Critical care science最新文献

{"title":"Neurocritical care management supported by multimodal brain monitoring after acute brain injury.","authors":"Elisabete Monteiro,&nbsp;António Ferreira,&nbsp;Edite Raquel Mendes,&nbsp;Sofia Rocha E Silva,&nbsp;Isabel Maia,&nbsp;Cláudia Camila Dias,&nbsp;Marek Czosnyka,&nbsp;José Artur Paiva,&nbsp;Celeste Dias","doi":"10.5935/2965-2774.20230036-en","DOIUrl":"10.5935/2965-2774.20230036-en","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between different intensive care units and levels of brain monitoring with outcomes in acute brain injury.</p><p><strong>Methods: </strong>Patients with traumatic brain injury and subarachnoid hemorrhage admitted to intensive care units were included. Neurocritical care unit management was compared to general intensive care unit management. Patients managed with multimodal brain monitoring and optimal cerebral perfusion pressure were compared with general management patients. A good outcome was defined as a Glasgow outcome scale score of 4 or 5.</p><p><strong>Results: </strong>Among 389 patients, 237 were admitted to the neurocritical care unit, and 152 were admitted to the general intensive care unit. Neurocritical care unit management patients had a lower risk of poor outcome (OR = 0.228). A subgroup of 69 patients with multimodal brain monitoring (G1) was compared with the remaining patients (G2). In the G1 and G2 groups, 59% versus 23% of patients, respectively, had a good outcome at intensive care unit discharge; 64% versus 31% had a good outcome at 28 days; 76% versus 50% had a good outcome at 3 months (p < 0.001); and 77% versus 58% had a good outcome at 6 months (p = 0.005). When outcomes were adjusted by SAPS II severity score, using good outcome as the dependent variable, the results were as follows: for G1 compared to G2, the OR was 4.607 at intensive care unit discharge (p < 0.001), 4.22 at 28 days (p = 0.001), 3.250 at 3 months (p = 0.001) and 2.529 at 6 months (p = 0.006). Patients with optimal cerebral perfusion pressure management (n = 127) had a better outcome at all points of evaluation. Mortality for those patients was significantly lower at 28 days (p = 0.001), 3 months (p < 0.001) and 6 months (p = 0.001).</p><p><strong>Conclusion: </strong>Multimodal brain monitoring with autoregulation and neurocritical care unit management were associated with better outcomes and should be considered after severe acute brain injury.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10321439","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":"Extubation failure and the use of noninvasive ventilation during the weaning process in critically ill COVID-19 patients.","authors":"Viviane Martins Corrêa Boniatti,&nbsp;Chaiane Ribeiro Pereira,&nbsp;Gabriela Machado Costa,&nbsp;Michelle Carneiro Teixeira,&nbsp;Alessandra Preisig Werlang,&nbsp;Francielle Thaisa Morais Martins,&nbsp;Leonardo da Silva Marques,&nbsp;Wagner Luís Nedel,&nbsp;Márcio Manozzo Boniatti","doi":"10.5935/2965-2774.20230009-en","DOIUrl":"10.5935/2965-2774.20230009-en","url":null,"abstract":"<p><strong>Objective: </strong>To assess the outcome of extubation in COVID-19 patients and the use of noninvasive ventilation in the weaning process.</p><p><strong>Methods: </strong>This retrospective, observational, single-center study was conducted in COVID-19 patients aged 18 years or older who were admitted to an intensive care unit between April 2020 and December 2021, placed under mechanical ventilation for more than 48 hours and progressed to weaning. Early extubation was defined as extubation without a spontaneous breathing trial and immediate use of noninvasive ventilation after extubation. In patients who underwent a spontaneous breathing trial, noninvasive ventilation could be used as prophylactic ventilatory assistance when started immediately after extubation (prophylactic noninvasive ventilation) or as rescue therapy in cases of postextubation respiratory failure (therapeutic noninvasive ventilation). The primary outcome was extubation failure during the intensive care unit stay.</p><p><strong>Results: </strong>Three hundred eighty-four extubated patients were included. Extubation failure was observed in 107 (27.9%) patients. Forty-seven (12.2%) patients received prophylactic noninvasive ventilation. In 26 (6.8%) patients, early extubation was performed with immediate use of noninvasive ventilation. Noninvasive ventilation for the management of postextubation respiratory failure was administered to 64 (16.7%) patients.</p><p><strong>Conclusion: </strong>We found that COVID-19 patients had a high rate of extubation failure. Despite the high risk of extubation failure, we observed low use of prophylactic noninvasive ventilation in these patients.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10617907","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":"Prone position failure in moderate-severe acute respiratory distress syndrome: and now?","authors":"Carmen Silvia Valente Barbas, Corinne Taniguchi","doi":"10.5935/2965-2774.2023.Edit-1.v35n2-en","DOIUrl":"10.5935/2965-2774.2023.Edit-1.v35n2-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10617903","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":"Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study.","authors":"Ana Carolina de Miranda,&nbsp;Fernanda do Carmo De Stefani,&nbsp;Bruna Cassia Dal Vesco,&nbsp;Hipólito Carraro Júnior,&nbsp;Jamil Assreuy,&nbsp;Luis Gustavo Morello,&nbsp;Igor Alexandre Cortês de Menezes","doi":"10.5935/2965-2774.20230348-en","DOIUrl":"10.5935/2965-2774.20230348-en","url":null,"abstract":"<p><strong>Objective: </strong>To measure the prognostic value of peripheral ischemic microvascular reserve in the context of persistent sepsis-induced hyperlactatemia and measure its influence on the temporal dynamics of lactate and the strength of association between these variables.</p><p><strong>Methods: </strong>This post hoc analysis of the peripheral perfusion index/postocclusive reactive hyperemia trial, an observational cohort study that enrolled patients with sepsis who persisted with lactate levels ≥ 2mmol/L after fluid resuscitation (with or without shock). Peripheral ischemic microvascular reserve was evaluated using the association of the peripheral perfusion index and postocclusive reactive hyperemia techniques. The cutoff point of ∆ peripheral perfusion index peak values (%) defined the groups with low (≤ 62%) and high peripheral ischemic microvascular reserve (> 62%).</p><p><strong>Results: </strong>A total of 108 consecutive patients with persistent sepsis-induced hyperlactatemia were studied. The high peripheral ischemic microvascular reserve group showed higher 28-day mortality than the low peripheral ischemic microvascular reserve group (p < 0.01). The temporal dynamics of lactate within the first 48 hours showed a rapid decrease in lactate levels in the low peripheral ischemic microvascular reserve group (p < 0.01). However, this result was not reproduced in the linear mixed effects model. A weak correlation between peripheral ischemic microvascular reserve (%) and lactate level (mmol/L) was observed within the first 24 hours (r = 0.23; p < 0.05).</p><p><strong>Conclusion: </strong>The prognostic value of high peripheral ischemic microvascular reserve was confirmed in the context of persistent sepsis-induced hyperlactatemia. Although there was a weak positive correlation between peripheral ischemic microvascular reserve value and lactate level within the first 24 hours of sepsis diagnosis, the low peripheral ischemic microvascular reserve group appeared to have a faster decrease in lactate over the 48 hours of follow-up.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10617909","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":"Oropharyngeal colostrum administration in neonates with gastroschisis: a randomized clinical trial.","authors":"Hellen Porto Pimenta,&nbsp;Adriana Duarte Rocha,&nbsp;Aline Carnevale Lia Dias Guimarães,&nbsp;Ana Carolina Carioca da Costa,&nbsp;Maria Elisabeth Lopes Moreira","doi":"10.5935/2965-2774.20230010-en","DOIUrl":"10.5935/2965-2774.20230010-en","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of colostrum therapy on days to start a suckling diet in newborns diagnosed with simple gastroschisis.</p><p><strong>Methods: </strong>Randomized clinical trial with newborns diagnosed with simple gastroschisis at a federal hospital in Rio de Janeiro who were randomized to receive oropharyngeal administration of 0.2mL of colostrum or a \"sham procedure\" during the first 3 days of life. The analysis included clinical outcomes such as days without food, days with parenteral feeding, days until the start of enteral feeding, days to reach complete enteral feeding, sepsis and length of hospital stay.</p><p><strong>Results: </strong>The onset of oral feeding (suction) in patients with simple gastroschisis in both groups occurred at a median of 15 days.</p><p><strong>Conclusion: </strong>The present study showed that there were no significant differences in the use of colostrum therapy and the number of days to the start of enteral feeding and suction diet between groups of newborns with simple gastroschisis.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10617910","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":"Effects of participation in interdisciplinary rounds in the intensive care unit on family satisfaction: A cross-sectional study.","authors":"Daniel Schneider,&nbsp;Regis Goulart Rosa,&nbsp;Rosa da Rosa Minho Dos Santos,&nbsp;Débora Vaccaro Fogazzi,&nbsp;Gabriela Soares Rech,&nbsp;Daiana Barbosa da Silva,&nbsp;Mellina da Silva Terres","doi":"10.5935/2965-2774.20230274-en","DOIUrl":"10.5935/2965-2774.20230274-en","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether family participation in intensive care unit interdisciplinary bedside rounds affects family satisfaction.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a 56-bed, adult, mixed intensive care unit of a tertiary hospital in Southern Brazil. From May to June 2019, family members of patients who stayed in the intensive care unit for at least 48 hours were invited to participate in the study at the time of patient discharge. The main exposure variable was participation in intensive care unit bedside rounds during the intensive care unit stay. Family satisfaction was assessed by using the Brazilian version of the Family Satisfaction in the Intensive Care Unit questionnaire.</p><p><strong>Results: </strong>Of the 234 screened individuals, 118 were included. Eleven participants withdrew consent. A total of 107 individuals were assessed; 58 (54%) reported being present during bedside rounds, and 49 (46%) reported never being present. General satisfaction and satisfaction with the decision-making process were higher among families who were present during rounds than among families who were not (p = 0.01 and p = 0.007, respectively).</p><p><strong>Conclusion: </strong>The presence during interdisciplinary rounds was associated with improved general satisfaction and satisfaction with the decision-making aspect. This outcome indicates that efforts must be directed to conduct studies with more robust methodologies to confirm this association.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10321438","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":"Cytokine hemoadsorption with CytoSorb® in patients with sepsis: a systematic review and meta-analysis.","authors":"Jiovany Jhan Carlos Saldaña-Gastulo,&nbsp;María Del Rosario Llamas-Barbarán,&nbsp;Lelis G Coronel-Chucos,&nbsp;Yamilée Hurtado-Roca","doi":"10.5935/2965-2774.20230289-en","DOIUrl":"10.5935/2965-2774.20230289-en","url":null,"abstract":"Objective To analyze the effect of CytoSorb® on mortality, interleukin levels, vasopressor use and adverse events in patients with sepsis. Methods We searched MEDLINE®, Embase and the Cochrane Library for randomized controlled trials and cohort studies that reported the use of CytoSorb® among septic patients. The primary outcome was mortality, and secondary outcomes included the use of vasopressors, levels of inflammatory markers, predicted versus observed mortality, length of stay in the intensive care unit, and adverse events. Results We included 6 studies enrolling 413 patients, and assessment for risk of bias indicated variations in study quality from high to moderate. The overall mortality rate was 45%, and no significant effect on mortality was found at 28 - 30 days (RR 0.98 [0.12 - 8.25] for the randomized clinical trial and RR 0.74 [0.49 - 1.13] for cohort studies). We did not perform a metanalysis for other outcomes due to the small number of studies found or the lack of data. Conclusion Our study found very low certainty evidence, due to imprecision, risk of bias, and heterogeneity, thereby showing no benefit of CytoSorb® use in terms of mortality at 28 - 30 days. We cannot recommend the use of CytoSorb® in septic or septic shock patients outside clinical trials. Further high-quality randomized trials with a common intervention arm are needed to evaluate the influence of CytoSorb® in this population. PROSPERO register CRD42021262219","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10321444","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 the COVID-19 pandemic on predictions of death from stroke in a poor region of Brazil: a retrospective cohort study.","authors":"João Ricardo Bispo de Jesus,&nbsp;Paulo Ricardo Martins-Filho,&nbsp;Aline Ferreira de Brito Mota,&nbsp;Crislaine Souza Santos,&nbsp;Joyce Menezes Santos,&nbsp;Franklim Oliveira Souza,&nbsp;Raphaela Barroso Guedes-Granzotti,&nbsp;Miburge Bolivar Gois-Junior,&nbsp;Kelly da Silva","doi":"10.5935/2965-2774.20230357-en","DOIUrl":"https://doi.org/10.5935/2965-2774.20230357-en","url":null,"abstract":"Stroke and cardiovascular disease are the leading causes of morbidity and mortality worldwide. However, epidemiological indicators show a decrease in the number of stroke deaths in recent decades, which can be attributed to advances in clinical interventions. The coronavirus disease 2019 (COVID-19) pandemic and the redirection of health services raised concerns about the diagnosis and treatment of other diseases and health problems, particularly in low-income areas.(1) Although the occurrence of stroke is relatively low among patients hospitalized with COVID-19, the risk of death is higher among those with these two conditions.(2) Thus, the aim of this study was to investigate the impact of the COVID-19 pandemic on the prediction of deaths from stroke in a low-income region of Brazil. This was a retrospective cohort of stroke patients admitted to a tertiary hospital in the state of Sergipe between February 2019 and February 2020 (prepandemic period) and between March 2020 and March 2021 (during the pandemic). Sergipe is located in Brazil’s Northeast region, which has the highest concentration of highly vulnerable people in the country. The following predictor variables were dichotomized: sex (female or male); age (< 60 years or ≥ 60 years); marital status (with a partner [married, stable union, or other forms of union] or without a partner [widowed, single, or divorced]); orotracheal intubation (yes or no); alternative feeding route (yes or no); dysphagia (yes or no); poststroke motor dysfunction (yes or no); poststroke communication difficulties (yes or no); dyspnea (yes or no); mental confusion (yes or no); length of stay (< 14 days or ≥ 14 days); stroke period (prepandemic or during the COVID-19 pandemic); and laboratory diagnosis of COVID-19 with reverse-transcriptase polymerase chain reaction (RT‒PCR; yes or no). A multiple logistic regression model was built with backward selection to assess the influence of predictor variables on the outcome of interest (in-hospital death). The odds ratio (OR) with a 95% confidence interval (95%CI) was used as a measure of association. Analyses were performed by using JASP software version 0.13 (JASP Team, Amsterdam, Netherlands). This study was approved by the Human Research Ethics Committee of the Federal University of Sergipe (approval number 4.219.456). Written informed consent was obtained from all participants. The current study included 253 stroke patients: 115 who had a stroke before the pandemic and 138 who had a stroke during the pandemic. Most patients were men (53.8%) and over 60 years of age (82.6%). COVID-19 was identified in 20 (14.5%) of stroke patients hospitalized during the pandemic. Fifty-three in-hospital deaths were recorded, with 26 (49.1%) occurring prior to the pandemic and 27 (50.9%) occurring during the pandemic. Ten (37%) deaths reported during the pandemic were among patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). João Ricardo Bispo de Jesus","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10287266","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":"Estimated continuous cardiac output based on pulse wave transit time in critically ill children: a report of two cases.","authors":"Humberto Magalhães Silva,&nbsp;Raisa Sanches Uzun,&nbsp;Isabel de Siqueira Ferraz,&nbsp;Marcelo Barciela Brandão,&nbsp;Tiago Henrique de Souza","doi":"10.5935/2965-2774.20230305-en","DOIUrl":"https://doi.org/10.5935/2965-2774.20230305-en","url":null,"abstract":"<p><p>Cardiac output is an essential determinant of oxygen delivery, although unreliably measured on clinical examination and routine monitoring. Unfortunately, cardiac output monitoring is rarely performed in pediatric critical care medicine, with a limited availability of accurate methods for children. Herein, we report two pediatric cases in which noninvasive pulse-wave transit time-based cardiac output monitoring (esCCO, Nihon Kohden, Tokyo, Japan) was used. The esCCO system calculates cardiac output continuously by using the negative correlation between stroke volume and pulse wave transit time and requires only electrocardiogram monitoring, noninvasive blood pressure, and pulse oximetry signals. Before starting its use, esCCO should be calibrated, which can be done using patient information (gender, age, height, and body weight) or entering cardiac output values obtained by other methods. In both cases, when calibrations were performed using patient information, the agreement between esCCO and echocardiographic measurements was poor. However, after calibration with transthoracic echocardiography, the cardiac output values obtained by both methods remained similar after 2 hours and 18 hours. The results indicate that the esCCO system is suitable for use in children; however, further studies are needed to optimize its algorithm and determine its accuracy, precision, and trend in children.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10288719","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":"Does an educational website improve psychological outcomes and satisfaction among family members of intensive care unit patients?","authors":"Tarissa da Silva Ribeiro Haack, Regis Goulart Rosa, Cassiano Teixeira, Daniel Sganzerla, Caroline Cabral Robinson, Cláudia Severgnini Eugênio, Cleidilene Ramos Magalhães","doi":"10.5935/2965-2774.20230113-en","DOIUrl":"10.5935/2965-2774.20230113-en","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of an educational website on satisfaction and symptoms of anxiety and depression among family members of critically ill adult patients.</p><p><strong>Methods: </strong>We embedded an analysis of website access in a cohort study conducted in intensive care units with flexible visiting hours in Brazil. Family members were guided to access an educational website designed to help them understand the processes and emotions associated with an intensive care unit stay. Subjects were evaluated for baseline data within the first 48 hours following enrollment and outcome assessment at up to 7 days after patient discharge from the intensive care unit, death, or until the 30th day of the study. The main outcomes were satisfaction using the Critical Care Family Needs Inventory and the presence of anxiety and depression symptoms using the Hospital Anxiety and Depression Scale.</p><p><strong>Results: </strong>A total of 532 family members were evaluated during the study period. Of these, 61 (11.5%) accessed the website. After adjustments, family members who accessed the website had significantly better mean Critical Care Family Needs Inventory scores (152.8 versus 145.2, p = 0.01) and a lower prevalence of probable clinical anxiety (prevalence ratio 0.35; 95%CI 0.14 - 0.89) than family members who did not access the website. There were no differences regarding symptoms of depression.</p><p><strong>Conclusion: </strong>Access to an educational website was associated with higher family satisfaction with care and a lower prevalence of clinical anxiety.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10337448","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}