Intensive and Critical Care Nursing最新文献

{"title":"Caring for Victims of Child Abuse in the Pediatric ICU - Letter on Berdida & Grande","authors":"Sari Luthfiyah, Triwiyanto Triwiyanto, Enung Mardiyanah Hidayat, Indriatie Indriatie, Aida Novitasari","doi":"10.1016/j.iccn.2025.104052","DOIUrl":"10.1016/j.iccn.2025.104052","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"90 ","pages":"Article 104052"},"PeriodicalIF":4.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895425","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":"Extracorporeal membrane oxygenation and diurnal analgosedation: A comparative retrospective study in ventilated patients","authors":"Christopher Remmington ,&nbsp;Luigi Camporota ,&nbsp;Cathrine A. McKenzie ,&nbsp;Fraser Hanks ,&nbsp;Barnaby Sanderson ,&nbsp;Louise Rose","doi":"10.1016/j.iccn.2025.104056","DOIUrl":"10.1016/j.iccn.2025.104056","url":null,"abstract":"<div><h3>Background</h3><div>Diurnal variation of analgosedation may worsen patient outcomes. However, there is no data reporting diurnal variation in patients receiving extracorporeal membrane oxygenation (ECMO).</div></div><div><h3>Objectives</h3><div>To compare diurnal variation of analgosedation doses in mechanically ventilated adult patients and those receiving ECMO.</div></div><div><h3>Setting</h3><div>Five ICUs (65 beds) including an ECMO unit, with patient recruitment from July 2021 to July 2023.</div></div><div><h3>Methods</h3><div>Retrospective single-centre cohort study including patients aged ≥ 16 years receiving continuous intravenous (IV) opioid (fentanyl) and/or sedative (midazolam and/or propofol), receiving mechanical ventilation with or without ECMO. We collected data on all intravenous analgosedation doses (excluding boluses) from 07:00 to 18:59 (day) or from 19:00 to 06:59 (nighttime) for 48 h.</div></div><div><h3>Results</h3><div>We identified 1277 patients; of whom 166 (13.0 %) received ECMO and 1111 (87.0 %) received no ECMO. Most were male 815 (63.8 %), median (interquartile range (IQR)) age 58 (42–70) years. We found no diurnal variation of analgosedation doses in ECMO patients. However, we found higher doses of fentanyl (mean difference 1.7 µg/kg, 95 % Confidence Interval (CI): 1.0, 2.4 μg/kg, p &lt; 0.001) and propofol (mean difference 2.3 mg/kg, 95 % CI: 1.7, 2.9 mg/kg, p &lt; 0.001) at nighttime compared to daytime in non-ECMO patients. A higher proportion of ECMO patients received neuromuscular blocking drugs compared to non-ECMO group 120 (72.3 %) vs 138 (12.4 %); p &lt; 0.001.</div></div><div><h3>Conclusions</h3><div>We found higher doses of fentanyl and propofol IV infusion doses at nighttime in non-ECMO patients. However, we found no diurnal variation of analgosedation doses in ECMO patients, most likely due to deep sedation and use of neuromuscular blocking medicines.</div></div><div><h3>Implications for clinical practice</h3><div>Patient factors, critical illness factors and type of ICU admission are likely contributory factors to differences in diurnal variation of analgosedation doses in ECMO and non-ECMO populations.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104056"},"PeriodicalIF":4.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887800","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":"Accounting for hierarchy and human behaviour in closed‑loop ventilation trials: Letter on van Haren et al.","authors":"Yayu Wu","doi":"10.1016/j.iccn.2025.104053","DOIUrl":"10.1016/j.iccn.2025.104053","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"90 ","pages":"Article 104053"},"PeriodicalIF":4.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881609","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 role of AI in emergency department triage: An integrative systematic review","authors":"Rabie Adel El Arab,&nbsp;Omayma Abdulaziz Al Moosa","doi":"10.1016/j.iccn.2025.104058","DOIUrl":"10.1016/j.iccn.2025.104058","url":null,"abstract":"<div><h3>Background</h3><div>Overcrowding in emergency departments (EDs) leads to delayed treatments, poor patient outcomes, and increased staff workloads. Artificial intelligence (AI) and machine learning (ML) have emerged as promising tools to optimize triage. Objective: This systematic review evaluates AI/ML-driven triage and risk stratification models in EDs, focusing on predictive performance, key predictors, clinical and operational outcomes, and implementation challenges.</div></div><div><h3>Methods</h3><div>Following PRISMA 2020 guidelines, we systematically searched PubMed, CINAHL, Scopus, Web of Science, and IEEE Xplore for studies on AI/ML-driven ED triage published through January 2025. Two independent reviewers screened studies, extracted data, and assessed quality using PROBAST, with findings synthesized thematically.</div></div><div><h3>Results</h3><div>Twenty-six studies met inclusion criteria. ML-based triage models consistently outperformed traditional tools, often achieving AUCs &gt; 0.80 for high acuity outcomes (e.g., hospital admission, ICU transfer). Key predictors included vital signs, age, arrival mode, and disease-specific markers. Incorporating free-text data via natural language processing enhances accuracy and sensitivity. Advanced ML techniques, such as gradient boosting and random forests, generally surpassed simpler models across diverse populations. Reported benefits included reduced ED overcrowding, improved resource allocation, fewer mis-triaged patients, and potential patient outcome improvements.</div></div><div><h3>Conclusion</h3><div>AI/ML-based triage models hold substantial promise in improving ED efficiency and patient outcomes. Prospective, multi-center trials with transparent reporting and seamless electronic health record integration are essential to confirm these benefits.</div></div><div><h3>Implications for Clinical Practice</h3><div>Integrating AI and ML into ED triage can enhance assessment accuracy and resource allocation. Early identification of high-risk patients supports better clinical decision-making, including critical care and ICU nurses, by streamlining patient transitions and reducing overcrowding. Explainable AI models foster trust and enable informed decisions under pressure. To realize these benefits, healthcare organizations must invest in robust infrastructure, provide comprehensive training for all clinical staff, and implement ethical, standardized practices that support interdisciplinary collaboration between ED and ICU teams.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104058"},"PeriodicalIF":4.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882566","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 associated with significant post-traumatic-stress symptoms among bereaved family members of patients who died in intensive care units","authors":"Wei-En Hung ,&nbsp;Wen-Chi Chou ,&nbsp;Chen Hsiu Chen ,&nbsp;Siew Tzuh Tang","doi":"10.1016/j.iccn.2025.104055","DOIUrl":"10.1016/j.iccn.2025.104055","url":null,"abstract":"<div><h3>Objective</h3><div>Few studies comprehensively investigate factors associated with significant post-traumatic-stress-disorder (PTSD) symptoms among family members of ICU decedents. We aimed to identify factors associated with significant PTSD symptoms among bereaved ICU family members, focusing on those modifiable through high-quality end-of-life ICU care.</div></div><div><h3>Methods</h3><div>A cohort study of 321 bereaved family members of critically ill patients assessed PTSD symptoms at 1, 3, 6, 13, 18, and 24 months postloss using the Impact of Event Scale-Revised (IES-R). Family-rated quality of dying and death (QODD) and ICU care satisfaction were assessed 1 month postloss using the ICU-QODD and Family Satisfaction in the ICU (FS-ICU) scales, respectively. Multivariable logistic regression with generalized estimating equations examined associations between significant PTSD symptoms and intrapersonal (demographics, vulnerabilities), interpersonal (perceived social support measured by the Medical Outcome Study Social Support Survey), bereavement-related (patient demographics, clinical characteristics), and death-circumstance (ICU-QODD and FS-ICU scores) factors identified from significant univariate analyses.</div></div><div><h3>Results</h3><div>Prevalence of significant PTSD symptoms decreased substantially over time (from 11.0 % at 1 month to 0 % at 24 months post loss). Financial insufficiency (adjusted odds ratio [AOR][95 % CI] = 3.281[1.306, 8.244]) and use of antidepressants in the year prior to the patient’s critical illness (AOR[95 % CI] = 6.406 [1.868, 21.967]) increased the likelihood of significant PTSD symptoms. Stronger family-perceived social support (AOR[95 % CI] = 0.964 [0.941, 0.988]) and higher family-judged patient QODD in ICUs (AOR[95 % CI] = 0.632 [0.435, 0.918]) lowered the odds of significant PTSD symptoms.</div></div><div><h3>Conclusions</h3><div>Modifiable end-of-life ICU care factors, i.e. higher family-judged patient QODD and family-perceived social support, reduced bereaved ICU family members’ likelihood of significant PTSD symptoms.</div></div><div><h3>Implications for clinical practice</h3><div>To reduce the likelihood of significant PTSD symptoms in bereaved family members, ICU clinicians should provide high-quality end-of-life care to improve patient QODD and leverage social support, particularly for at-risk groups with financial challenges or prior antidepressant use.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104055"},"PeriodicalIF":4.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882563","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":"Optimization pathways for ICU delirium prevention and Management: Structured family Interventions, multisensory care Integration, and Innovative Approaches in Pediatric patient care with Future Perspectives – Letter on Ma et al.","authors":"Wei Xiong ,&nbsp;Ting Zheng ,&nbsp;Jie Liang","doi":"10.1016/j.iccn.2025.104045","DOIUrl":"10.1016/j.iccn.2025.104045","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"90 ","pages":"Article 104045"},"PeriodicalIF":4.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886657","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":"From ICU to emergency department: Integrating sustainability for a greener healthcare future – Response to Golcuk et al.","authors":"Davide Bartoli ,&nbsp;Francesco Petrosino ,&nbsp;Luciano Midolo ,&nbsp;Gianluca Pucciarelli ,&nbsp;Francesca Trotta","doi":"10.1016/j.iccn.2025.104043","DOIUrl":"10.1016/j.iccn.2025.104043","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104043"},"PeriodicalIF":4.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882567","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":"Corneal injury in critically ill sedated and mechanically ventilated patients: reflections on a meta-analysis – Letter on Rezende do Prado et al.","authors":"Liqun Xu,&nbsp;Dengying Long","doi":"10.1016/j.iccn.2025.104050","DOIUrl":"10.1016/j.iccn.2025.104050","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"90 ","pages":"Article 104050"},"PeriodicalIF":4.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881607","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":"Timing, bias, and diversity: Unaddressed gaps in SEM scanner-based pressure injury prediction - Letter on Bayoumi et al.","authors":"Juan Ye ,&nbsp;Kun Huang","doi":"10.1016/j.iccn.2025.104051","DOIUrl":"10.1016/j.iccn.2025.104051","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"90 ","pages":"Article 104051"},"PeriodicalIF":4.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881608","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":"Predicting violence in the intensive care unit: Can artificial intelligence protect those who care?","authors":"Gideon U. Johnson,&nbsp;Amanda Towell-Barnard,&nbsp;Beverley Ewens","doi":"10.1016/j.iccn.2025.104054","DOIUrl":"10.1016/j.iccn.2025.104054","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"89 ","pages":"Article 104054"},"PeriodicalIF":4.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882561","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}