Australian Critical Care最新文献

{"title":"Enhancing communication equity in critical care: Multimodal and technological approaches to overcome language barriers—Letter on Power et al.","authors":"Xiaolong Zhang PhD, Zekai Yu BSc Candidate","doi":"10.1016/j.aucc.2025.101286","DOIUrl":"10.1016/j.aucc.2025.101286","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101286"},"PeriodicalIF":2.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481398","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":"Cycle ergometers in extracorporeal membrane oxygenation patient rehabilitation: A scoping review","authors":"Pedro Rodrigues RN, MN ,&nbsp;Pedro Alçada Guimarães MN, RN ,&nbsp;Luis Migues Ferreira PhD ,&nbsp;Carla Silvia Fernandes PhD","doi":"10.1016/j.aucc.2025.101287","DOIUrl":"10.1016/j.aucc.2025.101287","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this scoping review was to determine what evidence is available regarding the use of the cycle ergometer in the rehabilitation of adult patients undergoing extracorporeal membrane oxygenation.</div></div><div><h3>Methods</h3><div>This scoping review was conducted according to the Joanna Briggs Institute guidelines for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Detailed searches were conducted in the following electronic databases: Medical Literature Analysis and Retrieval System Online (MEDLINE®; via PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL®; via EBSCO), Embase (via Elsevier), Web of Science, and the Cochrane Library. The search was conducted without temporal limits until December 2024.</div></div><div><h3>Results</h3><div>Sixteen published studies were included. The implementation of cycle ergometers varied across studies, with initiation times ranging from the early days of extracorporeal membrane oxygenation support to considerably later stages. Most programs integrated cycle ergometers as part of a broader multimodal rehabilitation strategy.</div></div><div><h3>Conclusion</h3><div>This scoping review highlights significant variation in the use of cycle ergometers, emphasising the heterogeneity in their implementation across the included studies. Most studies did not document adverse effects associated with the use of the cycle ergometer, suggesting its safe implementation.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101287"},"PeriodicalIF":2.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490790","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":"Incidence of pressure injuries and effectiveness of a prevention care bundle in critically ill Vietnamese patients: A prospective cohort study","authors":"Ca Thi Mai Luu RN, MN ,&nbsp;Tung-Chen Han RN, PhD ,&nbsp;Ngan Hoang Kim Trieu MD ,&nbsp;Huy Minh Pham MD, PhD ,&nbsp;Dai Quang Huynh MD, PhD ,&nbsp;Linh Thanh Tran MD ,&nbsp;Thi Thi Ho RN ,&nbsp;Phong Thanh Phung MN, PhD ,&nbsp;Trang Thi Minh Nguyen MD, PhD ,&nbsp;Bang Thi Kim Nguyen MN, PhD ,&nbsp;Thao Thi Ngoc Pham MD, PhD","doi":"10.1016/j.aucc.2025.101262","DOIUrl":"10.1016/j.aucc.2025.101262","url":null,"abstract":"<div><h3>Background</h3><div>Pressure injury (PI) presents a major challenge for critically ill patients with multiple risk factors for developing PI. Advanced prevention bundles have been implemented in developed countries, leading to a reduction in PI rates. However, a knowledge gap remains regarding PI incidence and prevention bundles in developing Asian countries.</div></div><div><h3>Objectives</h3><div>The objectives of this study were to identify the incidence of PIs and the effectiveness of the PI prevention care bundle in critically ill Vietnamese patients.</div></div><div><h3>Methods</h3><div>This prospective cohort study included patients admitted to a medical-surgical intensive care unit between April and August 2023. PI was defined according to the 2019 National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel/Pan Pacific Pressure Injury Alliance guideline. Data on patient demographics, PI characteristics, Braden Scale scores on days 1 and 7, and PI prevention care bundle compliance proportion were collected.</div></div><div><h3>Results</h3><div>Of the 120 patients enrolled in the study, 12.5%(15 patients) developed PIs (95% confidence interval [CI]: 6.9–19.9%). The most common PI location was the gluteal region (12 patients), followed by the sacrum (six patients), with eight of 15 patients presenting a single PI. In the generalised estimating equation model, Braden scores improved by 1.67 points from day 1 to day 7 (95% CI: 1.24–2.10). Each 10% increase in PI prevention care bundle compliance proportion was associated with a 0.45-point improvement (95% CI: 0.20–0.70).</div></div><div><h3>Conclusions</h3><div>The incidence of PIs was 12.5% in critically ill Vietnamese patients. A higher compliance with the PI prevention care bundle was associated with improved Braden scores. Further research is needed to evaluate the effectiveness of different prevention care bundles in critically ill patients.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101262"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470991","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":"Availability and use of indirect calorimetry in adult Australian and New Zealand intensive care units: A report using data from an observational study of nutrition practices","authors":"Oana A. Tatucu-Babet APD, PhD ,&nbsp;Linda Nguyen BHlth&BiomedSc(Hons) ,&nbsp;Emma J. Ridley APD, PhD","doi":"10.1016/j.aucc.2025.101270","DOIUrl":"10.1016/j.aucc.2025.101270","url":null,"abstract":"<div><h3>Background</h3><div>Indirect calorimetry is recommended as the reference method for determining energy expenditure and guiding energy delivery in critical care nutrition practice guidelines. However, the availability and use of indirect calorimetry in Australian and New Zealand intensive care units (ICUs) is unknown.</div></div><div><h3>Objectives</h3><div>To report on the availability and use of indirect calorimetry in Australian and New Zealand ICUs.</div></div><div><h3>Methods</h3><div>A binational multicentre observational study of nutrition practices was conducted in adult ICUs over a 1-week period in February 2021. All adult ICUs were invited to participate via multiple forums. Participating sites completed a once-off form on hospital and nutrition services which included questions relating to the availability and frequency of use (daily, fortnightly, monthly, and do not use) of indirect calorimetry. Data were collected on the type of device used and barriers to use. Data are reported as n (%).</div></div><div><h3>Results</h3><div>Forty-four ICUs reported data on hospital and nutrition services. Indirect calorimetry was available in 13 of 44 sites (30%): 12 sites in Australia and one in New Zealand. The COSMED Quark RMR (6/13 [46%]) and Q-NRG+ (5/13 [38%]) devices were the most commonly available. Indirect calorimetry was most frequently used on a weekly (4/13 [31%]) or monthly basis (4/13 [31%]). One site (8%) reported using indirect calorimetry fortnightly, with the remaining sites (4/13 [31%]) reporting that they do not use indirect calorimetry due to a lack of training (1/4 [25%]), no funding for consumables and a lack of training (1/4 [25%]), and for reasons not further specified (2/4 [50%]).</div></div><div><h3>Conclusions</h3><div>In 2021, indirect calorimetry was available in 30% of ICUs across Australia and New Zealand. However, only one-third of sites used this technology weekly, with reasons limiting use including a lack of training and funding for consumables. Expanding dedicated training programs and improving funding models may help overcome these barriers.</div></div><div><h3>Study registration</h3><div><span><span>https://www.anzctr.org.au/</span><svg><path></path></svg></span>.</div></div><div><h3>Trial ID</h3><div>ACTRN12620001025921.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101270"},"PeriodicalIF":2.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338904","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":"Nurses’ experiences of fundamental care delivery in the intensive care unit: A qualitative systematic review","authors":"Krystle Waltrovitz RN, MN ,&nbsp;Tiffany Conroy RN, PhD, FACN ,&nbsp;Rebecca Feo BPsych(Hons), PhD","doi":"10.1016/j.aucc.2025.101274","DOIUrl":"10.1016/j.aucc.2025.101274","url":null,"abstract":"<div><h3>Objectives</h3><div>Fundamental care is relationship-based care delivered by nurses in an integrated manner to meet patients' essential physical, relational, and psychosocial needs. Research on patients' and families' experiences in the intensive care unit (ICU) has reported deficits in fundamental care delivery, leading to poor patient experiences and suboptimal recovery. Understanding nurses' experience of delivering fundamental care in this context can shed light on these poor experiences. This review sought to answer the following question: “What are nurses’ experiences of fundamental care delivery in the ICU?”</div></div><div><h3>Review method used</h3><div>A qualitative systematic review was conducted following JBI methods.</div></div><div><h3>Data sources</h3><div>A systematic search of five electronic databases was undertaken on January 31, 2025: MEDLINE, Cumulative Index for Nursing and Allied Health (CINAHL), APA PsycINFO, Scopus, and Emcare. A total of 5498 papers were retrieved.</div></div><div><h3>Review methods</h3><div>A total of 3750 papers were screened after duplicate removal, with 25 papers meeting eligibility criteria. All were independently critically appraised by two authors.</div></div><div><h3>Results</h3><div>Twenty-five papers representing 785 participants were included. Relationship development between nurses and patients was important for nurses to deliver fundamental care. When nurses were unable to develop these relationships, they felt unable to optimally meet patients’ fundamental care needs, resulting in nurses experiencing feelings of frustration and failure. Several strategies were utilised by nurses to develop relationships and deliver fundamental care: getting to know patients, empathy, reassurance, touch, comfort, and informing and involving patients and families. However, nurses also articulated challenges in developing relationships and delivering fundamental care, including patient-specific, nurse-specific, and contextual factors.</div></div><div><h3>Conclusions</h3><div>This review provides insights into nurses’ experiences of fundamental care delivery in the ICU. Given the negative emotions nurses experience when they encounter challenges in delivering fundamental care, research is required to explore ways in which nurses can be better supported to deliver fundamental care in the ICU. The identified strategies might be helpful for nurses to utilise; however, research on their feasibility and effectiveness is warranted.</div></div><div><h3>Registration</h3><div>The systematic review followed an a priori protocol, registered with in the International Prospective Register of Systematic Reviews (PROSPERO [CRD42023428325]).</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101274"},"PeriodicalIF":2.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335906","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":"Evaluation of the delivery of an intensive care nursing course during the COVID-19 pandemic and beyond: A cross-sectional study","authors":"Pauline Wong BN(Hons), PhD, RN,&nbsp;Angelique Clarke RN, MNur(Critcare),&nbsp;Melissa Njoku RN, MNur,&nbsp;Kelly L. Ottosen RN, MHealthSc,&nbsp;Carly Rienecker RN, MNur,&nbsp;Wendy E. Pollock RN, RM, PhD","doi":"10.1016/j.aucc.2025.101256","DOIUrl":"10.1016/j.aucc.2025.101256","url":null,"abstract":"<div><h3>Background</h3><div>Monash University offers graduate study in Intensive Care Unit (ICU) nursing. Course delivery of graduate ICU nursing was significantly impacted by the COVID-19 pandemic, requiring adaptation from fully on-campus to fully online modes throughout 2020. From 2021, a flexible hybrid approach was implemented allowing students the choice of either mode, in addition to asynchronous online learning.</div></div><div><h3>Aim/objective</h3><div>The aim of this study was to evaluate the delivery of a graduate ICU nursing course during and after the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>A cross-sectional study using an anonymous online survey was administered to students from March 2020 to June 2023. Data items included delivery mode, content, learning activities, and clinical experience using a Likert scale and open-ended questions. Descriptive analysis of the sample was reported as mean or median depending on the distribution pattern. Free-text responses underwent thematic analysis.</div></div><div><h3>Results</h3><div>Thirteen cohorts of students (n = 948) yielded 539 responses, representing a 57% response rate. On-campus attendance increased significantly from 29.2% in 2021 to 44.4% in 2023, while online attendance has decreased to 48.9% from 65.8% in 2021. Overall, satisfaction with learning has risen for both on-campus and online students. On-campus satisfaction almost doubled from 23.3% in 2021 to 43.6% in 2023, while online satisfaction varied between 42.1% and 59.3% since 2021. Students appreciate the flexibility of the hybrid model but suggest separating the two modalities to enhance the student experience.</div></div><div><h3>Conclusions</h3><div>The COVID-19 pandemic necessitated innovative changes in course delivery, leading to the adoption of flexible learning modalities. While students appreciated the flexibility of the hybrid model, further efforts are required to seamlessly integrate both modalities during synchronous teaching.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101256"},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321761","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":"Identification of Takotsubo syndrome in intensive care units: A scoping review","authors":"Vicky Visvanathan RN, MN,&nbsp;Rasika Jayasekara RN, PhD,&nbsp;Matylda Howard RN, DHSc","doi":"10.1016/j.aucc.2025.101269","DOIUrl":"10.1016/j.aucc.2025.101269","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this scoping review was to evaluate existing evidence on assessment and screening tools for Takotsubo syndrome (TTS) with a focus on understanding whether a clinical pathway tailored for intensive care unit (ICU) patients is warranted, given the high risk and complex presentation of Takotsubo syndrome in critically ill populations.</div></div><div><h3>Review methods and data sources</h3><div>This review followed the framework of Arksey and O'Malley. Searches spanned 10 databases, including MEDLINE, EMBASE, and CINAHL, plus grey literature, covering English-language studies on adults. The search strategy included Medical Subject Headings terms, keywords, Boolean operators, and truncations. We organised citations with EndNote (Clarivate Analytics, Philadelphia, PA, USA) and screened studies using Covidence, with eligibility confirmed by consensus.</div></div><div><h3>Results</h3><div>Thirty-two studies met the inclusion criteria, with publications ranging from 1990 to June 2024. Fourteen studies assessed electrocardiographic features to distinguish TTS from other cardiac conditions; 11 studies examined biomarkers with the potential for early detection of TTS. Five studies assessed echocardiographic markers for identifying transient left ventricular dysfunction associated with TTS. Two scoring systems, the International Takotsubo score and Platelets and Thrombosis in Sheba score, show potential for TTS diagnosis but lack validation specific to the ICU, limiting clinical utility. This review found that integrating distinctive electrocardiographic patterns and elevated biomarker ratios could provide valuable early indicators of TTS in intensive care settings. Echocardiographic parameters, including contrast imaging and wall motion score indices, could further support differentiation of TTS from other acute myocardial conditions in critically ill patients.</div></div><div><h3>Conclusions</h3><div>This review highlights gaps in ICU-specific TTS assessment practices, suggesting that developing a tailored clinical pathway, followed by validation, could support early recognition and management of TTS in ICU settings, enabling timely intervention and enhancing patient outcomes.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101269"},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144331380","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":"Targeted temperature management to minimise secondary brain injury after cardiac arrest: A systematic review","authors":"Joana Costa Seixas RN ,&nbsp;Mariana Oliveira RN ,&nbsp;Mariana Monteiro RN ,&nbsp;Maria do Rosário Pinto PhD, MSc, CNS ,&nbsp;Cândida Durão MSc, CNS ,&nbsp;Gisela Teixeira MSc, RN ,&nbsp;Helga Rafael Henriques PhD, MSc, CNS ,&nbsp;Joana Ferreira Teixeira MSc, CNS","doi":"10.1016/j.aucc.2025.101264","DOIUrl":"10.1016/j.aucc.2025.101264","url":null,"abstract":"<div><h3>Background</h3><div>A patient recovering from an in-hospital or out-of-hospital cardiac arrest (CA) requires interventions for recovery, particularly for minimising secondary brain injury. Targeted temperature management (TTM) is the intervention with the greatest impact on neurological recovery.</div></div><div><h3>Aim</h3><div>The aim of this systematic review was to describe current TTM in adult CA patients and its impact on functional outcomes.</div></div><div><h3>Methods</h3><div>This systematic review was developed between March and May 2024 according to the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting. Eligibility criteria were established. We systematically reviewed studies enrolling adult CA patients who received TTM and reported functional outcomes<strong>.</strong> The search strategy was applied in the following databases: Medline and CINAHL Ultimate, the Cochrane Central Register of Controlled Trials, through EBSCO, and Scopus. The Rayyan software was used for the final extraction and selection.</div></div><div><h3>Results</h3><div>The studies retrieved highlight the following interventions for neuroprotection: the use of a continuous temperature feedback system (continuous temperature monitoring with vesical, oesophageal, or parenthetic probes) for temperature induction; conducting a preinduction time between 390 min (6.5 h) and 12 h and an induction time greater than 440 min (7.3 h); setting the target temperature between 32 °C and 37.5 °C according to the patient's characteristics for a maintenance period between 24 and 48 h; the administration of sedatives, antipyretics, and neuromuscular blockers; and the assessment of neurological prognosis only after the rewarming phase, using scales such as the Cerebral Performance Category and the Modified Rankin Score.</div></div><div><h3>Conclusions</h3><div>Continuous research and investment in this area of knowledge are highly encouraged, particularly in terms of refining accurate neurological prognostic tools and assessment scales.</div></div><div><h3>Registration</h3><div>PROSPERO Registration ID: CRD42024588646.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101264"},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321582","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":"Animal-assisted services in Australia and New Zealand intensive care units: A cross-sectional survey","authors":"Kristen Ranse RN, PhD ,&nbsp;Tania Lovell RN, MPH-HM ,&nbsp;Belinda Henderson RN, MAdvHIthPracIC ,&nbsp;Kate Kyiet MMgt ,&nbsp;Kate Martin BBus ,&nbsp;Sumeet Rai FCICM","doi":"10.1016/j.aucc.2025.101272","DOIUrl":"10.1016/j.aucc.2025.101272","url":null,"abstract":"<div><h3>Background</h3><div>While animal-assisted services have demonstrated clinical benefits for patients in acute and subacute healthcare settings, there is a paucity of research evidence regarding these services in intensive care units (ICUs).</div></div><div><h3>Objective</h3><div>The objectives of this study were (1) to identify the prevalence of animal-assisted services in ICUs in Australia and New Zealand and (2) to gain an understanding of the key characteristics, practices, and barriers of animal-assisted services in ICUs.</div></div><div><h3>Methods</h3><div>Between February and May 2024, a cross-sectional online survey was distributed via convenience and snowball sampling approaches to a representative from all Australian and New Zealand ICUs. Descriptive statistics were calculated to summarise survey responses.</div></div><div><h3>Results</h3><div>From the survey responses (n = 63; response rate: 47%), animal-assisted services were or had been offered in 44% of ICUs (n = 28). While there were variations in the characteristics and delivery of animal-assisted services, every service involved dogs, targeted patients as recipients of the service, and required patient and staff hand hygiene. Most respondents indicated that dogs need to be washed and brushed prior to visiting the ICU and remain on a leash while in the ICU. There were no reports of adverse events. Common barriers to animal-assisted services included a lack of program initiation, staffing constraints, infection control policies, and limited funding.</div></div><div><h3>Conclusions</h3><div>This study provides preliminary evidence of the prevalence and characteristics of animal-assisted services in Australian and New Zealand ICUs. Variation in the characteristics of animal-assisted services demonstrates a need for identification of best practices pertaining to animal-assisted services in the ICU and the development of guidelines to support the implementation of these services. Future interventional studies are required to provide further evidence of the feasibility and effectiveness of animal-assisted services, both as meet-and-greet-style support programs and treatment interventions in ICUs.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101272"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313657","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":"Handgrip and inspiratory muscle strength as surrogates for intensive care unit–acquired weakness: A prospective cohort study in Taiwan","authors":"Meng-Shan Wu NP, RN ,&nbsp;Shih-Chi Ku MD, MPH ,&nbsp;Tyng-Guey Wang MD, PhD ,&nbsp;Tony Yu-Chang Yeh MD, PhD ,&nbsp;Shu-Fen Siao RN ,&nbsp;Yu-Chun Chang RN ,&nbsp;Ya-Fang Yu MMS, RN ,&nbsp;Cheryl Chia-Hui Chen RN, DNSc","doi":"10.1016/j.aucc.2025.101263","DOIUrl":"10.1016/j.aucc.2025.101263","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this prospective cohort study was to investigate the incidence of intensive care unit (ICU)–acquired weakness (ICUAW) and compare handgrip strength (HGS) and inspiratory muscle strength, measured by maximum inspiratory pressure (MIP), between critical illness survivors with and without ICUAW. Additionally, we examined whether HGS and MIP could serve as surrogate measures for ICUAW and establish reference cut-off values for both HGS and MIP in Taiwanese ICU survivors.</div></div><div><h3>Methods</h3><div>A total of 274 ICU survivors aged ≥20 yrs without prior systemic weakness from six medical ICUs at a tertiary care hospital in Taiwan were consecutively enrolled. ICUAW was identified at the time of ICU discharge using standardised manual muscle testing based on the Medical Research Council scale. Simultaneously, HGS and MIP were assessed. A receiver operating characteristic curve analysis was performed to evaluate whether HGS and MIP could serve as surrogate markers for ICUAW and to establish their cut-off values.</div></div><div><h3>Results</h3><div>Among the 406 enrolled participants, 310 survived their ICU stay, and 274 completed the Medical Research Council test upon ICU discharge. The survivors were predominantly male (65.7%), with a median age of 70 years (interquartile range: 59–80). Acute respiratory failure was the leading cause of ICU admission (52.9%), and 60.2% of patients required mechanical ventilation during their ICU stay, with a median duration of 8 days (interquartile range: 3–8). ICUAW was identified in 23.0% of survivors. Fewer participants in the ICUAW group were able to complete HGS (87.1%) and MIP (45.2%) assessments, likely due to physical limitations. Compared with those without ICUAW, the ICUAW group was significantly older, had higher Acute Physiology and Chronic Health Evaluation scores at admission, required longer mechanical ventilation, had longer ICU stays, and displayed weaker HGS and lower MIP at ICU discharge. The receiver operating characteristic curve analysis demonstrated that both HGS and MIP served as promising surrogate markers with areas under the curve of 0.842 and 0.822, respectively, and optimal cut-offs of 10.9 kg-force for HGS and 22.5 cmH₂O for MIP. Additionally, sex-specific cut-offs were also identified.</div></div><div><h3>Conclusions</h3><div>HGS and MIP show promise as surrogate markers for ICUAW, with our ICU survivor cohort revealing comparable HGS and lower MIP cut-off values compared to previous recommendations. These results emphasise the importance of tailored cut-offs and screening approaches for different ethnic and geographic regions. Additionally, they provide preliminary reference values for ICU survivors in Taiwan and highlight the need for further studies in the region.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101263"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313671","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}