Intensive and Critical Care Nursing最新文献

{"title":"Effects of omega-3 fatty acids on hyper-inflammatory response and clinical outcomes in critically ill patients: a meta-analysis","authors":"Ting Liu ,&nbsp;Xin Wang ,&nbsp;Xiao-hua Wang ,&nbsp;Can Wang ,&nbsp;Jian-zheng Cai ,&nbsp;Hai-fang Wang","doi":"10.1016/j.iccn.2025.104228","DOIUrl":"10.1016/j.iccn.2025.104228","url":null,"abstract":"<div><h3>Background</h3><div>There are still debates regarding the impact of omega-3 fatty acids on immune response and clinical outcomes in critically ill patients.</div></div><div><h3>Objective</h3><div>Explore the effects of omega-3 fatty acids on hyper-inflammatory response and clinical outcomes in critically ill patients.</div></div><div><h3>Methods</h3><div>We searched five databases from inception to July 18, 2024 and collected randomized controlled trials in which critically ill patients treated in an intensive care unit (ICU) were administered omega-3 fatty acids as a supplement. Data were expressed as mean difference, standard mean difference, or odds ratio with 95% confidence interval (CI).</div></div><div><h3>Results</h3><div>There were 41 randomized controlled trials that met the inclusion criteria, and they involved 3152 patients. The intervention with omega-3 fatty acids significantly reduced the following biomarkers: white blood cell count on day 3 and day 6/7, tumor necrosis factor-α (TNF-α) on day 3 and day 5, interleukin-1 (IL-1), interleukin-6 (IL-6), and procalcitonin at the last observation post-intervention. The intervention also reduced the Sequential Organ Failure Assessment (SOFA) score on day 5 and lowered the risk of secondary infections and new sepsis/septic shock, both determined during follow-up. It also significantly shortened the ICU stay and reduced the 28-day mortality rate, although ICU mortality rate remained unchanged.</div></div><div><h3>Conclusions</h3><div>Omega-3 fatty acids supplementation may be effective in modulating hyper-inflammatory responses, reducing the risk of complications and disease severity, and improving clinical outcomes.</div></div><div><h3>Implications for clinical practice</h3><div>Omega-3 fatty acids may serve as a potential nutritional therapy for critically ill patients, when medical staff identify the hyperinflammatory status of patients based on medical history, clinical manifestations, and laboratory results.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104228"},"PeriodicalIF":4.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103233","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":"Escalation metrics, clinical nuance, and the early warning score paradox – Response to Chen et al.","authors":"Jody Ede,&nbsp;Ruth Endacott,&nbsp;Bridie Kent","doi":"10.1016/j.iccn.2025.104229","DOIUrl":"10.1016/j.iccn.2025.104229","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104229"},"PeriodicalIF":4.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048768","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":"Refining the understanding of ICU Nurses’ attitudes towards family involvement: Key methodological, conceptual, contextual, and statistical considerations – Response to Bahramnezhad et al.","authors":"Isha Verkaik ,&nbsp;Nini H. Jonkman ,&nbsp;Paul J.T. Rood ,&nbsp;Frederique Paulus ,&nbsp;Anne M. Eskes","doi":"10.1016/j.iccn.2025.104216","DOIUrl":"10.1016/j.iccn.2025.104216","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104216"},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048769","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":"Impact of catheter size and endotracheal tube diameter on PEEP stability during closed suctioning in a simulated ARDS patient: a bench top study","authors":"Alberto Lucchini ,&nbsp;Marco Giani ,&nbsp;Chiara Maria Scala ,&nbsp;Sonno Sara ,&nbsp;Carluccio Salvatore ,&nbsp;Rigaldo Simone ,&nbsp;Andrea Restivo ,&nbsp;Giuseppe Foti ,&nbsp;Emanuele Rezoagli","doi":"10.1016/j.iccn.2025.104233","DOIUrl":"10.1016/j.iccn.2025.104233","url":null,"abstract":"<div><h3>Objectives</h3><div>Endotracheal suctioning is performed in mechanically ventilated patients to remove airway secretions. The American Association for Respiratory Care (AARC) has provided recommendations on endotracheal suctioning techniques and catheter size selection over the years (1993, 2010, 2022). This bench-top study aimed to compare the effects of closed-suction system manoeuvres performed with different catheter diameters on PEEP and Tidal Volume in an experimental setup of mechanical ventilation in a simulated ARDS scenario.</div></div><div><h3>Methods</h3><div>A lung simulator was used to simulate severe ARDS in adult patients. Endotracheal suctioning was performed using a closed suction system with two catheter sizes (12 and 14 Fr). and two endotracheal tube diameters (7 mm and 8 mm). The lung simulator was ventilated with different combinations of PEEP (10,15 cmH₂0), tidal volume (240,420 ml), and respiratory rates (10,16,24b/min). PEEP and Tidal Volume were assessed both before suctioning and at the 15th second of the endotracheal suctioning manœuvre.</div></div><div><h3>Results</h3><div>The median PEEP loss was −1.54 cmH₂O (IQR: −5.93 to −0.59), and the median tidal volume loss was −153.91 ml (IQR: −213.92 to −100.35). Univariate analysis identified endotracheal tube diameter, tidal volume, and suction catheter diameter as significant factors influencing PEEP loss (p &lt; 0.001), and multivariable analysis confirmed these associations (p &lt; 0.001 for all variables). Suction catheter diameter was the only factor significantly associated with tidal volume loss (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Endotracheal tube diameter and tidal volume significantly influenced PEEP loss, and suction catheter diameter significantly influenced both PEEP and tidal volume loss during closed suctioning in simulated adults with ARDS.</div></div><div><h3>Implications for clinical practice</h3><div>Results of this bench-top study suggest that, for adult patients with ARDS, the suction catheter should not exceed 50% of the inner diameter of the endotracheal tube, as recommended in the 1993 AARC guidelines. In this bench-top study, following the 2022 AARC recommendations led to a significant reduction in PEEP levels during endotracheal suctioning.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104233"},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048767","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":"Reported contributors to communication vulnerability for adult patients in critical care","authors":"Laura Istanboulian ,&nbsp;Amy Freeman-Sanderson ,&nbsp;Anthony Gilding ,&nbsp;Praisy Rampogu ,&nbsp;Kelly M. Smith ,&nbsp;Karen Soldatić","doi":"10.1016/j.iccn.2025.104231","DOIUrl":"10.1016/j.iccn.2025.104231","url":null,"abstract":"<div><h3>Background</h3><div>Patients admitted to the intensive care unit experience communication vulnerability due to patient-factors including the use of an advanced airway to facilitate mechanical ventilation. Communication vulnerability puts patients at risk for adverse safety events and breakdowns in care. A more complete understanding of communication vulnerability that includes socio-relational and contextual factors can expose opportunities to improve patient communication and safety in the intensive care unit.</div></div><div><h3>Aim</h3><div>To expand our understanding of patient communication vulnerability in the adult intensive care unit using a disability rights approach.</div></div><div><h3>Methods</h3><div>We used a qualitative descriptive methodology including semi-structured interviews and paired content analysis. Between January – April 2024, 22 participants were interviewed including 11 professionally diverse healthcare providers, 7 family members, and 4 patient survivors from a community academic hospital in Toronto, Canada. Interviews were audio recorded and transcribed.</div></div><div><h3>Findings</h3><div>Patient, family, and healthcare provider participants described often converging patient-, socio-relational-, environmental-, and structural- factors that contribute to patient communication vulnerability in the adult intensive care unit. In addition to patient factors, reported socio-relational factors included insufficient clinician communication training. Reported environmental factors included insufficent communication tool accessibility, lack of patient privacy, lighting and noise levels. Reported structural factors of communication vulnerability included family inclusion and infection control policies.</div></div><div><h3>Conclusions</h3><div>This study presents patient, family, and healthcare provider reported contributors to patient communication vulnerability in the intensive care unit beyond patient-factors. Identifying socio-relational, environmental and structural related factors contributing to communication vulnerability provides multiple opportunities to improve patient communication practices and safety for adults in the intensive care unit.</div></div><div><h3>Implications for Clinical Practice</h3><div>Using a disability rights approach to understanding patient communication vulnerability in the adult intensive care unit exposed socio-relational and contextual opportunities for system-based practice change. These include systemic availabilty of communication tools and conducting environmental scans of lighting and noise-levels.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104231"},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049241","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":"Key elements of quality improvement programs to prevent catheter-associated bloodstream infections in neonatal ICUs","authors":"Daniel Joseph E. Berdida ,&nbsp;Stijn Blot ,&nbsp;Elsa da Palma Afonso","doi":"10.1016/j.iccn.2025.104217","DOIUrl":"10.1016/j.iccn.2025.104217","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104217"},"PeriodicalIF":4.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049242","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":"Nursing surveillance for clinical deterioration among intensive care unit patients: A scoping review","authors":"Yeonju Kim ,&nbsp;Yesol Kim ,&nbsp;Jiin Kim ,&nbsp;Mona Choi","doi":"10.1016/j.iccn.2025.104218","DOIUrl":"10.1016/j.iccn.2025.104218","url":null,"abstract":"<div><h3>Objectives</h3><div>To comprehensively examine and summarize the existing knowledge on nursing surveillance for clinical deterioration among intensive care unit patients by presenting study and subject, clinical deterioration, and nursing surveillance characteristics in quantitative and qualitative studies.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in five electronic databases. Literature addressing nursing surveillance for detecting clinical deterioration among adult intensive care unit patients was included. Surveillance identified in quantitative studies was categorized into four nursing data types (scales, assessment records, activity records, and notes). Themes and subthemes were identified from qualitative studies. This review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline.</div></div><div><h3>Results</h3><div>Twenty-four sources of evidence were included. Most studies were published since 2012 and conducted in developed countries. Forty-seven clinical deterioration events were identified, and prolonged length of stay was the most frequently identified events. Forty-two surveillance variables were categorized into nursing data types. Assessment records were the most frequently used nursing surveillance variables, yet notes were insufficiently employed. Qualitatively identified surveillance was categorized into six themes: vigilance and monitoring, detection and decision making, integrated documentation practice, collaborative communication, intervention and risk management, and interaction with information technology systems.</div></div><div><h3>Conclusions</h3><div>The integration of quantitative surveillance data with qualitative elements has the potential to enhance patient safety in intensive care environments. This scoping review offers valuable insights for nursing researchers, educators, practitioners, and stakeholders by presenting a comprehensive understanding of nursing surveillance. By synthesizing evidence that connects surveillance variables with specific nursing data types, this review highlights more effective use of surveillance data in the early detection of clinical deterioration among intensive care patients.</div></div><div><h3>Implications for clinical practice</h3><div>This paper provides a comprehensive understanding of nursing surveillance, including the utilization of nursing surveillance data and the implementation of nursing surveillance research into clinical practice.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104218"},"PeriodicalIF":4.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026605","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":"Enhancing statistical rigor, data visualization, and multidisciplinary engagement in longitudinal delirium management research – Response to Rahimi-Bashar et al.","authors":"Oliver Coolens ,&nbsp;Peter Nydahl","doi":"10.1016/j.iccn.2025.104215","DOIUrl":"10.1016/j.iccn.2025.104215","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104215"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922166","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 Ideal Human Care in Green ICU: An integrated AI framework for future ICU care","authors":"Masoud Arabfard ,&nbsp;Alvin D. Jeffery ,&nbsp;SeyedTayeb Moradian ,&nbsp;Hong-Gu He ,&nbsp;Vinciya Pandian ,&nbsp;Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2025.104213","DOIUrl":"10.1016/j.iccn.2025.104213","url":null,"abstract":"<div><h3>Background</h3><div>Intensive Care Units (ICUs) present a high-stakes environment where timely decision-making is critical for managing patients with life-threatening conditions. The continuous influx of complex data often challenges clinicians, increasing the risk of errors. Artificial Intelligence (AI) offers transformative potential to enhance ICU care by supporting data analysis, decision-making, and workflow efficiency.</div></div><div><h3>Objective</h3><div>This review aims to explore current applications of AI in ICUs, assess their impact on clinical outcomes, workflow optimization, and ethical considerations, and propose an Integrated AI Framework for enhanced critical care delivery.</div></div><div><h3>Methods</h3><div>A literature search was conducted across PubMed, Scopus, and Web of Science, focusing on studies published between 2014 and 2024. The data were synthesized using an inductive thematic analysis approach to evaluate AI’s impact on clinical outcomes and to identify key barriers to its integration.</div></div><div><h3>Results</h3><div>AI has demonstrated significant advancements in ICU care, including early detection of sepsis, prediction of cardiac arrest, and workflow optimization through decision support systems. Predictive models reduced sepsis-related mortality by up to 20%, while workflow enhancements improved medication accuracy by 30% and reduced adverse events by 25%. Advanced techniques such as natural language processing (NLP), large language models (LLMs), and multimodal data integration have further streamlined ICU operations. However, challenges remain, including algorithmic bias, data privacy concerns, and integration barriers.</div></div><div><h3>Proposed Model</h3><div>The <em>Ideal Human Care in Green ICU model</em> integrates advanced AI technologies with multidisciplinary collaboration to provide personalized, evidence-based, and patient-centered care. This model emphasizes ethical AI practices, transparency, and family engagement to ensure responsible implementation.</div></div><div><h3>Conclusion</h3><div>AI can transform ICU care by improving outcomes and workflows, but ethical, practical, and explainable challenges must be addressed through diverse, validated research.</div></div><div><h3>Implications for clinical practice</h3><div>AI integration in ICUs improves patient outcomes and workflows by enabling early detection and precise treatment, but ethical issues and real-world validation are crucial.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104213"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983904","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":"Intensive care nurses’ desire in expanding scope of practice: a local perspective","authors":"Sally Jeston,&nbsp;Julia Charlton,&nbsp;Diana Zannino,&nbsp;Michael Cheung,&nbsp;Leah Hickey","doi":"10.1016/j.iccn.2025.104214","DOIUrl":"10.1016/j.iccn.2025.104214","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104214"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983825","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}