Anaesthesia Critical Care & Pain Medicine最新文献

{"title":"Factors influencing the turnover of nurses in French intensive care unit—A multicenter interview survey","authors":"Charles-Hervé Vacheron ,&nbsp;Marlene Bras ,&nbsp;Arnaud Friggeri ,&nbsp;Cyril Manzon ,&nbsp;Emmanuel Vivier ,&nbsp;Lyon Sud Nursing Research Group ,&nbsp;Anaelle Caillet ,&nbsp;Florent Wallet","doi":"10.1016/j.accpm.2024.101460","DOIUrl":"10.1016/j.accpm.2024.101460","url":null,"abstract":"<div><h3>Background</h3><div>Nurse retention is a major concern in healthcare settings, especially among intensive care units (ICU), in which nurses are highly specialized. The objective was to describe the nurse courses after their entrance into the ICU, their motivation for leaving the ICU, and to identify the independent factors that influenced the nurse resignation from their units.</div></div><div><h3>Methods</h3><div>In 3 different centers, every ICU nurse working between 2013 and 2023 was telephonically contacted and was asked to describe their career and, when appropriate, the reasons that influenced their resignation from their units; they rated on a Likert scale of 14 factors that influenced their decision.</div></div><div><h3>Results</h3><div>Among the 405 nurses who worked in these ICUs between 2013 and 2023, 265 (65.0%) were included in the study, and 93 (35.1%) were still working in their unit. The median time of professional experience of the nurses in their ICU was 5.8 [5.0–7.0] years, and at 10 years, 26.3% [20.4–33.9] of the nurses remained in their unit, 23.8% [17.3–32.8] left the ICU but were still in-hospital nurses, and 22.4% [15.8–31.7] underwent specialization. A minority of nurses resigned and changed their careers (9.5% [5.3–17.0]). The main factors influencing the nurse’s resignation from their unit were belonging to Generation Y or Z (HR 1.89 [1.35;2.64]), experiencing symptoms of burnout (2.37 [1.63;3.46]), and pregnancy during the ICU (1.77 [1.41;2.23]). The COVID-19 period was inconsistently associated with nurse resignation depending on the center. The main motivations to leave the unit were organizational (variability of schedule, night shift), personal (willingness to change, personal event), and related to the ICU workload.</div></div><div><h3>Conclusion</h3><div>Nurse retention is an increasing concern, associated with the generational aspects and increased prevalence of burnout. Structural changes will have to be made to reduce the turnover.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101460"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878323","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}

{"title":"Extracorporeal membrane oxygenation in trauma patient in France: A retrospective nationwide registry","authors":"Vincent Legros ,&nbsp;Yannick Hourmant ,&nbsp;Louis Genty ,&nbsp;Karim Asehnoune ,&nbsp;Quentin De Roux ,&nbsp;Lucie Picard ,&nbsp;Jean-Denis Moyer ,&nbsp;Fanny Bounes ,&nbsp;Martin Cailloce ,&nbsp;Anais Adolle ,&nbsp;Alexandre Behouche ,&nbsp;Benjamin Bergis ,&nbsp;Jeremy Bourenne ,&nbsp;Cyril Cadoz ,&nbsp;Emilie Charbit ,&nbsp;Jonathan Charbit ,&nbsp;Baptiste Compagnon ,&nbsp;Charlotte Florin ,&nbsp;Nouchan Mellati ,&nbsp;Marie Moisan ,&nbsp;Arthur James","doi":"10.1016/j.accpm.2024.101457","DOIUrl":"10.1016/j.accpm.2024.101457","url":null,"abstract":"<div><h3>Background</h3><div>Indications for Veno-venous (VV) or veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) after trauma rely on poor evidence. The main aims were to describe the population of trauma patients requiring either VV or VA ECMO and report their clinical management and outcomes.</div></div><div><h3>Methods</h3><div>An observational multicentre retrospective study was conducted in 17 Level 1 trauma centres in France between January 2010 and December 2021. All patients admitted for major trauma were screened for inclusion, and those receiving either VV ECMO or VA ECMO were included. The primary outcome was in-hospital mortality.</div></div><div><h3>Results</h3><div>Among the 52,851 patients screened, 179 were included, with 143 supported by VV ECMO (median [Q1-Q3] age 32 years [24–48]; men 83.5%; injury severity score [ISS] 33 [25–43] and 76 (53.6%) with a traumatic brain injury [TBI]) and 36 supported by VA ECMO (median age 39 years [25–55]; men 88.9%; ISS 36 [25–56] and 23 (63.9%) with a TBI). In the VV ECMO group, three indications for ECMO implementation were chest injuries (<em>n</em> = 68, 47.6%), ventilator-associated pneumonia (VAP; <em>n</em> = 57, 39.9%), and extra-respiratory acute respiratory distress syndrome (ARDS; <em>n</em> = 57, 39.9%). In the VV ECMO group, 45.8% (n = 65) died in the hospital, with 33 (48.5%) deaths following cannulation for chest injuries, 22 (39.3%) following cannulation for VAP, and 10 (55.6%) following cannulation for extrapulmonary ARDS. In the VA ECMO group, 75.0% (<em>n</em> = 27) died during their hospital stay.</div></div><div><h3>Conclusions</h3><div>In-hospital mortality of trauma patients requiring ECMO for refractory ARDS varied according to indications. The best prognosis was observed in the subgroup of pneumonia-induced ARDS patients.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101457"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878363","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}

{"title":"Self-reported penicillin allergy and beta-lactam allergy label: Is ICU so different?","authors":"Charles Tacquard,&nbsp;Marc Leone,&nbsp;Aurélie Gouel-Cheron","doi":"10.1016/j.accpm.2024.101467","DOIUrl":"10.1016/j.accpm.2024.101467","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101467"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899829","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}

{"title":"Recent advances in perioperative care of patients using new antihyperglycaemic drugs and devices dedicated to diabetes","authors":"Rami El Ojaimi ,&nbsp;Gaëlle Cheisson ,&nbsp;Emmanuel Cosson ,&nbsp;Carole Ichai ,&nbsp;Sophie Jacqueminet ,&nbsp;Bogdan Nicolescu-Catargi ,&nbsp;Alexandre Ouattara ,&nbsp;Igor Tauveron ,&nbsp;Paul Valensi ,&nbsp;Dan Benhamou","doi":"10.1016/j.accpm.2024.101468","DOIUrl":"10.1016/j.accpm.2024.101468","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101468"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916119","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}

{"title":"Self-Reported Penicillin Allergy and antibiotic use in critical care: An observational, retrospective study","authors":"Elise Davis ,&nbsp;Catherine Snelson ,&nbsp;Nick Murphy ,&nbsp;James Hodson ,&nbsp;Miruna David ,&nbsp;Tonny Veenith ,&nbsp;Tony Whitehouse","doi":"10.1016/j.accpm.2024.101461","DOIUrl":"10.1016/j.accpm.2024.101461","url":null,"abstract":"<div><h3>Background</h3><div>Patients with Self-Reported Penicillin Allergy (SRPA) receive alternative antibiotics, which increase the length of stay and hospital costs, but the impact of SRPA on mortality in critically ill patients is not well described.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective analysis of routinely gathered clinical data for all intensive care unit (ICU) admissions over nine years. The primary outcome was 28-day mortality, which was analyzed using a time-to-event approach with multivariable models to adjust for confounding factors, including age, comorbidities, sex, and admission SOFA score (as a measure of organ dysfunction). Antibiotic prescriptions during the ICU stay were also interrogated and compared.</div></div><div><h3>Results</h3><div>Of 35,319 admissions, 11.7% had SRPA. Compared with non-SRPA, patients with SRPA were more likely to be female (52.2% <em>vs.</em> 37.4%, <em>p</em> &lt; 0.001) and had more comorbidities (<em>p</em> &lt; 0.001) but had similar admission SOFA scores (median: 3.5 in both groups, <em>p</em> = 0.839). Patients with SRPA had significantly lower 28-day mortality (9.6% <em>vs.</em> 10.9%, <em>p</em> = 0.011). After multivariable adjustment for baseline characteristics, this effect persisted for unplanned (hazard ratio [HR]: 0.76, 95% CI: 0.68−0.86, <em>p</em> &lt; 0.001), but not planned admissions (HR: 1.21, 95% CI: 0.92−1.58, <em>p</em> = 0.172). Whilst the duration of antibiotics in ICU was similar in the SRPA and non-SRPA groups (mean: 3.4 <em>vs.</em> 3.4 days, <em>p</em> = 0.663), the antibiotics used differed, with SRPA patients being significantly more likely to receive quinolones or other anti-Gram-positive antibiotics (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>SRPA was associated with a survival benefit that persisted after adjustment for confounders for unplanned ICU admissions. Patients with SRPA were more likely to receive antibiotics that are not active against anaerobic bacteria.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101461"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883184","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}

{"title":"Significance of ongoing enhancement of Pediatric Intensive Care Unit follow-up","authors":"Pawel Wieczorek ,&nbsp;Michal Pruc ,&nbsp;Lukasz Szarpak","doi":"10.1016/j.accpm.2024.101464","DOIUrl":"10.1016/j.accpm.2024.101464","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101464"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883244","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}

{"title":"The association between neuraxial labor analgesia and subacute pain after childbirth: A randomized controlled trial","authors":"Chin Wen Tan ,&nbsp;D.G.P. Luther ,&nbsp;Hon Sen Tan ,&nbsp;Nabilah Rahman ,&nbsp;Mihir Gandhi ,&nbsp;Rehena Sultana ,&nbsp;Alex Tiong Heng Sia ,&nbsp;Ban Leong Sng","doi":"10.1016/j.accpm.2024.101450","DOIUrl":"10.1016/j.accpm.2024.101450","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101450"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644641","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}

{"title":"A French regional survey of the role of general practitioners in the follow-up of patients with post-intensive-care syndrome (PICS)","authors":"N. Elhadjene ,&nbsp;A. Crouzet,&nbsp;R. Charles,&nbsp;J. Morel","doi":"10.1016/j.accpm.2024.101466","DOIUrl":"10.1016/j.accpm.2024.101466","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101466"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883157","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}

{"title":"Association between driving pressure, systemic inflammation and non-pulmonary organ dysfunction in patients with acute respiratory distress syndrome, a prospective pathophysiological study","authors":"Enric Barbeta ,&nbsp;Carlos Ferrando ,&nbsp;Rubén López-Aladid ,&nbsp;Anna Motos ,&nbsp;Letícia Bueno-Freire ,&nbsp;Laia Fernández-Barat ,&nbsp;Alba Soler-Comas ,&nbsp;Andrea Palomeque ,&nbsp;Albert Gabarrús ,&nbsp;Antonio Artigas ,&nbsp;Marta Camprubí-Rimblas ,&nbsp;Gianluigi Li Bassi ,&nbsp;Teresa López-Sobrino ,&nbsp;Elena Sandoval ,&nbsp;David Toapanta ,&nbsp;Sara Fernández ,&nbsp;Ricard Mellado-Artigas ,&nbsp;Luigi Zattera ,&nbsp;Jordi Vallverdú ,&nbsp;John G. Laffey ,&nbsp;Antoni Torres","doi":"10.1016/j.accpm.2024.101458","DOIUrl":"10.1016/j.accpm.2024.101458","url":null,"abstract":"<div><h3>Background</h3><div>Driving pressure is thought to determine the effect of low tidal ventilation on survival in patients with acute respiratory distress syndrome. The leading cause of mortality in these patients is non-pulmonary multiorgan dysfunction, which is believed to worsen due to the biological response to mechanical ventilation (biotrauma). Therefore, we aimed to analyze the association between driving pressure, biotrauma, and non-pulmonary multiorgan dysfunction. Additionally, we analyzed this relationship for tidal volume/predicted body weight.</div></div><div><h3>Methods</h3><div>Observational study that included adult patients with acute respiratory distress syndrome undergoing invasive mechanical ventilation admitted to the Hospital Clinic of Barcelona, Spain, between June 2019 and February 2021. We conducted mixed-effects models to assess the effects of driving pressure and tidal volume/predicted body weight on the evolution of 22 log-transformed biomarker variables during the first, third, and fifth days after study enrollment. These 22 systemic biomarkers characterized epithelial and endothelial pulmonary dysfunction, inflammation, and coagulation disorders in the included patients. In the same fashion, the association between driving pressure and non-pulmonary multiorgan dysfunction was evaluated by the non-pulmonary sequential organ failure assessment score (non-pulmonary SOFA) and its associated variables. Finally, we performed mediation analyses to assess whether the relationship between biomarkers and driving pressure was mediated by other ventilator-induced lung injury parameters.</div></div><div><h3>Results</h3><div>Thirty-eight patients were included. Driving pressure was independently associated with soluble Receptor for advanced glycation end-products, Interleukin (IL)-8, IL-6, IL-10, IL-17, Interferon-ɣ, Chemokine (C-C motif)-2, Vascular endothelial growth factor, Tissue factor, Protein C, Protein S, and higher dose of norepinephrine. However, this relationship attenuated over time. In contrast, tidal volume/predicted body weight was not associated with any of the 22 biomarkers tested . A concomitant increase in positive end-inspiratory plateau pressure or tidal volume did not mediate the effect of driving pressure on biomarkers. Conversely, the association between compliance of the respiratory system and pulmonary epithelial dysfunction was primarily mediated by driving pressure.</div></div><div><h3>Conclusions</h3><div>Driving pressure, but not tidal volume/predicted body weight, was correlated with epithelial and endothelial pulmonary dysfunction, inflammation, coagulation disorders, and hemodynamic dysfunction. However, this relationship diminished over time.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101458"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878356","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}

{"title":"Severe acute kidney injury in patients with COVID-19 acute respiratory distress syndrome: A multicenter retrospective study","authors":"Khalil Chaïbi ,&nbsp;Damien Roux ,&nbsp;Tài Pham ,&nbsp;Xosé Pérez-Fernandez,&nbsp;Guillaume Louis","doi":"10.1016/j.accpm.2024.101452","DOIUrl":"10.1016/j.accpm.2024.101452","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"44 1","pages":"Article 101452"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711026","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}