Intensive and Critical Care Nursing最新文献

{"title":"A triangular approach for Configuring the ventilator in Acute Respiratory Distress Syndrome","authors":"Farshid Rahimi-Bashar , Alberto Lucchini , Vinciya Pandian , Hay Baggen , Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2025.103965","DOIUrl":"10.1016/j.iccn.2025.103965","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103965"},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367072","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 potential impact of critical illness on sexuality","authors":"Louise Bourke, Valerie Smith, John Gilmore","doi":"10.1016/j.iccn.2025.103967","DOIUrl":"10.1016/j.iccn.2025.103967","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"88 ","pages":"Article 103967"},"PeriodicalIF":4.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163866","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 good death for end-of-life patients in the intensive care unit based on nurses’ perspectives: A systematic review","authors":"Ifa Hafifah ,&nbsp;Wasinee Wisesrith ,&nbsp;Noraluk Ua-Kit","doi":"10.1016/j.iccn.2024.103930","DOIUrl":"10.1016/j.iccn.2024.103930","url":null,"abstract":"<div><h3>Background</h3><div>Ensuring a good death in the intensive care unit (ICU) is crucial due to high global mortality rates. Despite the central role of nurses in end-of-life care, existing reviews often focus on patients or families and overlook nurses’ perspectives.</div></div><div><h3>Objectives</h3><div>This study aims to investigate the factors associated with a good death for end-of-life patients in the ICU based on nurses’ perspectives by systematically summarizing current evidence.</div></div><div><h3>Methods</h3><div>The researchers utilized a systematic review followed the PRISMA 2020 guidelines and was registered with PROSPERO. Databases searched included Scopus, ProQuest, PubMed, ScienceDirect, EBSCOhost, and Google Scholar. Inclusion criteria covered English-language quantitative studies published from the inception until February 20, 2024, that reported factors influencing a good death from the perspective of ICU nurses, and were available in full text. The exclusion criteria included studies with mixed participants if separate analyses for nurses were not provided. Risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for analytical cross-sectional studies, and a narrative synthesis was performed.</div></div><div><h3>Results</h3><div>Five high-quality studies were included, involving 1,654 ICU nurses with an average age between 28.64 and 41.40 years, predominantly female (54.8 % to 91 %). Identified factors included nurses’ personal factors, nurses’ job characteristics, nurses’ clinical competence in end-of-life care, and process of healthcare.</div></div><div><h3>Conclusions</h3><div>The review highlights the vital factor influencing a good death from ICU nurses’ perspectives. Awareness of personal and job-related factors, along with enhanced clinical competence in end-of-life care, are essential for supporting patients to achieve a good death.</div></div><div><h3>Implications for Clinical Practice</h3><div>ICU nurses can enhance their clinical competence in end-of-life care. Hospital managers should take into account nurses’ work experience when assigning staff and consider implementing fixed shifts. Future research should explore these factors globally and develop interventions to support a good death in the ICU.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103930"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148339","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":"Risk markers for postoperative reintubation of intensive care unit patients: A retrospective multicentre study of the National Intensive Care Registry","authors":"Hirotaka Masaki ,&nbsp;Shogo Suzuki ,&nbsp;Natsuki Nakayama ,&nbsp;Eri Kobayashi ,&nbsp;Akiko Fujii ,&nbsp;Kimitoshi Nishiwaki ,&nbsp;Masaaki Mizuno ,&nbsp;Masahiro Nakatochi","doi":"10.1016/j.iccn.2025.103956","DOIUrl":"10.1016/j.iccn.2025.103956","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate postoperative reintubation incidence and identify risk markers to expedite the identification of high-risk patients after ICU admission.</div></div><div><h3>Methods</h3><div>We performed this retrospective multicentre study that included postoperative adult patients admitted to Japanese ICUs between April 2015 and March 2022 using the Japanese Intensive care PAtient Database (JIPAD). Data regarding the patients treated in included ICUs were accumulated by the JIPAD, which we received for research use. Logistic regression analysis with generalised estimating equations was used to estimate odds ratios (ORs) of 1-standard deviation increments and 95 % confidence intervals (CIs) for the association of each variable available within 24 h after ICU admissions with reintubation.</div></div><div><h3>Results</h3><div>Among 13,219 admissions during the study period, 828 patients were postoperatively reintubated (incidence = 6.26 %, 95 % CI: 5.86–6.69). Maximum partial pressure of carbon dioxide (PaCO₂), bilirubin, and blood urea nitrogen (adjusted OR = 1.138, 95 % CI: 1.055–1.228; adjusted OR = 1.101, 95 % CI: 1.018–1.191; and adjusted OR = 1.105, 95 % CI: 1.016–1.203, respectively) and body mass index (BMI) and minimum white blood cells counts (adjusted OR = 0.867, 95 % CI: 0.797–0.944; and adjusted OR = 0.878, 95 % CI: 0.815–0.946, respectively) were significantly associated with postoperative reintubation.</div></div><div><h3>Conclusions</h3><div>Postoperative reintubation incidence in Japanese ICUs was estimated to be 6.26%. BMI, maximum PaCO₂, clinical laboratory data reflecting surgical invasiveness, and immunosuppression may be risk markers for postoperative reintubation.</div></div><div><h3>Implications for clinical practice</h3><div>Our study will help identify high-risk patients for postoperative reintubation early post-ICU admission, enabling early and focused nursing care to prevent reintubation, such as early mobilisation and ambulation.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103956"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149207","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":"Incidence and characteristics of device-related pressure injuries in intensive care: A four-year analysis","authors":"Paul Fulbrook ,&nbsp;Jacob Butterworth","doi":"10.1016/j.iccn.2025.103955","DOIUrl":"10.1016/j.iccn.2025.103955","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe and analyse the incidence and characteristics of intensive care-acquired device-related pressure injuries.</div></div><div><h3>Design</h3><div>Secondary data analysis of intensive care-acquired pressure injuries during 2019–2022.</div></div><div><h3>Setting</h3><div>Single general intensive care unit in Brisbane, Australia.</div></div><div><h3>Main outcome measures</h3><div>Intensive care-acquired pressure injury incidence, device-related pressure injury incidence, non-device-related pressure injury incidence, pressure injury category and location, device associated with pressure injury.</div></div><div><h3>Results</h3><div>During the 4-year period, there were 7343 intensive care admissions of whom 413 (5.6 %) patients developed an intensive care-acquired pressure injury. The incidence of device-related pressure injury was 4.0 % compared to 2.7 % non-device-related pressure injury. In total there were 461 device-related pressure injuries, which were mostly (55 %) associated with endotracheal tubes or the methods used to secure them. Consequently, the majority of injuries were found on the mucous membranes (lips, mouth and tongue). The other main devices associated with injuries were high-flow nasal prongs (9.3 %), indwelling urinary catheters (6.7 %), nasogastric tubes (6.5 %) and oxygen masks (5.0 %). Overall, device-related pressure injuries were less severe than non-device-related pressure injuries, however they occurred in a shorter time frame (median 4 days versus 6 days). A range of factors was associated with device-related pressure injuries but overall, their presence or duration was less than with non-device-related pressure injuries.</div></div><div><h3>Conclusion</h3><div>The study results provide rigorous evidence of the incidence and characteristics of device-related pressures injuries, that can be used to benchmark with other intensive care units nationally and internationally.</div></div><div><h3>Implications for Clinical Practice</h3><div>Endotracheal tube-associated pressure injuries were the most common type of device-related injury, providing a clear focus for preventative intervention. Given the high proportion of these device-related injuries, effective interventions would have a significant impact on overall reduction of intensive care-acquired pressure injuries. Since most injuries occur within three days of device insertion, early preventative intervention is time-critical.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103955"},"PeriodicalIF":4.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148722","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":"“Should we still use chlorhexidine oral care? Yes!”","authors":"Mónica Vázquez-Calatayud ,&nbsp;Rosa García-Díez","doi":"10.1016/j.iccn.2025.103953","DOIUrl":"10.1016/j.iccn.2025.103953","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"87 ","pages":"Article 103953"},"PeriodicalIF":4.9,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082697","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":"Educational interventions reduce the severity of post intensive care syndrome-family − Letter on Hayes et al.","authors":"Farshid Rahimi-Bashar,&nbsp;Athanasios Chalkias,&nbsp;Keivan Gohari-Moghadam,&nbsp;Malihe Salimi-bani,&nbsp;Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2024.103799","DOIUrl":"10.1016/j.iccn.2024.103799","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103799"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989784","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":"Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study","authors":"Bert Maertens ,&nbsp;Stijn Blot ,&nbsp;Diana Huis in ’t Veld ,&nbsp;Koen Blot ,&nbsp;Annelies Koch ,&nbsp;Katrien Mignolet ,&nbsp;Elise Pannier ,&nbsp;Tom Sarens ,&nbsp;Werner Temmerman ,&nbsp;Walter Swinnen","doi":"10.1016/j.iccn.2024.103769","DOIUrl":"10.1016/j.iccn.2024.103769","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.</div></div><div><h3>Design</h3><div>Historical observational surveillance study conducted over 13 years.</div></div><div><h3>Setting</h3><div>A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.</div></div><div><h3>Participants</h3><div>Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.</div></div><div><h3>Interventions</h3><div><span>Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, </span>chlorhexidine oral care, and daily sedation assessment.</div></div><div><h3>Measurements and main results</h3><div>A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.</div></div><div><h3>Conclusions</h3><div>Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.</div></div><div><h3>Implications for Practice</h3><div>The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103769"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753666","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":"Relationship between microaspiration and ventilator-associated events: A post-hoc analysis of a randomized controlled trial","authors":"Guillaume Millot ,&nbsp;Hélène Behal ,&nbsp;Emmanuelle Jaillette ,&nbsp;Christophe Girault ,&nbsp;Guillaume Brunin ,&nbsp;Julien Labreuche ,&nbsp;Isabelle Alves ,&nbsp;Franck Minacori ,&nbsp;Hugues Georges ,&nbsp;Patrick Herbecq ,&nbsp;Cyril Fayolle ,&nbsp;Patrice Maboudou ,&nbsp;Farid Zerimech ,&nbsp;Malika Balduyck ,&nbsp;Saad Nseir","doi":"10.1016/j.iccn.2024.103778","DOIUrl":"10.1016/j.iccn.2024.103778","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship between ventilator-associated events (VAE) and microaspiration in intubated patients has not be studied. The objective of this study was to evaluate the relationship between abundant microaspiration of oropharyngeal secretions or gastric contents and the incidence of VAE.</div></div><div><h3>Patients and methods</h3><div>This was a <em>post hoc</em> analysis of the BESTCUFF study, which was a multicenter, cluster randomized, cross-over, controlled, open-label trial in adult patients ventilated for over 48 h. All tracheal aspirates were sampled for 48 h following enrollment, with quantitative measurement of pepsin and alpha-amylase. VAE were identified using National Healthcare Safety Network criteria, based on PEEP or FiO₂ variations compared to stable parameters in previous days. The primary objective was to assess the relationship between abundant global microaspiration and the incidence of VAE, adjusted for pre-specified confounding factors (sex, SAPS II score and Glasgow coma scale).</div></div><div><h3>Results</h3><div>261 patients were included, of which 31 (11.9%) developed VAE, with an overall median age of 65 (interquartile range 52–74), a majority of male patients (164, 62.8%), a median SAPS II score of 50 [40–61], a median SOFA score of 8 [5–11], and acute respiratory failure as main reason for ICU admission (117, 44.8%).The incidence of VAE was not significantly associated with abundant global microaspiration (adjusted cause-specific hazard ratio (cHR): 1.55 [0.46–5.17), abundant gastric microaspiration (adjusted cHR: 1.24 [0.61–2.53), or with abundant oropharyngeal microaspiration (adjusted HR: 1.07 [0.47–2.42]).</div></div><div><h3>Conclusions</h3><div>Our results suggest no significant association between abundant global, gastric or oropharyngeal microaspiration and the incidence of VAE.</div></div><div><h3>Implications for clinical practice</h3><div>This study underscores that measuring microaspiration in intubated critically ill patients might not be useful to predict the diagnosis of VAE or to evaluate interventions aiming at preventing these complications.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103778"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790637","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":"Association of norepinephrine with pressure ulcer development in critically ill patients with COVID-19-related acute respiratory distress syndrome: A dose–response analysis","authors":"Ata Mahmoodpoor ,&nbsp;Athanasios Chalkias ,&nbsp;Morteza Izadi ,&nbsp;Kievan Gohari-Moghadam ,&nbsp;Farshid Rahimi-Bashar ,&nbsp;Ayişe Karadağ ,&nbsp;Masoum Khosh-Fetrat ,&nbsp;Amir Vahedian-Azimi","doi":"10.1016/j.iccn.2024.103796","DOIUrl":"10.1016/j.iccn.2024.103796","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the correlation between varying doses of norepinephrine (NE) and the incidence of pressure injuries (PIs) in COVID-19 patients in intensive care units (ICUs).</div></div><div><h3>Design</h3><div>A retrospective multicenter study was conducted on 1,078 COVID-19 patients admitted to ICUs with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. The research spanned from March 2020 to April 2021 across five university-affiliated hospitals in Iran. Univariate and multivariate binary logistic regression analyses, along with linear and non-linear dose–response assessments, were utilized to evaluate the relationship between NE dosages and the probability of PI development.</div></div><div><h3>Findings</h3><div>The multivariate analysis revealed a significant association between higher doses of NE administered over 24 h (OR: 1.832, 95 % CI: 1.218–2.754, P=0.004) and cumulative doses (OR: 1.408, 95 % CI: 1.204–1.975, P=0.048) with the occurrence of PIs. Moreover, patients receiving high NE doses had a nearly fourfold increased risk of developing PIs, regardless of PIs stage, compared to those on low or moderate doses (&gt;15 µg/min vs. ≤ 15 µg/min; OR: 4.401, 95 % CI: 3.339–5.801, P=0.001). Although the linear dose–response analysis did not show a significant correlation between NE doses and PI development (P&gt;0.05), the non-linear analysis indicated that NE doses ≤ 9 µg/min were associated with a reduced risk of PI development.</div></div><div><h3>Conclusion</h3><div>Maintaining NE infusion within the range of 1–9 µg/min appears to be most effective in reducing the likelihood of PIs in ICU patients with COVID-19. Lower NE doses (≤9 µg/min) were associated with a lower risk of PI development, suggesting that factors beyond NE dosage or the use of other vasopressors may play a crucial role in PI formation in this patient cohort.</div></div><div><h3>Implications for Clinical Practice</h3><div>Rather than suggesting a specific threshold, clinicians should consider further studies to determine the optimal dose that balances microvascular perfusion and patient outcomes. It is crucial to comprehensively evaluate additional factors and selectively use vasopressors. Individualized care, including regular monitoring and personalized treatment plans, is essential for achieving the best outcomes in this patient population.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103796"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908708","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}