Intensive and Critical Care Nursing最新文献

{"title":"A self-administered ICU-distress thermometer used to identify and track specific sources of distress in ICU patients during recovery","authors":"José G.M. Hofhuis ,&nbsp;Lisa de Zwart ,&nbsp;Aly Hovingh ,&nbsp;Peter E. Spronk","doi":"10.1016/j.iccn.2025.103994","DOIUrl":"10.1016/j.iccn.2025.103994","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop a new ICU-distress thermometer to characterize problems as perceived by individual patients and to evaluate it’s potential usability in the follow-up of ICU survivors.</div></div><div><h3>Methods</h3><div>An ICU-distress thermometer was developed through an iterative process involving several discussions with healthcare professionals and ICU survivors. Patients surviving the ICU with an ICU length of stay &gt; 48 h were included and their scores on the instrument were used to assess internal consistency. We assessed the ICU-distress thermometer’s usefulness and the burden experienced by ICU patients at specific time points: before ICU admission and 3, 6 and 12 months after hospital discharge.</div></div><div><h3>Results</h3><div>We included a total of 280 ICU patients from four ICUs in the Netherlands between 2020 and 2022. The ICU-distress thermometer showed good to excellent internal reliability i.e. Cronbach’s α for the total symptom score (41 items) was good – excellent between 0.901 and 0.945 and was easily used by patients at ICU-follow up out-clinics. It helped focus conversations on patient’s complaints. The perceived distress score increased at 3 months after hospital discharge (median 5 [3.3–7]); compared to baseline (median 1 [0–4]; P &lt; 0.001), stabilized between 3–6 months (median 5 [2.5–6]; P = 0.012) and decreased at 12 months (median 3 [2–6]; P = NS). Patients reported changes in perceived problems resulting in a functional decline such as muscle weakness or pain.</div></div><div><h3>Conclusions</h3><div>The ICU-distress thermometer is a valuable tool with good internal consistency that prevents overwhelming patients with numerous high quality, but non-focussed validated surveys. It improves insight in individually perceived relevant problems and focus specific support needs of ICU survivors during their recovery phase.</div></div><div><h3>Implications for clinical practice</h3><div>The novel ICU-distress thermometer is helpful during ICU follow-up to gain insight in the spectrum and extent of the sources of distress to facilitate appropriate care support and focussed referrals.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 103994"},"PeriodicalIF":4.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of indices of inferior vena cava in predicting fluid responsiveness in patients with shock: A systematic review and meta-analysis","authors":"Yang Wenwen ,&nbsp;Xu Ping ,&nbsp;Dong Yue ,&nbsp;Lu Xuan","doi":"10.1016/j.iccn.2025.104015","DOIUrl":"10.1016/j.iccn.2025.104015","url":null,"abstract":"<div><h3>Objectives</h3><div>To synthesise quantitative research findings on the accuracy of inferior vena cava (IVC) indices in judging fluid responsiveness (FR) in patients with shock.</div></div><div><h3>Methods</h3><div>A total of nine electronic databases were searched from inception to April 8, 2024. The risk of bias of the included studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. A <em>meta</em>-analysis of the values of external validations of the model was performed by Stata 16.0. Pooled estimates were calculated according to the true positive, false positive, false negative, true negative, sensitivity, and specificity using random-effects models. Meta-regression was adopted to investigate between-study heterogeneity, and funnel plots were tested for publication bias.</div></div><div><h3>Results</h3><div>Twenty-nine studies were included in the <em>meta</em>-analysis (1833 patients). For FR, the sensitivity was 0.82 (95 %CI, 0.75–0.87), specificity was 0.82 (95 % CI, 0.77–0.87), positive likelihood ratio was 4.58 (95 %CI, 3.48–6.03), negative likelihood ratio was 0.22 (95 %CI, 0.16–0.31), diagnostic odds ratio was 20.65 (95 %CI, 12.84–33.14), and the area under the summary receiver operating characteristic curve was 0.89 (95 % CI, 0.86–0.91). All studies had a low or moderate risk of bias in terms of methodological quality. There was heterogeneity among the included studies (sensitivity: <em>I</em>² = 83.04 %, <em>P</em> &lt; 0.001, specificity: <em>I</em>² = 78.78 %, <em>P</em> &lt; 0.001), and bivariate <em>meta</em>-regression analysis showed that fluid infusion ingredient, reference standards and thresholds, and type of measurement (invasive or non-invasive) were sources of literature heterogeneity.</div></div><div><h3>Conclusion</h3><div>The IVC indices moderately predicted the incidence of FR in patients with shock. However, significant heterogeneity was evident among the included studies. Studies of high methodological quality in specific subgroups of shock are needed to evaluate the efficacy of IVC indices as predictors of FR.</div></div><div><h3>Implications for Clinical Practice</h3><div>Monitoring of the inferior vena cava (IVC) by ultrasonography has been shown to have a clinical value in terms of volume reactivity, with the potential to provide non-invasive and effective guidance.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104015"},"PeriodicalIF":4.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes and practices of multiprofessional clinicians towards assisted dying in ICU: A scoping review","authors":"Luke Costello ,&nbsp;Brigitta Fazzini","doi":"10.1016/j.iccn.2025.104014","DOIUrl":"10.1016/j.iccn.2025.104014","url":null,"abstract":"<div><h3>Background</h3><div>Care of the dying is at the forefront in intensive care unit (ICU); however there is persistent debate surrounding clinicians’ interventions to aid the dying process and make this more bearable and compassionate for patients. Since the expansion of assisted dying internationally, it is unclear how common this occurs within critical care. This work aims to evaluate the knowledge, attitudes and international practices of ICU clinicians about assisted dying.</div></div><div><h3>Methods</h3><div>Systematic literature search of PubMed, Embase and CINAHL including articles discussing the knowledge or attitudes towards and/or practices of assisted dying in ICU. The preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review guidelines were followed. Records were included from 2002 as the year when assisted dying was first legalised in Belgium and by healthcare professionals. A qualitative data synthesis approach was used.</div></div><div><h3>Results</h3><div>17 studies were eligible and included in the qualitative analysis. Knowledge of assisted dying was rarely assessed directly in the data, though self-reported knowledge was low apart from in one Canadian survey of ICU physicians. Abilities to define modalities of assisted dying were low across all studies where it was measured. Attitudes were highly variable, ranging from 23.6% to 76.5% in support of assisted dying, though clinicians’ answers were inconsistent within and between studies. Actual practices of assisted dying in ICU were rarely measured or discussed, despite evidence of assisted dying in Canada and The Netherlands. Outside of legal pathways, there is also evidence of covert interventions either via non-framework approaches where it is otherwise legal or in countries where there is no supportive legislation.</div></div><div><h3>Conclusion</h3><div>ICU clinicians have heterogeneous knowledge and attitudes towards assisted dying, and overall familiarity remains low. The relevance of assisted dying to the ICU setting remains controversial, and its incidence is unclear.</div></div><div><h3>Implications for clinical practice</h3><div>Evaluating the attitudes and experiences of ICU clinicians about assisted dying is important to gain insight about clinical practices.</div><div>This holistic viewpoint is key to develop management strategies focused on humanisation of care for patients and families while understanding how to support multidisciplinary clinicians in critical care so they can provide safe and respectful interventions.</div><div>The identification of its incidence in legal and illegal frameworks and knowledge gaps is key when developing further research and planning tailored interventions.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104014"},"PeriodicalIF":4.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family auditory stimulation: A promising family-centered care strategy for preventing ICU delirium","authors":"Mu-Hsing Ho,&nbsp;Hye Ri Choi","doi":"10.1016/j.iccn.2025.104016","DOIUrl":"10.1016/j.iccn.2025.104016","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104016"},"PeriodicalIF":4.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of social media for intensive care practice","authors":"Antonija Petosic ,&nbsp;Kjetil Sunde ,&nbsp;Hilde Wøien","doi":"10.1016/j.iccn.2025.104019","DOIUrl":"10.1016/j.iccn.2025.104019","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104019"},"PeriodicalIF":4.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is appropriate ICU care?","authors":"Marieke Zegers,&nbsp;Gijs Hesselink","doi":"10.1016/j.iccn.2025.104018","DOIUrl":"10.1016/j.iccn.2025.104018","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104018"},"PeriodicalIF":4.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Impella Utilization in cardiogenic shock and high-risk percutaneous coronary interventions: Optimizing patient outcomes through evidence-based strategies and comprehensive training","authors":"Fung Ming Lau ,&nbsp;Mu-Hsing Ho ,&nbsp;Wai Chi Polly Li","doi":"10.1016/j.iccn.2025.104023","DOIUrl":"10.1016/j.iccn.2025.104023","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104023"},"PeriodicalIF":4.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing high-flow nasal cannula success in acute hypoxemic respiratory failure – Letter on Zevallos-Villegas et al.","authors":"Yan Fang ,&nbsp;Wen-Li Wu ,&nbsp;Li-Fen Hu ,&nbsp;Xiao-Xiao Luo ,&nbsp;Xian-Rong Shi","doi":"10.1016/j.iccn.2025.104008","DOIUrl":"10.1016/j.iccn.2025.104008","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104008"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic pain in ICU survivors: Potential risk factors and relationship with post-traumatic stress disorder symptoms and health related quality of life","authors":"Evangelia Giannelou ,&nbsp;Elizabeth Papathanassoglou ,&nbsp;Maria Karanikola ,&nbsp;Margarita Giannakopoulou ,&nbsp;Evangelos Bozas ,&nbsp;Niki Skopeliti ,&nbsp;Meropi Mpouzika","doi":"10.1016/j.iccn.2025.104003","DOIUrl":"10.1016/j.iccn.2025.104003","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify patient characteristics and clinical factors during ICU hospitalization potentially associated with chronic pain occurrence, and to determine its relationship with symptoms of post-traumatic stress disorder (PTSD) and health-related quality of life (HRQoL) at three time points after ICU discharge.</div></div><div><h3>Methods</h3><div>Adult ICU survivors were enrolled in a prospective, repeated measures study. The study was carried out in two phases. Phase I was conducted during the first 5 days of survivors’ ICU hospitalization where patient characteristics and clinical data were collected. Phase II was conducted via telephone interviews after 3 (T1), 6 (T2) and 12 (T3) months post-ICU discharge, where pain, PTSD-related symptoms, and HRQoL were assessed with the Numeric Rating Scale (NRS), Davidson Trauma Scale (DTS), and 36-Item Short Form Survey version 2 (SF-36v2), respectively.</div></div><div><h3>Results</h3><div>Data from 59 survivors were analysed, 69.5% of whom were males. The sample’s mean age was 52.7 (SD 18.9) years and 62.7% of them reported NRS&gt;3 at T1, indicating chronic pain. After adjusting for sex, age, and APACHE II score, chronic pain was significantly associated with: (a) length of stay in the ICU (OR=1.42; 95%CI: 1.03–1.95; p=0.030) and (b) clinically relevant symptoms of PTSD at T1 (OR=10.04; 95%CI: 2.44–41.24; p=0.001) and T2 (OR=11.90; 95%CI: 1.28–110.49; p=0.029). Lower SF-36v2 scores in all domains at T1, several domains at T2, and two domains at T3 were significantly associated with CP occurrence.</div></div><div><h3>Conclusions</h3><div>Of the patient characteristics and clinical factors analysed, only longer length of stay in ICU was significantly associated with higher odds of chronic pain occurrence, which in turn was linked to PTSD-related symptoms and lower HRQoL after ICU discharge.</div></div><div><h3>Implications for Clinical Practice</h3><div>Clinical interventions aimed at optimizing ICU length of stay, such as the implementation of early mobility programs and multidisciplinary rehabilitation, may support prevention of chronic pain occurrence and improve long-term outcomes.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"88 ","pages":"Article 104003"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing mental health engagement and screening protocols in ICU recovery clinics - Letter on Hussain et al.","authors":"Ya-ting Jiang ,&nbsp;Lucia D'Angelo ,&nbsp;Suwas Bhandari ,&nbsp;Yu-Qiang Gong ,&nbsp;Yu Hao","doi":"10.1016/j.iccn.2025.103992","DOIUrl":"10.1016/j.iccn.2025.103992","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 103992"},"PeriodicalIF":4.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}