Intensive and Critical Care Nursing最新文献

{"title":"Should we use artificial intelligence (AI) for writing ICU diaries? Not yet!","authors":"Ingrid Egerod","doi":"10.1016/j.iccn.2024.103868","DOIUrl":"10.1016/j.iccn.2024.103868","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103868"},"PeriodicalIF":4.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523965","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":"Factors associated with the effectiveness of high-flow therapy in patients with acute hypoxemic respiratory failure: An observational study","authors":"Annette Zevallos-Villegas ,&nbsp;Jesus Gonzalez-Rubio ,&nbsp;Fernando Neria Serrano ,&nbsp;Berta Gallego-Rodriguez ,&nbsp;Miguel Lorente-Gonzalez ,&nbsp;Alberto Najera ,&nbsp;Jose Rafael Teran-Tinedo ,&nbsp;Juan D. Navarro-Lopez ,&nbsp;Lydia Jimenez-Diaz ,&nbsp;Pedro Landete","doi":"10.1016/j.iccn.2024.103874","DOIUrl":"10.1016/j.iccn.2024.103874","url":null,"abstract":"<div><h3>Backward</h3><div>The COVID-19 pandemic has severely tested global health systems. Non-invasive respiratory support, especially combining high-flow nasal cannula (HFNC) and continuous positive airway pressure, has effectively treated COVID-19 induced Acute Hypoxemic Respiratory Failure and reduced mortality. However, HFNC alone is more comfortable, better tolerated, and less costly than non-invasive ventilation. Understanding which patients benefit from HFNC monotherapy versus combined therapies is essential.</div></div><div><h3>Methods</h3><div>This observational study included patients admitted to the intermediate respiratory care unit of a COVID-19 hospital between December 2020 and September 2021. All patients treated with HFNC were included (n = 1301). HFNC failure was defined as the need for escalated therapy (non-invasive ventilation, intubation) or death. Epidemiological, clinical, non-invasive respiratory support parameters, and laboratory data were collected, and a multivariable analysis identified key determinants.</div></div><div><h3>Results</h3><div>HFNC was successful in 39.9 % of patients. (n = 511) Risk factors for HFNC failure included increased age, male gender, obesity, obstructive sleep apnea, higher respiratory rate, initial SpO2/FiO2 ≤ 148, and initial PaO2/FiO2 ≤ 100. An increase in the ROX Index at 24 h and slower disease progression were associated with successful treatment. These findings led to the developmet of an index to identify patients who benefit most from HFNC monotherapy.</div></div><div><h3>Conclusions</h3><div>HFNC monotherapy can be effective for a specific profile of patients with Acute Hypoxemic Respiratory Failure due to COVID-19. This tool may help manage these patients more appropriately. Further studies are needed to determine if these findings can be applied to Acute Hypoxemic Respiratory Failure caused by other pathologies.</div></div><div><h3>Implications for Clinical Practice</h3><div>This study underscores the importance of early identification and management of patients at risk of HFNC failure in intermediate respiratory care units. By recognizing factors such as age, comorbidities, and respiratory indices, healthcare providers can implement targeted strategies to enhance HFNC success. These strategies may include more stringent monitoring, tailored respiratory support, and timely escalation to more intensive therapies if needed. Our findings highlight the need for a comprehensive approach to managing severe respiratory failure in critical care settings, ultimately improving patient outcomes and reducing the burden on healthcare systems.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103874"},"PeriodicalIF":4.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515353","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":"Symptom management of thirst for seriously ill and dying patients in critical care","authors":"Natalie Pattison","doi":"10.1016/j.iccn.2024.103869","DOIUrl":"10.1016/j.iccn.2024.103869","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103869"},"PeriodicalIF":4.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515355","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":"Treatment futility: Continuation or withdrawal of life-sustaining treatment in intensive care units","authors":"Hye Ri Choi ,&nbsp;Mu-Hsing Ho ,&nbsp;Chia-Chin Lin","doi":"10.1016/j.iccn.2024.103813","DOIUrl":"10.1016/j.iccn.2024.103813","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103813"},"PeriodicalIF":4.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515356","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":"Do we still need to talk about antimicrobial resistance?","authors":"Jean-Ralph Zahar,&nbsp;Pierre Moenne-Locoz","doi":"10.1016/j.iccn.2024.103860","DOIUrl":"10.1016/j.iccn.2024.103860","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103860"},"PeriodicalIF":4.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515352","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":"A guide to the guidelines: Closing the gap from practice guidelines to quality of care improvement in ventilator-associated pneumonia","authors":"Guillaume Millot,&nbsp;Gregoire Demont,&nbsp;Saad Nseir","doi":"10.1016/j.iccn.2024.103870","DOIUrl":"10.1016/j.iccn.2024.103870","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103870"},"PeriodicalIF":4.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515351","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":"Non-timely and incomplete carbapenem infusions: A plea to include administration practices as a key element in antimicrobial stewardship","authors":"Dorian Vanneste,&nbsp;Hendrik Bracht,&nbsp;Isabel Spriet","doi":"10.1016/j.iccn.2024.103872","DOIUrl":"10.1016/j.iccn.2024.103872","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103872"},"PeriodicalIF":4.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515354","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":"Validity and reliability of the Endotracheal Suction Assessment Tool© in adult ICU patients: A methodological study","authors":"İlkin Yılmaz ,&nbsp;Zilan Baran","doi":"10.1016/j.iccn.2024.103862","DOIUrl":"10.1016/j.iccn.2024.103862","url":null,"abstract":"<div><h3>Background</h3><div>Novice nurses often find endotracheal suctioning signs unfamiliar. The Endotracheal Suction Assessment Tool© (ESAT©) aids pediatric nurses in suctioning but lacks an adult equivalent. A valid and reliable ESAT© for assessing intensive care unit patients’ suction needs across different populations is necessary.</div></div><div><h3>Aim</h3><div>To test the validity and reliability of the ESAT© in adult ICU patients.</div></div><div><h3>Methods</h3><div>This methodological study assessed suction needs in patients at a tertiary adult ICU of a university hospital. Two independent observers used the ESAT© to determine suction needs. Data from 106 suction procedures were collected using a patient characteristics form, the ESAT©, and a suction monitoring form. The ESAT© includes eight respiratory and ventilation parameters and seven clinical consideration parameters. Hemodynamic and respiratory parameters were measured before, and one and five minutes after suction. Linguistic validity, content validity, and pilot testing were conducted. Interobserver agreement was evaluated, and psychometric evaluation was done using content validity index (CVI) and intraclass correlation coefficient (ICC). Data were analyzed with paired samples <em>t</em>-test and ANOVA.</div></div><div><h3>Results</h3><div>Item CVI ranged from 0.80 to 1.00, and scale CVI was 0.96. Inter-item correlation and ICC for inter-rater reliability were both 0.933 (95 % CI = 0.903–0.954, p &lt; 0.001 for ICC). Cohen’s Kappa coefficients ranged from 0.690 to 1.000 (p &lt; 0.001), indicating high consistency between raters for all tool items. All scale items showed near-perfect agreement except SpO2, which showed substantial agreement.</div></div><div><h3>Conclusion</h3><div>The S-CVI was good, indicating near-perfect agreement among raters. ESAT© is highly reliable and valid for determining suction needs in adult intensive care patients.</div></div><div><h3>Implications for Practice</h3><div>The ESAT© aids autonomous decision-making for suctioning needs. Originally for novice pediatric nurses, the ESAT© was adapted for adult intensive care nurses. The ESAT© is valid and reliable for adult intensive care patients.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103862"},"PeriodicalIF":4.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484164","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":"Effects of Wab-WPPEP on post-intensive care syndrome-family in family caregivers of heart valve replacement patients: A randomized controlled trial","authors":"Jing Xiong ,&nbsp;Ting-Ting Wu ,&nbsp;Hong Cai ,&nbsp;Jin-Yi He ,&nbsp;Tang-Ying Wang ,&nbsp;Xiu-Xia Lin ,&nbsp;Hong Li","doi":"10.1016/j.iccn.2024.103817","DOIUrl":"10.1016/j.iccn.2024.103817","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effects of a WeChat applet-based whole process psychological empowerment program (Wab-WPPEP) on post-intensive care syndrome-family in family caregivers of heart valve replacement patients.</div></div><div><h3>Design</h3><div>Two-arm, parallel, randomized controlled clinical trial.</div></div><div><h3>Settings</h3><div>A tertiary general hospital in Fuzhou, China.</div></div><div><h3>Methods</h3><div>Participants were randomly assigned to two groups. The intervention group received Wab-WPPEP, while the control group received routine care. The intervention was implemented from ICU admission to one month post-discharge. The primary outcome was anxiety, while secondary outcomes included depression, post-traumatic stress disorder (PTSD), and quality of life. Outcomes were assessed at baseline (T0), before ICU transfer (T1), pre-discharge (T2), and one month post-discharge (T3) using standardized questionnaires. Generalized estimating equations were used to analyze the repeated-measures data.</div></div><div><h3>Results</h3><div>The intervention group exhibited greater improvements in anxiety (T1: <em>β</em> = −1.92, 95 % CI: −2.35 to −1.49, <em>P</em> &lt; 0.001; T2: <em>β</em> = −1.66, 95 % CI: −2.03 to −1.29, <em>P</em> &lt; 0.001; T3: <em>β</em> = −3.98, 95 % CI: −4.34 to −3.62, <em>P</em> &lt; 0.001), depression (T1: <em>β</em> = −1.32, 95 % CI: −1.79 to −0.85, <em>P</em> &lt; 0.001; T2: <em>β</em> = −1.70, 95 % CI: −2.08 to −1.32, <em>P</em> &lt; 0.001), and quality of life (T2: <em>β</em> = 31.16, 95 % CI: 21.35 to 40.98, <em>P</em> &lt; 0.001) compared to the routine-care group. PTSD scores were also significantly lower in the intervention group (<em>t</em> = −6.454, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Wab-WPPEP significantly reduced anxiety and depression, improved quality of life, and alleviated PTSD symptoms in family caregivers of heart valve replacement patients.</div></div><div><h3>Implications for clinical practice</h3><div>Comprehensive psychological interventions should be implemented throughout the ICU stay and recovery period to improve family caregiver well-being.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103817"},"PeriodicalIF":4.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484163","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":"Simulated haemodynamic parameters and different infusion set-up affect drug delivery during syringe pump change over: A bench-top study in a laboratory setting","authors":"Alberto Lucchini ,&nbsp;Stefano Elli ,&nbsp;Alessia Burgazzi ,&nbsp;Laura Malvestuto Grilli ,&nbsp;Claudia Pes ,&nbsp;Katia Ferrari ,&nbsp;Letizia Fumagalli ,&nbsp;Chiara Fiorillo ,&nbsp;Marco Giani ,&nbsp;Emanuele Rezoagli","doi":"10.1016/j.iccn.2024.103861","DOIUrl":"10.1016/j.iccn.2024.103861","url":null,"abstract":"<div><h3>Background</h3><div>Infusion therapy is widely used in clinical settings, particularly in intensive care units.</div></div><div><h3>Aim</h3><div>to explore the influence of simulated cardiac output on “bolus” or “backflow” events that can occur during syringe pump changeover, considering several factors that have been previously outlined in published research. Syringe infusion pumps are commonly used for precise continuous intravenous drug delivery. Syringe pump changeover can be a challenging procedure.</div></div><div><h3>Methods</h3><div>Bench-top study in a laboratory setting. An extracorporeal circuit was used to simulate a cardiac output of 5 l/min. The following variables were used: three levels of vertical position of the syringe pump (−50 cm, 0, +50 cm), three levels of Central Venous Pressure (−5, 10, and 15 mmHg), presence/absence of carrier infusion (5 ml/h), and presence/absence of a needle-free connector between the syringe and extension line.</div></div><div><h3>Results</h3><div>A total of 108 syringe pump changes were performed with different combinations of the investigated variables. The mean time for syringe pump changeover was equal to 9.48 ± 2.45 s and the overall fluid displacement was 8 ± 40 µL (microlitres) (range, −262–156 µL). The CVP level and vertical position of the pump always statistically affected the overall displacement during syringe pump changeover. When a second infusion with an equal velocity rate to that of a syringe pump infusion is present in the same lumen, the presence of a needle-free device reduces the overall volume of displacement.</div></div><div><h3>Conclusions</h3><div>Syringe pump changeover can be a critical moment for patients when vasoactive drugs are administered.</div></div><div><h3>Implications for clinical practice</h3><div>In a simulated environment with a cardiac output of 5 L/min, the CVP level and vertical position of the syringe pump generated bolus or backflow events during the syringe pump changeover. The application of carrier infusion appeared to intensify these phenomena. Employing a neutral, needle-free system can potentially aid in reducing the development of boluses or backflows.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103861"},"PeriodicalIF":4.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445977","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}