Intensive and Critical Care Nursing最新文献

{"title":"ECMO specialist’ challenges towards acquired infections during extracorporeal membrane oxygenation: An international qualitative ECMO infection study","authors":"Ali Ait Hssain ,&nbsp;Fatemeh Bahramnezhad ,&nbsp;Amir Vahedian-Azimi ,&nbsp;Abdulsalam Saif Ibrahim ,&nbsp;Ibrahim Fawzy Hassan ,&nbsp;Abbas Ali Imani Fooladi ,&nbsp;Ali Moradi ,&nbsp;Elie Azoulay ,&nbsp;Michael Darmon","doi":"10.1016/j.iccn.2025.104148","DOIUrl":"10.1016/j.iccn.2025.104148","url":null,"abstract":"<div><h3>Background</h3><div>Despite the life-saving potential of Extracorporeal Membrane Oxygenation (ECMO), it is not without significant challenges, particularly those associated with acquired infections during treatment. The purpose of this study was to explore the challenges that ECMO specialists faced regarding acquired infections by ECMO patients.</div></div><div><h3>Methods</h3><div>This qualitative study involved 19 ECMO specialists from around the world, representing key disciplines in ECMO care-including critical care physicians, ECMO nurses, respiratory therapists, microbiologists, cardiologists, cardiac surgeons, and perfusionists. All participants had at least five years of dedicated ECMO experience. Purposive sampling was conducted between August and December 2024. Data were collected through in-depth, semi-structured interviews with open-ended questions and analyzed using conventional content analysis.</div></div><div><h3>Results</h3><div>Data analysis revealed two principal themes regarding acquired infections in ECMO patients. The first theme, perceived challenges, encompassed the unique nature of ECMO-including its novel science, diverse cannulas and catheters, and varied equipment-alongside a lack of consensus on infection indicators, such as non-specific laboratory tests, absence of a unified infection definition, and scarce clinical signs. Additional challenges involved reliance on clinical experience over robust evidence, limited international guidelines, and patient-specific factors. The second theme focused on infection management strategies, emphasizing patient-centered care, family involvement, promotion of evidence via scientific meetings and prospective studies, prevention through adherence to aseptic principles, and strengthening multidisciplinary teamwork.</div></div><div><h3>Conclusion</h3><div>The challenges of acquired infections are one of the most important problems of patients undergoing ECMO, and of course, the approaches to its prevention are evolving.</div></div><div><h3>Implication for Clinical Practice</h3><div>The findings show that acquired infections in ECMO patients are a serious challenge requiring patient-centered and team-based care. Clearer clinical guidelines are needed for infection detection and prevention. Focusing on prevention, continuous education, and enhancing teamwork can improve treatment outcomes. Strengthening scientific evidence is also essential for clinical decision-making.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104148"},"PeriodicalIF":4.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711751","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 effect of the ShotBlocker® and breastfeeding on pain and comfort level during heel lance procedure in newborns: randomized controlled trial","authors":"Canan Dinç ,&nbsp;Gülçin Özalp Gerçeker ,&nbsp;Oğuzhan Kalkanli","doi":"10.1016/j.iccn.2025.104164","DOIUrl":"10.1016/j.iccn.2025.104164","url":null,"abstract":"<div><h3>Background</h3><div>Newborns are subjected to painful attempts in the early days of their lives due to medical requirements. Breastfeeding and innovative devices such as ShotBlocker® are used to alleviate pain.</div></div><div><h3>Objectives</h3><div>This study was planned to evaluate the effect of non-pharmacological methods on newborns’ pain and comfort level during the heel lance procedure in newborns.</div></div><div><h3>Design</h3><div>The study was a single-center, randomized controlled trial.</div></div><div><h3>Setting</h3><div>This study was conducted in the first-level neonatal intensive care unit between August 2021 and September 2022.</div></div><div><h3>Methods</h3><div>Ninety-six newborns were included in this study based on inclusion criteria. The newborns were randomly assigned to four groups: (a) breastfeeding, (b) ShotBlocker®, (c) breastfeeding + ShotBlocker®, and (d) standard care. Pain and comfort levels of newborns were evaluated according to the Neonatal Infant Pain Scale and the Newborn Comfort Behavior Scale before, during, and after the heel lance procedure. Crying time, heart rate, and oxygen saturation were recorded.</div></div><div><h3>Results</h3><div>The difference between the groups in terms of average crying time (p = 0.001) and comfort levels after the procedure (p = 0.001) was statistically significant. There was no difference in pain during and after the procedure. As a result of multiple analyses of variance in repeated measurements, a difference was found in comfort scores in terms of group, time, and group-time interaction (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The breastfeeding + ShotBlocker® group had the lowest mean crying time. There was no difference in procedure-related pain scores between the groups. The most comfortable groups after heel lance were the breastfeeding and breastfeeding + ShotBlocker® groups.</div></div><div><h3>Implication for clinical practice</h3><div>Breastfeeding, currently the gold non-pharmacological standard, increased comfort levels during the heel lance procedure. The breastfeeding + ShotBlocker® had a significant reduction in crying time and a significantly greater post-procedural comfort level (Clinical Trials number: NCT05246787).</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104164"},"PeriodicalIF":4.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711968","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":"Effectiveness of family-provider communication interventions on family’s psychological health, communication quality, and health care utilization in the ICU: A systematic review and meta-analysis of randomized controlled trials","authors":"ZhiRu Li ,&nbsp;FangYan Lu ,&nbsp;JingYun Wu ,&nbsp;JianHua Wei ,&nbsp;JiaLei Wang ,&nbsp;YanHong Dai ,&nbsp;JunQing Zhu ,&nbsp;Ping Xu ,&nbsp;HuaFen Wang","doi":"10.1016/j.iccn.2025.104166","DOIUrl":"10.1016/j.iccn.2025.104166","url":null,"abstract":"<div><h3>Objective</h3><div>This review aims to assess evidence regarding the effectiveness of family-provider communication interventions.</div></div><div><h3>Methods</h3><div>We searched six databases (PubMed, PsycINFO, Web of Science, EMBASE, CINAHL and the Cochrane Library). Two researchers independently extracted data and assessed bias. Data were analyzed using Stata software and Review Manager.</div></div><div><h3>Results</h3><div>Nineteen studies were included. Communication interventions had a moderate effect on family needs (SMD = −0.43, 95 % CI: −0.81 to −0.06, <em>P</em> = 0.025), small effects on 6-month psychological distress (Overall: SMD = −0.14, 95 % CI: −0.34 to −0.04, <em>P</em> = 0.04; Anxiety: SMD = −0.16, 95 % CI: −0.28 to −0.05, <em>P</em> = 0.004), and reduced symptom prevalence (Anxiety: RR = 0.78, 95 % CI: 0.65–0.94, <em>P</em> = 0.009; Depression: RR = 0.79, 95 % CI: 0.65–0.97, <em>P</em> = 0.022; PTSD: RR = 0.70, 95 % CI: 0.53–0.94, <em>P</em> = 0.015), with a small ICU stay reduction (SMD = −0.10, 95 % CI: −0.20 to −0.01, <em>P</em> = 0.036). Face-to-face (FTF) with print supplements had a moderate effect on family needs (SMD = −0.53, 95 % CI: −0.69 to −0.36, <em>P &lt;</em> 0.001), small effects on 3-month anxiety (RR = 0.59, 95 % CI: 0.44 to 0.79, <em>P &lt;</em> 0.001) and depression incidence (RR = 0.62, 95 % CI: 0.44 to 0.89, <em>P =</em> 0.009). Conversely, FTF with digital supplements yielded small effects on communication quality (SMD = 0.28, 95 % CI: 0.05–0.52, <em>P</em> = 0.01), 6-month psychological distress (Overall: SMD = −0.19, 95 % CI: −0.34 to −0.04, <em>P</em> = 0.01; Anxiety: SMD = −0.22, 95 % CI: −0.34 to −0.10, <em>P</em> &lt; 0.001; Depression: SMD = −0.17, 95 % CI: −0.29 to −0.04, <em>P</em> = 0.007; PTSD: SMD = −0.18, 95 % CI: −0.34 to −0.02, <em>P</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Family-provider communication interventions effectively<!--> <!-->improve<!--> <!-->family needs and communication quality,<!--> <!-->enhance<!--> <!-->long-term psychological outcomes, and<!--> <!-->reduce<!--> <!-->ICU stays. Print materials excelled in immediate information delivery and<!--> <!-->acute distress alleviation, while digital communication tools were superior for sustained communication and long-term distress management.<!--> <!-->Notably,<!--> <!-->despite<!--> <!-->nurses assuming<!--> <!-->multifaceted communication roles, robust evidence for their intervention effectiveness remains lacking.</div></div><div><h3>Implications for clinical practice</h3><div>ICU providers<!--> <!-->should consider utilizing<!--> <!-->print materials for immediate information delivery and digital tools for<!--> <!-->ongoing psychological support. Future studies must validate nurses’ communication roles and develop optimized strategies to enhance these interventions<!--> <!-->to fully leverage<!--> <!-->nurses’ professional expertise.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104166"},"PeriodicalIF":4.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711643","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":"Waveform thresholds and implementation considerations for pressure-at-the-gastric-tube-tip manometry – Response to Yao et al.","authors":"Yunxia Chen ,&nbsp;Zhiyuan Sheng ,&nbsp;Qianqian Liang","doi":"10.1016/j.iccn.2025.104161","DOIUrl":"10.1016/j.iccn.2025.104161","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104161"},"PeriodicalIF":4.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711644","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":"PICS cognitive paradox: the 19:1 screening mismatch demands dual-track assessment – Response to Zhang et al.","authors":"Rens Kooken,&nbsp;Bram Tilburgs,&nbsp;Mark van den Boogaard","doi":"10.1016/j.iccn.2025.104163","DOIUrl":"10.1016/j.iccn.2025.104163","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104163"},"PeriodicalIF":4.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711242","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":"Virtual reality for delirium: immersive training courses promote empathy and expertise in delirium management among registered nurses","authors":"Tanja Günther ,&nbsp;Florian Schimböck ,&nbsp;Martina Grosch ,&nbsp;Peter Nydahl","doi":"10.1016/j.iccn.2025.104167","DOIUrl":"10.1016/j.iccn.2025.104167","url":null,"abstract":"<div><h3>Background</h3><div>The use of virtual reality (VR) for educational purposes offers more complex training experiences than conventional methods. It remains unclear whether a training using a VR delirium application (VR-A), compared to traditional presentation-based training (TPT), has an impact on empathy and delirium-related knowledge among nursing professionals (NP).</div></div><div><h3>Methods</h3><div>Prospective, monocentric quasi-experimental crossover study involving clinically active nursing professionals. Two 45-minute training sessions were delivered in varying sequences (a) or b) first): a) VR-A offering a critical care patient’s and nursing perspectives; or b) TPT on delirium. NP completed a delirium knowledge questionnaire and the Saarbrücken Personality Questionnaire Short Form for empathy at three time points: before (T0), after the first (T1), and after the second (T2) training session. Statistical analyses including paired t-tests and time-series analysis were performed.</div></div><div><h3>Results</h3><div>In total, eighteen NPs participated; n = 12 received VR-A training first, and n = 6 received TPT first. Overall, participation in the training led to a significant increase from T0 to T2 in both empathy (mean difference (MD): 4.94, Standard Deviation (SD): 2.85, r = 0.617, p &lt; 0.001) and knowledge (MD: 3.78, SD: 4.81, r = 0.555, p = 0.004). When VR-A was conducted first, the increase in empathy was greater compared to TPT (MD: 5.75, SD: 2.89, p = 0.003), although no difference in knowledge acquisition was observed to be dependent on the order of the training sessions (MD: 2.0, SD: 0.6, p = 0.732).</div></div><div><h3>Conclusions</h3><div>A VR-A may increase delirium-specific empathy and knowledge, compared to TPT.</div><div>Future research should investigate the long-term effects of VR interventions on empathy development and explore optimal strategies for their didactic implementation.</div></div><div><h3>Implications for practice</h3><div>VR-A is a promising tool for fostering empathy for patients with delirium, but the effect of desensitation remains open.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104167"},"PeriodicalIF":4.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711967","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":"Post-ICU chronic pain and its determinants – Response to Liu et al.","authors":"Sigismond Lasocki,&nbsp;Baptiste Mottet,&nbsp;Cléor Cayla,&nbsp;Maeva Campfort","doi":"10.1016/j.iccn.2025.104156","DOIUrl":"10.1016/j.iccn.2025.104156","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104156"},"PeriodicalIF":4.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702985","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":"Reducing opioid exposure in ICU: exploring multidimensional approaches – Letter on Du Toit et al.","authors":"Xiaoyu Liu ,&nbsp;Yang Yang ,&nbsp;Yuehua Yan","doi":"10.1016/j.iccn.2025.104157","DOIUrl":"10.1016/j.iccn.2025.104157","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"92 ","pages":"Article 104157"},"PeriodicalIF":4.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719286","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":"Waveform thresholds and implementation considerations for pressure-at-the-gastric-tube-tip manometry – Letter on Chen et al.","authors":"Jiapeng Yao ,&nbsp;Feng Liang ,&nbsp;Cong Jin","doi":"10.1016/j.iccn.2025.104155","DOIUrl":"10.1016/j.iccn.2025.104155","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"91 ","pages":"Article 104155"},"PeriodicalIF":4.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595794","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":"Reimagining critical care through the lens of family-centred care interventions","authors":"Lotte Abildgren","doi":"10.1016/j.iccn.2025.104153","DOIUrl":"10.1016/j.iccn.2025.104153","url":null,"abstract":"","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"90 ","pages":"Article 104153"},"PeriodicalIF":4.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588414","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}