世界危重病急救学杂志(英文版)最新文献

{"title":"Sepsis and the diverse organ-gastrointestinal tract axis.","authors":"Jia Dong James Wang, Enhui Suan, Sean Siwei Li, Vishal G Shelat","doi":"10.5492/wjccm.v14.i4.105547","DOIUrl":"10.5492/wjccm.v14.i4.105547","url":null,"abstract":"<p><p>Sepsis remains a leading cause of morbidity and mortality worldwide, driven by a dysregulated host immune response to infection that culminates in multi-organ dysfunction. Recent advances highlight the gut microbiota's pivotal role in modulating immune responses and influencing the pathophysiology of sepsis through the organ-gastrointestinal tract axis. This review synthesizes current evidence on the bidirectional interplay between gut dysbiosis and the dysfunction of major organ systems-liver, lungs, kidneys, brain, and heart-during sepsis. We explore how gut-derived factors such as microbial translocation, endotoxins, and altered metabolite production exacerbate systemic inflammation and organ injury. In particular, we emphasize the roles of short-chain fatty acids, uremic toxins, bile acids, and trimethylamine-N-oxide in mediating immune dysfunction across the gut-organ axes. Therapeutic strategies targeting the gut microbiota- including prebiotics, probiotics, synbiotics, and fecal microbiota transplantation- show promise in preclinical and early clinical settings. However, challenges related to patient heterogeneity, safety, and the lack of precise biomarkers persist. This review consolidates disparate findings to underscore the gut as a central modulator in sepsis and advocates for microbiota-based interventions as adjunctive therapies in sepsis management.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"105547"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome predictors of systemic lupus erythematosus requiring admission to the intensive care unit.","authors":"Anitha P Mampilly, Binila Chacko, John Mathew, Krupa George, Anna Paul, Sudha Jasmine, Samuel George, Karthik Gunasekaran, Rajnin Nanda, Vaanya Bansal, John V Peter","doi":"10.5492/wjccm.v14.i4.108689","DOIUrl":"10.5492/wjccm.v14.i4.108689","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) patients are admitted to the intensive care unit (ICU) for disease flares and infections, both of which carry a high mortality risk. Studies characterizing the outcome predictors of SLE are few in the Asian continent. This study characterized the clinical profile, treatment, and outcome predictors of ICU admissions with SLE.</p><p><strong>Aim: </strong>To ascertain the reasons for ICU admission among SLE patients and to explore outcome predictors in these patients. The primary outcome was ICU mortality. Secondary outcomes included need for ventilation, inotropes, renal replacement therapy, and length of ICU and hospital stay.</p><p><strong>Methods: </strong>A retrospective study of 77 SLE patients was conducted in the medical ICU of a tertiary care teaching hospital in India. Clinical features, treatment, and outcomes of patients admitted between January 2018 and December 2022 were recorded. Factors associated with mortality were explored using bivariate and multivariate logistic regression analysis and reported as adjusted odds ratios with 95% confidence intervals.</p><p><strong>Results: </strong>The mean (SD) age was 31.1 (10.3) years; 83.1% were female. The median (interquartile) duration of SLE before admission was 12 (1-60) months; SLE was newly diagnosed in the current admission in 23.4%. The median Acute Physiology and Chronic Health Evaluation II score was 16.3 (14.5-18.2) and similar among survivors and non-survivors; 32 had evidence of disease flare, 44 had an infection, and one patient had an intracranial bleed. ICU admission was for respiratory failure (46.7%), hemodynamic instability (32.5%), and status epilepticus (14.3%). Twenty-nine patients (37.7%) had autoimmune hemolytic anemia, and 11 (14.3%) had diffuse alveolar hemorrhage. Immunomodulation included corticosteroids (96.1%), cyclophosphamide (33.8%), mycophenolate (23.4%), plasma exchange (13%), and immunoglobulins (11.7%). All patients received broad-spectrum antibiotics. Respiratory support, inotropes, and renal replacement therapy were required in 93.5%, 51.7%, and 32.5%, respectively. ICU mortality was 50.7% (95% confidence interval: 39%-62%). The mean ± SD hospital length of stay was 18.9 ± 14.3 days. On multivariate analysis, only shock (<i>P</i> = 0.004) was independently associated with mortality.</p><p><strong>Conclusion: </strong>Intercurrent infection and disease flare are common reasons for ICU admission in SLE patients. Despite multimodal therapy, mortality is high. Shock was independently associated with mortality.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"108689"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of music therapy on outcomes of critically ill patients.","authors":"Sabiha Mukhtar, Mohd Mustahsin, Madhulika Dubey, Syed Ahmed Hussain Kazmi, Piyush Shishir","doi":"10.5492/wjccm.v14.i4.111059","DOIUrl":"10.5492/wjccm.v14.i4.111059","url":null,"abstract":"<p><strong>Background: </strong>Intensive care units (ICUs) are stressful milieus for patients, particularly when under mechanical ventilation. Music is a non-pharmacological intervention that has shown a positive impact on physiological and psychological parameters in patients on mechanical ventilation.</p><p><strong>Aim: </strong>To evaluate outcome of music therapy on patients who are critically ill to note the effect on ICU stays.</p><p><strong>Methods: </strong>One-hundred-and-thirty-six adult patients with acute respiratory failure requiring mechanical ventilation for 48 hours or more were randomized into the music therapy or routine care (control) groups. Patients were assessed for weaning criteria before music therapy was given. If eligible, a 30-minute music therapy was given prior to the extubation. Vital parameters were recorded at 5-minute intervals of therapy. Visual Analog Scale (VAS)-Dyspnea and VAS-Anxiety (VAS-A) were assessed before and after therapy. Richmond Agitation-Sedation Scale and Numerical Rating Scale scoring were conducted.</p><p><strong>Results: </strong>The difference in times of ventilator support in the music therapy intervention group (58.22 ± 14.90 hours) and the control group (56.88 ± 13.10 hours) was not statistically significant. ICU length of stay was significantly lower in the music therapy group (4.97 ± 1.70 days <i>vs</i> control group: 5.70 ± 1.74 days). ICU mortality was significantly lower in the music therapy group as compared with the control group (7.4% <i>vs</i> 19.1%; <i>P</i> = 0.043). At 0 minute the VAS-A scores of the music therapy (6.82 ± 1.36) and control group (7.07 ± 1.07) were comparable. During the remainder of the observation period, the VAS score of the music therapy group was significantly lower than that of the control group.</p><p><strong>Conclusion: </strong>Music therapy is an inexpensive non-pharmacological intervention for patients in the ICU. However, future multicenter studies are warranted before routinely using music therapy in patients in the ICU.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"111059"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative care in pulmonary hypertension: A systematic review and meta-analysis.","authors":"Wajid Ali, Asad Ur Rab, Asim Shaikh, Gokhan Anil, Salim Surani, Munish Sharma","doi":"10.5492/wjccm.v14.i4.110597","DOIUrl":"10.5492/wjccm.v14.i4.110597","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) is a debilitating and progressive pulmonary pathology that often leads to death. Guidelines recommend the use of palliative care (PC) early in the treatment course to ease the burden of symptoms; however, uptake remains low.</p><p><strong>Aim: </strong>To evaluate barriers to PC uptake and determine its association with mortality in patients with PAH.</p><p><strong>Methods: </strong>All studies discussing PC in PAH were selected in our review and analysis. Clinical and cross-sectional studies were included. Barriers were described in a qualitative fashion. A random-effects meta-analysis was also conducted, in which the odds ratio for mortality was pooled and reported, along with 95% confidence intervals.</p><p><strong>Results: </strong>A total of 19 studies were included in the review. The most common barriers identified included feeling like the patients were \"not sick enough\", belief that PC is only appropriate for end-of-life care, belief that it would burden family members, and general feelings of hopelessness. Physicians identified structural causes, such as a lack of funding and low levels of PC-related knowledge, as barriers to recommending PC. The meta-analysis showed no statistically significant difference in mortality across four included studies (Log odds ratio = 0.89, 95% confidence intervals: -3.06-1.28). Heterogeneity was high (<i>I</i> ² = 80.32%).</p><p><strong>Conclusion: </strong>Uptake of PC in PAH is low due to patient and physician-level barriers, which can be overcome with systematic PC integration. Long-term studies are also needed to investigate the impact of PC on outcomes in PAH, as the current limited data show no significant difference.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"110597"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-arterial catheters: An evidence-based review of device design, function and application.","authors":"Julian Yaxley","doi":"10.5492/wjccm.v14.i4.109164","DOIUrl":"10.5492/wjccm.v14.i4.109164","url":null,"abstract":"<p><p>The intra-arterial catheter is a fundamental tool in contemporary critical care medicine. Intra-arterial catheters are widely used for a range of diagnostic and therapeutic purposes, and catheter insertion is an important clinical skill for clinicians managing critically unwell patients. The concepts and practical implications of catheter design on procedural technique and outcomes are frequently overlooked. This narrative review describes the clinical application of arterial catheters, the evidence supporting their use, and the rationale for key device characteristics.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"109164"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of exosomes from Wharton's Jelly-derived mesenchymal stem cells in traumatic brain injury.","authors":"Serdar Kabatas, Erdinç Civelek, Eyüp Can Savrunlu, Necati Kaplan, Tunç Akkoc, Nurten Küçükçakır, Mehmet Bozkurt, Erdal Karaöz","doi":"10.5492/wjccm.v14.i4.103782","DOIUrl":"10.5492/wjccm.v14.i4.103782","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a significant public health issue, leading to long-term neurological impairments. Current treatments offer limited recovery, particularly in restoring lost functions. Mesenchymal stem cell-derived exosomes (MSCdE) have shown potential for promoting neuroprotection and regeneration. This study evaluates the safety and efficacy of MSCdE therapy in TBI patients.</p><p><strong>Aim: </strong>To evaluate the safety and efficacy of MSCdE therapy in TBI patients.</p><p><strong>Methods: </strong>Five patients (mean age 27.00 ± 4.06 years) with TBI from combat injuries were treated with six rounds of MSCdE therapy (3 mL intrathecally and 3 mL intramuscularly per round). The patients were followed for one year. Adverse events were assessed using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0), and functional outcomes were evaluated with the functional independence measure (FIM), Modified Ashworth Scale (MAS), and Karnofsky Performance Scale (KPS).</p><p><strong>Results: </strong>No serious adverse events occurred, and only mild side effects [subfebrile fever (37.5 °C-37.9 °C), pain] were reported (CTCAE Grade 1). FIM motor scores improved significantly (46.20 ± 16.39 to 64.20 ± 18.20, <i>P</i> < 0.01), and FIM cognitive scores also showed significant improvement (30.60 ± 4.56 to 34.00 ± 1.41, <i>P</i> < 0.001). While MAS scores improved (right/left: 4.60/3.60 to 2.20/1.60), these changes were not statistically significant (<i>P</i> > 0.05), possibly due to low baseline spasticity. KPS scores significantly improved (46.00 ± 11.40 to 72.00 ± 8.37, <i>P</i> < 0.001), indicating enhanced overall functional status and quality of life.</p><p><strong>Conclusion: </strong>MSCdE therapy is safe and effective in improving motor function, cognition, and quality of life in TBI patients. Larger, controlled trials are needed to further validate these findings and optimize MSCdE therapy for TBI treatment.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"103782"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology and management of right ventricular failure in critically ill patients: A narrative review.","authors":"Riley Kermanian, Harpreet Dosanjh, Michael I Lewis, Yuri Matusov","doi":"10.5492/wjccm.v14.i4.111434","DOIUrl":"10.5492/wjccm.v14.i4.111434","url":null,"abstract":"<p><p>Right ventricular (RV) failure accounts for significant morbidity and mortality in critically ill patients. The RV is particularly vulnerable in conditions characterized by elevated pulmonary vascular afterload, which are commonly encountered in the intensive care unit (ICU). Conditions such as acute respiratory distress syndrome, pulmonary embolism, and decompensated pulmonary arterial hypertension are associated with acute and acute-on-chronic RV failure. In the ICU, RV failure may develop or worsen in patients with parenchymal pulmonary disease who acutely experience fluctuations in preload, excessive afterload, and/or insufficient myocardial contractility, often in addition to mechanical ventilation and circulatory compromise. This dynamic clinical scenario demands early recognition and intervention tailored to an individual patient's physiology. Distinguishing between acute and chronic RV failure in critical illness informs diagnostic workup, hemodynamic monitoring, and resuscitative efforts. This narrative review will provide an overview of common conditions associated with RV failure in critical illness, highlighting a practical, physiology-oriented approach to diagnosis and optimization of ventilator support, fluid resuscitation, vasopressor and inotrope use, and mechanical circulatory support. RV failure due to RV infarction or severe LV failure and decompensated congenital heart disease are distinct pathophysiologic entities. These conditions require distinct treatment approaches and are beyond the scope of this review.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"111434"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reactive oxygen species elevations in human immune cell subsets during sepsis are mitigated by norepinephrine and N-acetylcysteine.","authors":"Joby Thoppil, J David Farrar, Drashya Sharma, Shaun Kirby, Angela Mobley, Daniel Mark Courtney","doi":"10.5492/wjccm.v14.i4.108638","DOIUrl":"10.5492/wjccm.v14.i4.108638","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a life-threatening condition caused by a dysregulated host response to infection. Peripheral blood mononuclear cells (PBMCs) are critical mediators of the immune response and may exhibit redox imbalance during sepsis. Reactive oxygen species (ROS) are known to influence immune cell signaling, and excessive ROS accumulation may contribute to sepsis-associated immune alterations.</p><p><strong>Aim: </strong>To assess intracellular ROS levels in PBMC subsets from septic patients and determine whether norepinephrine (NE) or N-acetylcysteine (NAC) modulate ROS levels following inflammatory stimulation <i>in vitro</i>.</p><p><strong>Methods: </strong>PBMCs were isolated from Department of Emergency patients meeting SEP-1/SEP-2 sepsis criteria and from healthy controls without signs of infection. Intracellular ROS levels were measured using a total ROS detection assay and analyzed by flow cytometry. PBMCs were also stimulated <i>in vitro</i> with lipopolysaccharide (LPS) or hydrogen peroxide (H₂O₂), with or without co-treatment with NE or NAC.</p><p><strong>Results: </strong>ROS levels were significantly elevated in CD3+ and CD14+ cells from septic patients compared to controls. <i>In vitro</i> stimulation of control PBMCs with LPS or H₂O₂ increased ROS in CD3+ and CD14+ cells, which was attenuated by co-treatment with NE or NAC.</p><p><strong>Conclusion: </strong>ROS levels are elevated in specific PBMC subsets in sepsis, particularly CD3+ T cells and CD14+ monocytes. NE and NAC reduced ROS accumulation <i>in vitro</i>, supporting their potential role as redox modulators. These findings warrant further mechanistic investigation into immune redox regulation in sepsis.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"108638"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing diagnostic errors in critical care using millimeter-wave technology: A transformative approach to patient safety.","authors":"Andreas G Siamarou","doi":"10.5492/wjccm.v14.i4.104703","DOIUrl":"10.5492/wjccm.v14.i4.104703","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Diagnostic errors in critical care settings are a significant challenge, often leading to adverse patient outcomes and increased healthcare costs. Millimeter-wave (mmWave) technology, with its ability to provide high-resolution, real-time data, offers a transformative solution to enhance diagnostic accuracy and patient safety. This paper explores the integration of mmWave technology in intensive care units (ICUs) to enable non-invasive monitoring, minimize diagnostic errors, and improve clinical decision-making. By addressing key challenges, including data latency, signal interference, and implementation feasibility, this approach has the potential to revolutionize patient monitoring systems and set a new standard for critical care delivery. The paper discusses the high prevalence of diagnostic errors in medical care, particularly in primary care and ICUs, and emphasizes the need for improvement in diagnostic accuracy. Diagnostic errors are responsible for a significant number of deaths, disabilities, prolonged hospitalizations and delays in diagnosis worldwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To address this issue, the paper proposes the use of ultrafast wireless medical big data transmission in primary care, specifically in remote smart sensors monitoring devices. It suggests that wireless transmission with a speed up to 100 Gb/s (12.5 Gbytes/s) within a short distance (1-10 meters) is necessary to reduce diagnostic errors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The method used in the study, includes system design and testing a channel sounder operating at 63.4-64.4 GHz frequency range. The system demonstrated dynamic range of 70 dB, noise level of -110 dBm, and a time resolution of 1 ns. The experiment measured the impulse response of the channel in 36 locations within the primary care/ICU scenario.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The system was tested in a simulated ICU environment to evaluate the Latency: Assessing the time delay in data transmission and processing. The results of the study showed that the system met the requirements of ICUs, providing excellent latency values. The delay spread and excess delay values were within acceptable limits, indicating successful resolution of ICU requirements. The paper suggests timely deployment of such a system. Impact on data transmission: A 100 MB magnetic resonance imaging scan can be transmitted in approximately 0.008 seconds; A 1 GB scan would take approximately 0.08 seconds; This capability could revolutionize healthcare, enabling real-time remote diagnostics and comparisons with artificial Intelligence models, even in large-scale systems.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The experiment demonstrated the feasibility of using high-speed wireless transmission for improved diagnostics in ICUs, offering potential benefits in terms of reduced errors and improved patient outcomes. The findings are deemed valuable to the medical community and public healthcare systems, and it i","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"104703"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a noise reduction intervention in the intensive care unit: A prospective bicenter study.","authors":"Bernard Ong, Kay Choong See, Sunny Sunwoo Kim, Yie Hui Lau","doi":"10.5492/wjccm.v14.i4.106359","DOIUrl":"10.5492/wjccm.v14.i4.106359","url":null,"abstract":"<p><strong>Background: </strong>Excessive noise in healthcare environments-commonly described as \"unwanted sound\"-has been linked to a range of negative impacts on both patients and staff. In clinical settings, elevated noise levels have been associated with sleep disruption, heightened cardiovascular stress, and an increased risk of delirium in patients. Among healthcare workers, noise can impair focus and cognitive performance, potentially compromising care quality.</p><p><strong>Aim: </strong>To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units (ICUs), recognizing their potential impact on patient outcomes and healthcare effectiveness.</p><p><strong>Methods: </strong>A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups. An educational and behavioural intervention comprising talks, posters, and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18, 2023. Sound measurements were collected at 4 Locations within each ICU before and after intervention. Baseline measurements were taken from October 22, 2023 to October 29, 2023, and post-intervention measurements from December 21, 2023 to December 22, 2023. The hospitals served as the primary exposure variable, controlled for ICU type (medical <i>vs</i> surgical) and hour of the day.</p><p><strong>Results: </strong>Our analysis generated 48 pairs of peak and average sound level readings for each unit (control <i>n</i> = 48 readings; intervention <i>n</i> = 48 readings). The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level (<i>P</i> = 0.009) and a nonsignificant 4.3 dB decrease in peak sound level (<i>P</i> = 0.104), adjusted for hour of day and type of ICU.</p><p><strong>Conclusion: </strong>Educational and behavioural interventions successfully reduced average sound levels, emphasizing their positive impact on noise control. These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings. Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 4","pages":"106359"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}