Australian Critical Care最新文献

{"title":"Letter to the Editor: Clinical implementation considerations for machine learning–based delirium prediction models","authors":"XiRui Yang MBBS (Candidate for Master of Medicine (MM))","doi":"10.1016/j.aucc.2025.101423","DOIUrl":"10.1016/j.aucc.2025.101423","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101423"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092871","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":"Comment on “Antidepressant use, but not polypharmacy, is associated with worse outcomes after in-hospital cardiac arrest in older people”","authors":"YuZhu Fan Ms, WangQin Shen PHD","doi":"10.1016/j.aucc.2025.101413","DOIUrl":"10.1016/j.aucc.2025.101413","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101413"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092862","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":"Can handgrip strength reflect muscle dysfunction in individuals in intensive care units? A prospective observational study","authors":"Ruo-Yan Wu PT, MS ,&nbsp;Huan-Jui Yeh MD, PhD ,&nbsp;Mei-Wun Tsai PT, PhD ,&nbsp;Chiao-Nan Chen PT, PhD","doi":"10.1016/j.aucc.2025.101315","DOIUrl":"10.1016/j.aucc.2025.101315","url":null,"abstract":"<div><h3>Background</h3><div>Handgrip strength (HGS) is a tool for diagnosing intensive care unit (ICU)–acquired weakness. However, the influence of consciousness on HGS and its relationship with muscle dysfunction in the ICU remain unclear.</div></div><div><h3>Objectives</h3><div>This prospective observational study evaluated the feasibility, reliability, and performance of HGS in patients in the ICU with varying levels of consciousness and compared changes in muscle mass and HGS between patients with improved or worsened consciousness during their ICU stay.</div></div><div><h3>Methods</h3><div>Critically ill patients in surgical ICUs were assessed daily for HGS, quadriceps muscle thickness, and diaphragm thickness, along with consciousness evaluations using the Richmond Agitation-Sedation Scale (RASS). Muscle thickness was assessed by ultrasound. Patients were categorised into worsened, stable, or improved groups based on RASS score changes. The intraclass correlation coefficient assessed the HGS reliability across consciousness levels. Independent t-tests compared HGS and muscle thickness between patients with better consciousness (RASS −1 to 1) and poorer consciousness (RASS outside −1 to 1). Generalised estimating equations explored HGS and muscle thickness trends between the worsened and improved groups during the ICU stay.</div></div><div><h3>Results</h3><div>A total of 318 patients (mean age: 66.1 years; 32.4% female) were included in the study. HGS reliability was good in patients with RASS scores of 0 (intraclass correlation coefficient = 0.869). Patients with better consciousness displayed significantly higher HGS and quadriceps thickness than those with poorer consciousness. During ICU stay, HGS increased by 50% in the improved group; it decreased by 22% in the worsened group, showing a significantly opposite trend (p &lt; 0.001). The quadriceps and diaphragm thicknesses decreased in both groups, with no significant differences in the trends between them.</div></div><div><h3>Conclusions</h3><div>HGS assessment is feasible and reliable in ICU patients with a RASS score of 0. Improvements in HGS in critically ill patients are associated with improved consciousness rather than muscle mass gain.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101315"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092812","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":"Letter to “Incidence of pressure injuries and effectiveness of a prevention care bundle in critically ill Vietnamese patients: A prospective cohort study”","authors":"Lili Pan RN, BN (Registered Nurse, Bachelor of Nursing),&nbsp;Xia Luo RN, BN (Registered Nurse, Bachelor of Nursing),&nbsp;Jie Peng Associate Chief Physician, MB (Bachelor of Medicine)","doi":"10.1016/j.aucc.2025.101419","DOIUrl":"10.1016/j.aucc.2025.101419","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101419"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092826","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":"Reply to Letter to the Editor","authors":"Meredith Heily RN, M.Ed,&nbsp;Rebecca Jarden RN, PhD,&nbsp;Celene Y.L. Yap B.Pharm., PhD,&nbsp;Marie Gerdtz RN, PhD","doi":"10.1016/j.aucc.2025.101412","DOIUrl":"10.1016/j.aucc.2025.101412","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101412"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092852","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":"End-of-life conversations: Bridging legal and emotional challenges in critical care","authors":"Thomas Buckley RN, PhD","doi":"10.1016/j.aucc.2025.101416","DOIUrl":"10.1016/j.aucc.2025.101416","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 5","pages":"Article 101416"},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903720","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":"Application of the healthy aging brain care monitor for latent profile classification and influencing factors of post–intensive care syndrome in intensive care unit–transferred patients: A multicentre cohort study","authors":"Guangnan Liu MM ,&nbsp;Zhen Li MM ,&nbsp;Hui Zhang PhD ,&nbsp;Jinbang Liu BS ,&nbsp;Chengwu Yang BS ,&nbsp;Haoyu Bi BS ,&nbsp;Zhining Yang MM ,&nbsp;Yu Sheng PhD","doi":"10.1016/j.aucc.2025.101313","DOIUrl":"10.1016/j.aucc.2025.101313","url":null,"abstract":"<div><h3>Background</h3><div>Post–intensive care syndrome (PICS) significantly impacts intensive care unit (ICU)–transferred patients, causing long-term physical, cognitive, and psychological consequences. However, personalised interventions targeting the full spectrum of symptoms in these patients remain limited. Current mainstream PICS assessment methods involve multiple scales, which can be complex, whereas the Healthy Aging Brain Care Monitor offers a more streamlined approach for evaluating the full range of symptoms in ICU-transferred patients; thus, its application in this population requires further exploration.</div></div><div><h3>Objectives</h3><div>The objectives of this study were to classify the severity of PICS symptoms in ICU-transferred patients using the Healthy Aging Brain Care Monitor and to identify influencing factors associated with different PICS severity categories.</div></div><div><h3>Methods</h3><div>A cohort study was conducted at four tertiary hospitals in Beijing from January to December 2023, enrolling ICU-transferred patients. Data were collected using paper-based questionnaires, and a latent profile analysis was performed using Mplus 8.3 (Muthén &amp; Muthén, Los Angeles, CA, USA) to classify PICS severity. Differences between groups were analysed using chi-squared tests, Kruskal–Wallis tests, and logistic regression.</div></div><div><h3>Results</h3><div>The latent profile analysis identified three categories of PICS symptoms: “mild PICS group” (48.95%), “moderate PICS group” (28.69%), and “severe PICS group” (22.36%). Logistic regression analysis showed that factors such as education level (primary school or below, odds ratio [OR] = 3.129, 95% confidence interval [CI]: 1.182–6.985), Acute Physiology and Chronic Health Evaluation II score (OR = 1.100, 95% CI: 1.016–1.190), Sequential Organ Failure Assessment score (OR = 1.312, 95% CI: 1.110–1.552), and Hospital Anxiety and Depression Scale for depression score (OR = 1.721, 95% CI: 1.220–2.426) significantly influenced the likelihood of severe PICS symptoms.</div></div><div><h3>Conclusions</h3><div>The study revealed distinct PICS severity profiles in ICU-transferred patients, emphasising the significant role of baseline health, anxiety, and department of transfer in determining symptom severity. These findings highlight the potential for personalised, targeted interventions based on these profiles. Future research should explore how these factors interact and their causal relationships to better tailor interventions for improving recovery and quality of life post ICU discharge.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101313"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885951","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":"Emerging elements of paediatric post-sepsis care programs: A scoping review","authors":"Natalie J. Middleton BN, MClinNurs, RN ,&nbsp;Catherine Pienaar MMed ,&nbsp;Joanne Harvey BN, RN ,&nbsp;Emily Rice MBBS, FRACP ,&nbsp;Bernard McCarthy MBBS, FRACP PEM ,&nbsp;Fenella J. Gill BN, PhD RN, FACCCN ,&nbsp;Christopher C. Blyth MBBS(Hons), DCH, PhD, FRACP, FRCPA, GAICD","doi":"10.1016/j.aucc.2025.101316","DOIUrl":"10.1016/j.aucc.2025.101316","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a significant cause of mortality for children in Australia, particularly affecting young children, those with pre-existing health conditions and Aboriginal and Torres Strait Islander populations. The transition from hospital to home can be challenging for survivors, often leaving long-term impacts unaddressed.</div></div><div><h3>Objectives</h3><div>The objective of this study was to identify and describe existing post-sepsis care interventions and models of care for paediatric survivors, with the aim of informing the development of a post-sepsis care pathway.</div></div><div><h3>Methods</h3><div>The JBI Scoping Review Framework guided the identification and selection of relevant literature, Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines ensured transparent reporting, and the Patterns Advances Gaps Evidence for practice and Research and recommendations framework supported analysis and synthesis<strong>.</strong> Peer-reviewed literature was sourced from databases, the Cochrane Collaboration, reference lists, and expert consultations. Grey literature was identified through targeted searches of healthcare and paediatric organisation websites.</div></div><div><h3>Results</h3><div>Of 1843 records screened, eight met inclusion criteria: two peer-reviewed articles and six grey literature resources. Two emerging models of care were described: the Children's Hospital of Philadelphia Pediatric Sepsis Survivorship Program and the Queensland Paediatric Sepsis Program. The Children's Hospital of Philadelphia introduced a nurse coordinator role for discharge education and follow-up at 3 months utilising a survivor-needs questionnaire. The Queensland Paediatric Sepsis Program developed a webpage, videos, a family registry, and a peer mentor program codesigned with families. Both emphasised psychosocial support and care coordination, though neither had formal evaluations or measurable outcomes. Grey literature described general service approaches without defined interventions.</div></div><div><h3>Conclusion</h3><div>There is an evidence gap in structured, evaluated post-sepsis care for children. Only two emerging models of care were identified, neither formally assessed. Findings support the need for a comprehensive, culturally sensitive, family-centred care model and have informed the development of a pilot post-sepsis care pathway.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101316"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886525","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 nitty-gritty of characterizing a cardiac surgical research cohort","authors":"Rohan Magoon DM, MD,&nbsp;Varun Suresh DM, MD,&nbsp;Nitin Choudhary MD","doi":"10.1016/j.aucc.2025.101314","DOIUrl":"10.1016/j.aucc.2025.101314","url":null,"abstract":"","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101314"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886526","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 prevalence and use of arterial catheters in adult intensive care units: An Australian and New Zealand point prevalence study","authors":"Samantha Keogh RN, PhD, FACN ,&nbsp;Felicity Edwards BHlthSc, APD, AN ,&nbsp;Annabel Levido RN, MAppMngmnt ,&nbsp;Evan Alexandrou RN, PhD ,&nbsp;Amanda Corley RN, PhD ,&nbsp;Fiona Coyer RN, PhD ,&nbsp;Jayesh Dhanani MD, FCICM ,&nbsp;Kristen Gibbons BInfoTech, BMaths, PhD ,&nbsp;Naomi E. Hammond RN, PhD ,&nbsp;Serena Knowles RN, PhD ,&nbsp;Kevin B. Laupland MD, PhD, FCICM ,&nbsp;Mahesh Ramanan MBBS, FCICM ,&nbsp;Claire M. Rickard RN, PhD ,&nbsp;Andrew Udy MBChB, PhD, FCICM ,&nbsp;The George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group","doi":"10.1016/j.aucc.2025.101312","DOIUrl":"10.1016/j.aucc.2025.101312","url":null,"abstract":"<div><h3>Background</h3><div>Arterial catheters (ACs) are commonly used in intensive care units (ICUs) for monitoring and blood sampling. Optimising AC care requires a better understanding of current use and practices.</div></div><div><h3>Objective</h3><div>The objective of this study was to determine the prevalence of AC use in ICU patients and describe current clinical practices.</div></div><div><h3>Methods</h3><div>A prospective, multicentre, point prevalence study of patients aged ≥16 years was conducted across Australian and New Zealand ICUs as part of The George Institute for Global Health and Australian and New Zealand Intensive Care Society Clinical Trials Group Point Prevalence Program.</div></div><div><h3>Main outcome measure</h3><div>The primary outcome was AC prevalence.</div></div><div><h3>Results</h3><div>Of 924 patients from 59 ICUs, 68.2% had ACs, primarily in the radial artery (87.3%) with an open transducer set (65.7%). Most hospitals were metropolitan (88.1%) and publicly funded (84.7%). Patients had a mean age of 60.6 years (standard deviation: 16.4), 57.5% were male, and the mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 17.7 (standard deviation: 7.4). Mechanical ventilation was used for 39.8% of patients, and 34.3% received vasopressors. Most (93.0%) were first-time ICU admissions, mainly from emergency departments (34.7%) or operating theatres (31.1%). The presence of an AC was associated with a slightly higher illness severity score, as shown by APACHE II (Cohens <em>d</em>: 0.34; 95% confidence interval [CI]: 0.20–0.48), and a modest increase in ICU length of stay (Cliff's Delta: 0.19; 95% CI: 0.11–0.27), higher odds of mechanical ventilation (odds ratio: 5.13; 95% CI 3.64–7.24), and vasopressor use (odds ratio: 7.70; 95% CI: 5.09–11.64). Management practice varied, with dressing changes occurring weekly (36.0%), every 4 days (20.0%), or as clinically needed (20.0%). AC removal was mostly clinically indicated (62.0%), with 20% of ACs removed at time-based intervals.</div></div><div><h3>Conclusion</h3><div>The high prevalence of AC use in ICUs highlights the need for improved evidence-based guidance for practice, including indications for use, maintenance practice, and removal.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101312"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885950","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}