0.579).</div></div><div><h3>Conclusion</h3><div>No association was found between 3-mo functional outcomes and post-procedure oxygenation levels in patients with AIS treated successfully with EVT under general anesthesia.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101494"},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Time on the waiting list is an independent risk factor for day-90 mortality after lung transplantation 等待名单上的时间是肺移植术后90天死亡率的独立危险因素。
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.accpm.2025.101499
Enora Atchade , Vincent Bunel-Gourdy , Nathalie Zappella , Sylvain Jean-Baptiste , Alexy Tran-Dinh , Sébastien Tanaka , Brice Lortat-Jacob , Arnaud Roussel , Pierre Mordant , Yves Castier , Hervé Mal , Christian De Tymowski , Philippe Montravers
{"title":"Time on the waiting list is an independent risk factor for day-90 mortality after lung transplantation","authors":"Enora Atchade ,&nbsp;Vincent Bunel-Gourdy ,&nbsp;Nathalie Zappella ,&nbsp;Sylvain Jean-Baptiste ,&nbsp;Alexy Tran-Dinh ,&nbsp;Sébastien Tanaka ,&nbsp;Brice Lortat-Jacob ,&nbsp;Arnaud Roussel ,&nbsp;Pierre Mordant ,&nbsp;Yves Castier ,&nbsp;Hervé Mal ,&nbsp;Christian De Tymowski ,&nbsp;Philippe Montravers","doi":"10.1016/j.accpm.2025.101499","DOIUrl":"10.1016/j.accpm.2025.101499","url":null,"abstract":"<div><h3>Background</h3><div>The waitlist deaths of transplantation candidates based on their time on the waiting list (TWL) have already been studied, but the short-term mortality and early complications of lung transplant (LT) recipients based on their TWL have not been specifically studied. The first aim of this study was to assess the relationship between increased TWL and short-term mortality in LT recipients.</div></div><div><h3>Methods</h3><div>In this observational, monocentric, retrospective study, all patients who underwent LT between January 2016 and August 2022 at Bichat Claude Bernard Hospital, Paris were analyzed. Univariate analysis (chi2 test, Mann–Whitney test, Fisher’s exact test) and multivariate analysis (logistic regression) were performed. Ninety-days and one-year survival were studied (Kaplan–Meier curves, log-rank test). <em>p</em> &lt; 0.05 indicated statistical significance.</div></div><div><h3>Results</h3><div>242 LT patients were analyzed. The median TWL was 100 (43−229) days. Postoperative complications, including septic shock (36 <em>versus</em> 18%, <em>p</em> = 0.002), grade 3 primary graft dysfunction (31 <em>versus</em> 20%, <em>p</em> &lt; 0.001), and KDIGO3 acute kidney injury (8 <em>versus</em> 25%, <em>p</em> &lt; 0.001), were more common in the prolonged TWL (pTWL) group (&gt;100 days) than in the short TWL group (≤100 days). The duration of hospitalization in the ICU was longer (18 [11−34] <em>versus</em> 13 [9−23] days, <em>p</em> = 0.02) in the pTWL group. According to our multivariate analysis, TWL was an independent risk factor for 90-days mortality (OR 1.02, 95% CI [1.00−1.04]; <em>p</em> = 0.032).</div></div><div><h3>Conclusion</h3><div>TWL was an independent risk factor for 90-days mortality after LT. Receiving LT after more than 100 days on the waitlist exposes to increased postoperative complications.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101499"},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and safety of topical lignocaine anesthesia in improving patient satisfaction after endobronchial ultrasound–guided transbronchial needle aspiration under general anesthesia: A randomized controlled trial 局部利多卡因麻醉提高全身麻醉下超声引导下经支气管针吸术后患者满意度的有效性和安全性:一项随机对照试验。
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.accpm.2025.101495
Sen Zhang , Wannan Chen , Jian Wang , Changhong Miao , Hao Fang , Chao Liang
{"title":"Efficacy and safety of topical lignocaine anesthesia in improving patient satisfaction after endobronchial ultrasound–guided transbronchial needle aspiration under general anesthesia: A randomized controlled trial","authors":"Sen Zhang ,&nbsp;Wannan Chen ,&nbsp;Jian Wang ,&nbsp;Changhong Miao ,&nbsp;Hao Fang ,&nbsp;Chao Liang","doi":"10.1016/j.accpm.2025.101495","DOIUrl":"10.1016/j.accpm.2025.101495","url":null,"abstract":"<div><h3>Background</h3><div>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an effective technique used by thoracic surgeons and pulmonologists. This study evaluated the safety and efficacy of topical lignocaine anesthesia during bronchoscopy to improve the satisfaction of patients undergoing elective EBUS-TBNA under general anesthesia.</div></div><div><h3>Methods</h3><div>This was a single-center prospective randomized, double-blind clinical trial in University-affiliated teaching hospitals. A total of 196 patients underwent elective EBUS-TBNA under general anesthesia. Patients were randomly assigned to receive topical anesthesia with 1% lignocaine (T) or saline (C). The primary outcome was coughing frequency immediately after laryngeal mask removal. Secondary outcomes included coughing frequency and intensity (visual analog scale [VAS]), vital sign changes, adverse events, postoperative pulmonary complications, and the Quality of Recovery-15 (QoR-15) questionnaire.</div></div><div><h3>Results</h3><div>A total of 196 patients underwent randomization (91 in. T and 94 in C). Topical anesthesia with lignocaine significantly reduced the cough rate and VAS score immediately (<em>P</em> &lt; 0.001 and &lt; 0.001, respectively), 10 min (<em>P</em> &lt; 0.001 and &lt; 0.001), and 30 min (<em>P</em> = 0.005 and 0.001) after mask removal, and 2 h post-procedure (<em>P</em> = 0.003 and 0.006). No significant effect on vital signs was observed. The QoR-15 values 24 h after the procedure in group T were higher than those in group C (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>During EBUS-TBNA under general anesthesia, 1% lignocaine for topical anesthesia significantly decreased the incidence of postoperative coughing and increased patient satisfaction. Topical anesthesia should be routinely administered to patients undergoing EBUS-TBNA under general anesthesia.</div></div><div><h3>Registration</h3><div>Chinese Clinical Trial Registry; Registration number: ChiCTR2300072386; URL: <span><span>https://www.chictr.org.cn/showproj.html?proj=197032</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101495"},"PeriodicalIF":3.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deep neuromuscular block with pipecuronium in patients undergoing laparoscopic surgery — A prospective case series 哌库溴铵在腹腔镜手术患者中的深层神经肌肉阻滞-前瞻性病例系列。
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-19 DOI: 10.1016/j.accpm.2025.101493
László Asztalos , Zoltán Szabó-Maák , Mariann Berhés , Zsolt Kanyári , György Nagy , Adrienn Pongrácz , Réka Nemes , Sorin J. Brull , Béla Fülesdi
{"title":"Deep neuromuscular block with pipecuronium in patients undergoing laparoscopic surgery — A prospective case series","authors":"László Asztalos ,&nbsp;Zoltán Szabó-Maák ,&nbsp;Mariann Berhés ,&nbsp;Zsolt Kanyári ,&nbsp;György Nagy ,&nbsp;Adrienn Pongrácz ,&nbsp;Réka Nemes ,&nbsp;Sorin J. Brull ,&nbsp;Béla Fülesdi","doi":"10.1016/j.accpm.2025.101493","DOIUrl":"10.1016/j.accpm.2025.101493","url":null,"abstract":"<div><h3>Introduction</h3><div>We tested the feasibility of maintaining low intraabdominal pressures during pipecuronium-induced deep block (post-tetanic count ≥1, train-of-four count = 0) in patients undergoing laparoscopic surgery.</div></div><div><h3>Methods</h3><div>Ten adult patients awaiting cardiac surgery or heart transplantation and requiring non-elective abdominal surgery were included. Pipecuronium bromide 0.09 mg/kg was used for muscle relaxation and maintenance of deep block. Top-up doses of pipecuronium (0.01–0.02 mg/kg) were administered when post-tetanic count was 4–8. Intraabdominal pressures were kept below 10 mmHg. Mean arterial pressure was measured intra-arterially. Surgical field view was rated on a 5-point scale (1 = extremely poor, 5 = optimal).</div></div><div><h3>Results</h3><div>Induction dose of 0.09 mg/kg pipecuronium had an onset time of 5.3 (2.3–6.3, 25–75% IQR) min. Deep block was maintained for 51.2 ± 19.7 min. Top-up pipecuronium doses were necessary in 5 patients, 56.0 ± 28.1 min after the first dose. At the end of surgery, neuromuscular block was deep (post-tetanic count 0–6). Administration of 2 mg/kg of sugammadex induced recovery to train-of-four ratio ≥0.9 in 3.5 ± 1.6 min, and to train-of-four ratio = 1.0 in 4.3 ± 1.2 min. Mean intraabdominal pressure was 8.1 ± 1.1 mmHg during pneumoperitoneum. There was no significant change in heart rate (0.0, −2.6 to 0) beats/min.</div></div><div><h3>Discussion</h3><div>Pipecuronium is a rational alternative when deep neuromuscular block is necessary, because of its long-acting neuromuscular blocking effect that may be antagonized quickly and safely with sugammadex.</div></div><div><h3>Registration</h3><div>European Clinical Trials Database registration number: 2022-004114-11, Clinical Trials Database registration number: NCT06517524.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101493"},"PeriodicalIF":3.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Are corticosteroids in intensive care immunosuppressive? Reflections and hypotheses 重症监护患者使用皮质类固醇有免疫抑制作用吗?反思和假设。
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-14 DOI: 10.1016/j.accpm.2025.101492
Rayan Braïk
{"title":"Are corticosteroids in intensive care immunosuppressive? Reflections and hypotheses","authors":"Rayan Braïk","doi":"10.1016/j.accpm.2025.101492","DOIUrl":"10.1016/j.accpm.2025.101492","url":null,"abstract":"<div><div>This review reconsiders the classification of corticosteroids as immunosuppressants in the management of acute inflammatory conditions in critical care. Despite their widespread use in ARDS and septic shock, the association between corticosteroid therapy and increased infection risk remains contentious. By exploring alternative mechanisms and presenting new hypotheses, this review suggests that the traditional view of corticosteroids as immunosuppressants may be overly simplistic and context dependent.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101492"},"PeriodicalIF":3.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transfusion thresholds after acute brain injury: How can they impact on protocols optimizing brain oxygenation? 急性脑损伤后输血阈值:它们如何影响优化脑氧合的方案?
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-06 DOI: 10.1016/j.accpm.2025.101491
Pierre Bouzat, Fabio Silvio Taccone
{"title":"Transfusion thresholds after acute brain injury: How can they impact on protocols optimizing brain oxygenation?","authors":"Pierre Bouzat,&nbsp;Fabio Silvio Taccone","doi":"10.1016/j.accpm.2025.101491","DOIUrl":"10.1016/j.accpm.2025.101491","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101491"},"PeriodicalIF":3.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transfusion strategy in the most critically patients with trauma brain injury: Differences to other populations? 重型颅脑损伤患者输血策略:与其他人群的差异?
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-05 DOI: 10.1016/j.accpm.2025.101490
Fabien Coisy, Florian Ajavon, Jeffrey Lipman , Jean-Yves Lefrant, Xavier Bobbia
{"title":"Transfusion strategy in the most critically patients with trauma brain injury: Differences to other populations?","authors":"Fabien Coisy,&nbsp;Florian Ajavon,&nbsp;Jeffrey Lipman ,&nbsp;Jean-Yves Lefrant,&nbsp;Xavier Bobbia","doi":"10.1016/j.accpm.2025.101490","DOIUrl":"10.1016/j.accpm.2025.101490","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101490"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Protecting the lungs during surgery: Modes of ventilation are no silver bullet 在手术中保护肺部:各种通气方式并不是万能的。
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-01 DOI: 10.1016/j.accpm.2025.101488
Mauro Roberto Tucci , Sérgio Martins Pereira , Martin Girard
{"title":"Protecting the lungs during surgery: Modes of ventilation are no silver bullet","authors":"Mauro Roberto Tucci ,&nbsp;Sérgio Martins Pereira ,&nbsp;Martin Girard","doi":"10.1016/j.accpm.2025.101488","DOIUrl":"10.1016/j.accpm.2025.101488","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101488"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac surgery associated-acute kidney injury: Deciphering renal physiology to understand effects of amino acids infusion 心脏手术相关的急性肾损伤:破译肾脏生理学以了解氨基酸输注的影响。
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-01-31 DOI: 10.1016/j.accpm.2025.101487
Timothée Ayasse, Quentin De Roux, Ali Jendoubi, Nicolas Mongardon
{"title":"Cardiac surgery associated-acute kidney injury: Deciphering renal physiology to understand effects of amino acids infusion","authors":"Timothée Ayasse,&nbsp;Quentin De Roux,&nbsp;Ali Jendoubi,&nbsp;Nicolas Mongardon","doi":"10.1016/j.accpm.2025.101487","DOIUrl":"10.1016/j.accpm.2025.101487","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101487"},"PeriodicalIF":3.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing early mobilization in critically ill patients through multidisciplinary rounds: A process-focused observational study 通过多学科查房加强危重患者的早期动员:一项以过程为重点的观察性研究。
IF 3.7 3区 医学
Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-01-30 DOI: 10.1016/j.accpm.2025.101485
Nobuhiro Shiota , Nobuyuki Nosaka , Nobutoshi Nawa , Takeo Fujiwara , Hidenobu Shigemitsu , Kenji Wakabayashi
{"title":"Enhancing early mobilization in critically ill patients through multidisciplinary rounds: A process-focused observational study","authors":"Nobuhiro Shiota ,&nbsp;Nobuyuki Nosaka ,&nbsp;Nobutoshi Nawa ,&nbsp;Takeo Fujiwara ,&nbsp;Hidenobu Shigemitsu ,&nbsp;Kenji Wakabayashi","doi":"10.1016/j.accpm.2025.101485","DOIUrl":"10.1016/j.accpm.2025.101485","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Early mobilization (EM) is vital for critically ill patients, yet various barriers hinder its implementation in daily critical care practice. This study aimed to explore the impact of multidisciplinary rounds (MDR) on the initiation of EM.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, process-focused observational study in the medical/surgical intensive care unit (ICU) of a tertiary university medical center in Tokyo, Japan, including 301 patients who received physical therapy (PT) during their ICU stay. MDR implementation commenced in October 2016, followed by a year-long initiative to enhance awareness about the importance of EM. Patients admitted between April 2015 and September 2016 were categorized into the pre-MDR group (Phase 1, n = 110), while those admitted from October 2017 to March 2019 formed the post-MDR group (Phase 2, n = 191).</div></div><div><h3>Results</h3><div>EM practice was significantly increased in Phase 2, compared to Phase 1 (39.8% <em>vs.</em> 20.9%; <em>p</em> = 0.001), particularly among mechanically ventilated patients (33.8% <em>vs.</em> 9.3%; <em>p</em> &lt; 0.001). The median time from ICU admission to PT initiation was significantly reduced in Phase 2 (3.0 <em>vs.</em> 6.0 days, <em>p</em> &lt; 0.001). Additionally, PT consultations significantly increased from 9.2% to 16.5% (χ<sup>2</sup> = 27.75, <em>p</em> &lt; 0.001). MDR was associated with an 84% higher likelihood of initiating EM (adjusted relative risk 1.84, 95% CI 1.30–2.61).</div></div><div><h3>Conclusions</h3><div>MDR played a pivotal role in enhancing the initiation of EM for ICU patients, highlighting its significance in overcoming barriers to EM.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 2","pages":"Article 101485"},"PeriodicalIF":3.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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