Critical care science最新文献

{"title":"Scientific output and organizational characteristics in Brazilian intensive care units: a multicenter cross-sectional study.","authors":"Thiago Tavares Dos Santos, Luciano César Pontes de Azevedo, Antonio Paulo Nassar Junior, Jorge Ibrain Figueira Salluh","doi":"10.62675/2965-2774.20240006-en","DOIUrl":"10.62675/2965-2774.20240006-en","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations between the scientific output of Brazilian intensive care units and their organizational characteristics.</p><p><strong>Methods: </strong>This study is a re-analysis of a previous retrospective cohort that evaluated organizational intensive care unit characteristics and their associations with outcomes. We analyzed data from 93 intensive care units across Brazil. Intensive care units were assessed for scientific productivity and the effects of their research activities, using indicators of care for comparison. We defined the most scientifically productive intensive care units as those with numerous publications and a SCImago Journal Rank score or an H-index above the median values of the participating intensive care units.</p><p><strong>Results: </strong>Intensive care units with more publications, higher SCImago Journal Rank scores and higher H-index scores had a greater number of certified intensivists (median of 7; IQR 5 - 10 versus 4; IQR 2 - 8; with p < 0.01 for the comparison between intensive care units with more versus fewer publications). Intensive care units with higher SCImago Journal Rank scores and H-index scores also had a greater number of fully implemented protocols (median of 8; IQR 6 - 8 versus 5; IQR 3.75 - 7.25; p < 0.01 for the comparison between intensive care units with higher versus lower SCImago Journal Rank scores).</p><p><strong>Conclusions: </strong>Scientific engagement was associated with better staffing patterns and greater protocol implementation, suggesting that research activity may be an indicator of better intensive care unit organization and care delivery.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240006en"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781924","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":"ERRATUM.","authors":"","doi":"10.62675/2965-2774.20240066-enerr","DOIUrl":"https://doi.org/10.62675/2965-2774.20240066-enerr","url":null,"abstract":"<p><p>[This corrects the article doi: 10.62675/2965-2774.20240066-en] [This corrects the article doi: 10.62675/2965-2774.20240066-pt].</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240066enerr"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and preferences about family visitation restrictions and psychological distress among critical care clinicians in Brazil: results from a national survey.","authors":"Monisha Sharma, Sarah Wahlster, James A Town, Pratik V Patel, Gemi E Jannotta, Edilberto Amorim, Ariane Lewis, David M Greer, Israel Silva Maia, Erin K Kross, Claire J Creutzfeldt, Suzana Margareth Lobo","doi":"10.62675/2965-2774.20240112-en","DOIUrl":"10.62675/2965-2774.20240112-en","url":null,"abstract":"<p><strong>Objective: </strong>To explore the perceptions of healthcare workers in the intensive care unit about family visitation policies and to examine their impact on healthcare workers' psychological distress.</p><p><strong>Methods: </strong>We disseminated an electronic survey to interdisciplinary healthcare workers via the Associação de Medicina Intensiva Brasileira during Brazil's most severe peak of COVID-19 (March 2021). We assessed perceptions of and preferences for family visitation policies and measured healthcare worker distress, including burnout, depression, anxiety, irritability, and suicidal thoughts using validated scales. We conducted multivariable regressions to evaluate factors associated with healthcare worker distress, including family visitation policies and healthcare workers' concerns.</p><p><strong>Results: </strong>We included responses from 903 healthcare workers: 67% physicians, 10% nurses, 10% respiratory therapists, and 13% other. Most healthcare workers reported that their hospitals allowed no family visitation (55%) or limited visitation (43%), and only 2% reported allowing unlimited visitation. Most believed that limiting visitation negatively impacted patient care (78%), and 46% preferred allowing more visitation (which was lower among nurses [44%] than among physicians [50%]; p < 0.01). Approximately half (49%) of healthcare workers reported that limited visitation contributed to their burnout, which was lower among nurses (43%) than among physicians (52%), p = 0.08. Overall, 62% of healthcare workers reported burnout, 24% reported symptoms of major depression, 37% reported symptoms of anxiety, 11% reported excessive alcohol/drug consumption, and 14% reported thoughts of hurting themselves. In the multivariable analysis, family visitation policies (limited visitation versus no visitation) and preferences about policies (more visitation versus same or less) were not associated with psychological distress. Instead, financial concerns and reporting poor communication with supervisors were most strongly associated with burnout, depression, and anxiety.</p><p><strong>Conclusion: </strong>Half of healthcare workers self-reported that limited family visitation contributed to their burnout, and most felt that it negatively impacted patient care. However, family visitation preferences were not associated with healthcare worker distress in the multivariable regressions. More physicians than nurses indicated a preference for more liberal visitation policies.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240112en"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781910","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":"Closing the critical care knowledge gap: the importance of publications from low-income and middle-income countries.","authors":"Jorge Ibrain Figueira Salluh, Bruno Adler Maccagnan Pinheiro Besen, Sebastián González-Dambrauskas, Suchitra Ranjit, Daniela Carla Souza, Viviane Cordeiro Veiga, Mervyn Mer, Alejandro Bruhn, Otavio T Ranzani, Luigi Pisani, Diptesh Aryal, Madiha Hashmi, Sheila Nainan Myatra, Juliana Carvalho Ferreira, Antonio Paulo Nassar Junior","doi":"10.62675/2965-2774.20240251ed-en","DOIUrl":"10.62675/2965-2774.20240251ed-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240251eden"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781875","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":"Enhancing patient care: updated sedative choices in the intensive care unit.","authors":"Federico Carlos Carini, Mariana Luz, Dimitri Gusmao-Flores","doi":"10.62675/2965-2774.20240152-en","DOIUrl":"10.62675/2965-2774.20240152-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240152en"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781890","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":"Challenges in using the dynamic components of the SOFA score in health care databases.","authors":"Roberta Muriel Longo Roepke, Cornelius Sendagire, David Pilcher","doi":"10.62675/2965-2774.20240224-en","DOIUrl":"10.62675/2965-2774.20240224-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240224en"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741541","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":"Impact of intensive care unit admission on cancer patients: enhancing long-term survival through better understanding.","authors":"Ana Paula Agnolon Praça, Antonio Paulo Nassar Junior, Pedro Caruso","doi":"10.62675/2965-2774.20240212-en","DOIUrl":"10.62675/2965-2774.20240212-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240212en"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741544","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":"To: Clinical outcomes of intensive care unit-acquired weakness in critically ill COVID-19 patients. A prospective cohort study.","authors":"Rohan Magoon, Varun Suresh, Nitin Choudhary","doi":"10.62675/2965-2774.20240218-en","DOIUrl":"10.62675/2965-2774.20240218-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240218en"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741466","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":"Analyzing how the components of the SOFA score change over time in their contribution to mortality.","authors":"Barbara D Lam, Tristan Struja, Yanran Li, João Matos, Ziyue Chen, Xiaoli Liu, Leo Anthony Celi, Yugang Jia, Jesse Raffa","doi":"10.62675/2965-2774.20240030-en","DOIUrl":"10.62675/2965-2774.20240030-en","url":null,"abstract":"<p><strong>Objective: </strong>Determine how each organ component of the SOFA score differs in its contribution to mortality risk and how that contribution may change over time.</p><p><strong>Methods: </strong>We performed multivariate logistic regression analysis to assess the contribution of each organ component to mortality risk on Days 1 and 7 of an intensive care unit stay. We used data from two publicly available datasets, eICU Collaborative Research Database (eICU-CRD) (208 hospitals) and Medical Information Mart for Intensive Care IV (MIMIC-IV) (1 hospital). The odds ratio of each SOFA component that contributed to mortality was calculated. Mortality was defined as death either in the intensive care unit or within 72 hours of discharge from the intensive care unit.</p><p><strong>Results: </strong>A total of 7,871 intensive care unit stays from eICU-CRD and 4,926 intensive care unit stays from MIMIC-IV were included. Liver dysfunction was most predictive of mortality on Day 1 in both cohorts (OR 1.3; 95%CI 1.2 - 1.4; OR 1.3; 95%CI 1.2 - 1.4, respectively). In the eICU-CRD cohort, central nervous system dysfunction was most predictive of mortality on Day 7 (OR 1.4; 95%CI 1.4 - 1.5). In the MIMIC-IV cohort, respiratory dysfunction (OR 1.4; 95%CI 1.3 - 1.5) and cardiovascular dysfunction (OR 1.4; 95%CI 1.3 - 1.5) were most predictive of mortality on Day 7.</p><p><strong>Conclusion: </strong>The SOFA score may be an oversimplification of how dysfunction of different organ systems contributes to mortality over time. Further research at a more granular timescale is needed to explore how the SOFA score can evolve and be ameliorated.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240030en"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741443","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":"Rate of non-metastatic solid tumor progression following critical illness: a prospective cohort study of UK Biobank participants.","authors":"Kathryn Puxty, Rachel Keith, Joanne McPeake, David Morrison, Martin Shaw","doi":"10.62675/2965-2774.20240018-en","DOIUrl":"10.62675/2965-2774.20240018-en","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether admission to critical care is associated with subsequent disease progression in patients with non-metastatic solid tumors.</p><p><strong>Methods: </strong>This observational cohort study of UK Biobank participants identified those diagnosed with solid tumors and survived hospitalization. Two cohorts were identified based on critical care admission and new metastatic disease as reported at UK Biobank follow-up visits, or primary or secondary care records were compared. Cox proportional hazards analysis was used to account for potential confounders in the multivariate analysis.</p><p><strong>Results: </strong>A total of 1,854 solid tumor patients were identified, of whom 453 (24.4%) experienced critical care admission. Unadjusted rates of metastatic disease and death were higher for the critical care cohort with lower progression-free survival. At five years, 25% of the critical care survivors and 14% of the hospitalized survivors had developed metastatic disease (p < 0.001), with a corresponding progression-free survival rate of 65% versus 81% (p < 0.001). After adjustment for confounders, the hazard ratio for progression-free survival between critical care survivors and the hospitalized cohort was 1.69 (95%CIs 1.31 - 2.18; p < 0.001).</p><p><strong>Conclusion: </strong>Solid tumor patients admitted to the hospital within 2 years of diagnosis had poorer subsequent progression-free survival if they had experienced a critical care admission. This observation was maintained after adjustment for confounding variables.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240018en"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741546","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}