Journal of intensive medicine最新文献

{"title":"Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis","authors":"Shengjun Liu ,&nbsp;Longxiang Su ,&nbsp;Changjing Zhuge ,&nbsp;Huaiwu He ,&nbsp;Yun Long","doi":"10.1016/j.jointm.2023.02.007","DOIUrl":"10.1016/j.jointm.2023.02.007","url":null,"abstract":"<div><h3>Background</h3><p>The relationship between perfusion index (PI) and organ dysfunction in patients in the intensive care unit (ICU) is not clear. This study aimed to explore the relationship between PI and renal function in the perioperative critical care setting and evaluate the predictive efficiency of PI on patients with acute kidney injury (AKI) in the ICU.</p></div><div><h3>Methods</h3><p>This retrospective analysis involved 12,979 patients who had undergone an operation and were admitted to the ICU in Peking Union Medical College Hospital from January 2014 to December 2019. The distribution of average PI in the first 24 h after ICU admission and its correlation with AKI was calculated by Cox regression. Receiver operating characteristic (ROC) curves were generated to compare the ability of PI, mean arterial pressure (MAP), creatinine, blood urea nitrogen (BUN), and central venous pressure (CVP) to discriminate AKI in the first 48 h in all perioperative critically ill patients.</p></div><div><h3>Results</h3><p>Average PI in the first 24 h served as an independent protective factor of AKI (Odds ratio [OR]=0.786, 95% confidence interval [CI]: 0.704–0.873, <em>P</em> &lt;0.0001). With a decrease in PI by one unit, the incidence of AKI increased 1.74 times. Among the variables explored for the prediction of AKI (PI, MAP, creatine, BUN, and CVP), PI yielded the highest area under the ROC curve, with a sensitivity of 64.34% and specificity of 70.14%. A cut-off value of PI ≤2.12 could be used to predict AKI according to the Youden index. Moreover, patients in the low PI group (PI ≤2.12) exhibited a marked creatine elevation at 24–48 h with a slower decrease compared with those in the high PI group (PI &gt;2.12).</p></div><div><h3>Conclusions</h3><p>As a local blood flow indicator, the initial 24-h average PI for perioperative critically ill patients can predict AKI during their first 120 h in the ICU.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/1d/main.PMC10391560.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935873","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":"Nomogram prediction model called “ADPLCP” for predicting linezolid-associated thrombocytopenia in elderly individuals","authors":"Yanxin Liu ,&nbsp;Jiang Wang ,&nbsp;Tingting Liu ,&nbsp;Kun Xiao ,&nbsp;Peng Yan ,&nbsp;Xiangqun Fang ,&nbsp;Lixin Xie","doi":"10.1016/j.jointm.2022.12.003","DOIUrl":"10.1016/j.jointm.2022.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Linezolid-associated thrombocytopenia (LAT) leads to drug withdrawal associated with a poor prognosis. Some risk factors for LAT have been identified; however, the sample size of previous studies was small, data from elderly individuals are limited, and a simple risk score scale was not established to predict LAT at an early stage, making it difficult to identify and intervene in LAT at an early stage.</p></div><div><h3>Methods</h3><p>In this single-center retrospective case-control study, we enrolled elderly patients treated with linezolid in the intensive care unit from January 2015 to December 2020. All the data of enrolled patients, including demographic information and laboratory findings at baseline, were collected. We analyzed the incidence and risk factors for LAT and established a nomogram risk prediction model for LAT in the elderly population.</p></div><div><h3>Results</h3><p>A total of 428 elderly patients were enrolled, and the incidence of LAT was 35.5% (152/428). Age ≥80 years old (OR=1.980; 95% CI: 1.179–3.325; <em>P</em>=0.010), duration of linezolid ≥ 10 days (OR=1.100; 95% CI: 1.050–1.152; <em>P</em> &lt;0.0001), platelet count at baseline (100–149×10⁹/L <em>vs</em>. ≥200×10⁹/L, OR=8.205, 95% CI: 4.419–15.232, <em>P</em> &lt;0.0001; 150–199 ×10⁹/L <em>vs.</em> ≥200×10⁹/L, OR=3.067, 95% CI: 1.676–5.612, <em>P</em> &lt;0.001), leukocyte count at baseline ≥16×10⁹/L (OR=2.580; 95% CI: 1.523–4.373; <em>P</em> &lt;0.0001), creatinine clearance &lt;50 mL/min (OR=2.323; 95% CI: 1.388–3.890; <em>P</em>=0.001), and total protein &lt;60 g/L (OR=1.741; 95% CI: 1.039–2.919; <em>P</em>=0.035) were associated with LAT. The nomogram prediction model called “ADPLCP” (age, duration, platelet, leukocyte, creatinine clearance, protein) was established based on logistic regression. The area under the curve (AUC) of ADPLCP was 0.802 (95% CI: 0.748–0.856; <em>P</em> &lt;0.0001), with 78.9% sensitivity and 69.2% specificity (cut-off was 108). Risk stratification for LAT was performed based on “ADPLCP.” Total points of &lt;100 were defined as low risk, and the possibility of LAT was &lt;32.0%. Total points of 100–150 were defined as medium risk, and the possibility of LAT was 32.0–67.5%. A total point &gt;150 was defined as high risk, and the probability of LAT was &gt;67.5%.</p></div><div><h3>Conclusions</h3><p>We created the ADPLCP risk score scale to predict the occurrence of LAT in elderly individuals. ADPLCP is simple and feasible and is helpful for the early determination of LAT to guide drug withdrawal or early intervention.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/0f/main.PMC10391562.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935877","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":"Metabolic and nutritional aspects in continuous renal replacement therapy","authors":"Guy Fishman,&nbsp;Pierre Singer","doi":"10.1016/j.jointm.2022.11.001","DOIUrl":"10.1016/j.jointm.2022.11.001","url":null,"abstract":"<div><p>Nutrition is one of the foundations for supporting and treating critically ill patients. Nutritional support provides calories, protein, electrolytes, vitamins, and trace elements via the enteral or parenteral route. Acute kidney injury (AKI) is a common and devastating problem in critically ill patients and has significant metabolic and nutritional consequences. Moreover, renal replacement therapy (RRT), whatever the modality used, also profoundly impacts metabolism. RRT and of the extracorporeal circuit impede ‘effect the evaluation of a patient's energy requirements by clinicians. Substrates added and removed within the extracorporeal treatment are not always taken into consideration, making treatment even more challenging. Furthermore, evidence on nutritional support during continuous renal replacement therapy (CRRT) is scarce, and there are no clinical guidelines for nutrition adaptations during CRRT in critically ill patients. Most recommendations are based on expert opinions. This review discusses the complex interaction between nutritional support and CRRT and presents some milestones for nutritional support in critically ill patients on CRRT.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/a6/main.PMC10391575.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929863","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":"Antimicrobial stewardship in the intensive care unit","authors":"Zeynep Ture ,&nbsp;Rahmet Güner ,&nbsp;Emine Alp","doi":"10.1016/j.jointm.2022.10.001","DOIUrl":"10.1016/j.jointm.2022.10.001","url":null,"abstract":"<div><p>High resistance rates to antimicrobials continue to be a global health threat. The incidence of multidrug-resistant (MDR) microorganisms in intensive care units (ICUs) is quite high compared to in the community and other units in the hospital because ICU patients are generally older, have higher numbers of co-morbidities and immune-suppressed; moreover, the typically high rates of invasive procedures performed in the ICU increase the risk of infection by MDR microorganisms. Antimicrobial stewardship (AMS) refers to the implementation of coordinated interventions to improve and track the appropriate use of antibiotics while offering the best possible antibiotic prescription (according to dose, duration, and route of administration). Broad-spectrum antibiotics are frequently preferred in ICUs because of greater infection severity and colonization and infection by MDR microorganisms. For this reason, a number of studies on AMS in ICUs have increased in recent years. Reducing the use of broad-spectrum antibiotics forms the basis of AMS. For this purpose, parameters such as establishing an AMS team, limiting the use of broad-spectrum antimicrobials, terminating treatments early, using early warning systems, pursuing infection control, and providing education and feedback are used. In this review, current AMS practices in ICUs are discussed.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/59/main.PMC10391567.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935871","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":"Oxygenation target in acute respiratory distress syndrome","authors":"Gilles Capellier ,&nbsp;Loic Barrot ,&nbsp;Hadrien Winizewski","doi":"10.1016/j.jointm.2023.03.002","DOIUrl":"10.1016/j.jointm.2023.03.002","url":null,"abstract":"<div><p>Determining oxygenation targets in acute respiratory distress syndrome (ARDS) remains a challenge. Although oxygenation targets have been used since ARDS was first described, they have not been investigated in detail. However, recent retrospective and prospective trials have evaluated the optimal oxygenation threshold in patients admitted to the general intensive care unit. In view of the lack of prospective data, clinicians continue to rely on data from the few available trials to identify the optimal oxygenation strategy. Assessment of the cost-benefit ratio of the fraction of inspired oxygen (FiO₂) to the partial pressure of oxygen in the arterial blood (PaO₂) is an additional challenge. A high FiO₂ has been found to be responsible for respiratory failure and deaths in numerous animal models. Low and high PaO₂ values have also been demonstrated to be potential risk factors in experimental and clinical situations. The findings from this literature review suggest that PaO₂ values ranging between 80 mmHg and 90 mmHg are acceptable in patients with ARDS. The costs of rescue maneuvers needed to reach these targets have been discussed. Several recent papers have highlighted the risk of disagreement between arterial oxygen saturation (SaO₂) and peripheral oxygen saturation (SpO₂) values. In order to avoid discrepancies and hidden hypoxemia, SpO₂ readings need to be compared with those of SaO₂. Higher SpO₂ values may be needed to achieve the recommended PaO₂ and SaO₂ values.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/8b/main.PMC10181914.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9699556","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":"Ventilator-associated events: From surveillance to optimizing management","authors":"Sergio Ramirez-Estrada ,&nbsp;Yolanda Peña-Lopez ,&nbsp;Tarsila Vieceli ,&nbsp;Jordi Rello","doi":"10.1016/j.jointm.2022.09.004","DOIUrl":"10.1016/j.jointm.2022.09.004","url":null,"abstract":"<div><p>Mechanical ventilation (MV) is a life-support therapy that may predispose to morbid and lethal complications, with ventilator-associated pneumonia (VAP) being the most prevalent. In 2013, the Center for Disease Control (CDC) defined criteria for ventilator-associated events (VAE). Ten years later, a growing number of studies assessing or validating its clinical applicability and the potential benefits of its inclusion have been published. Surveillance with VAE criteria is retrospective and the focus is often on a subset of patients with higher than lower severity. To date, it is estimated that around 30% of ventilated patients in the intensive care unit (ICU) develop VAE. While surveillance enhances the detection of infectious and non-infectious MV-related complications that are severe enough to impact the patient's outcomes, there are still many gaps in its classification and management. In this review, we provide an update by discussing VAE etiologies, epidemiology, and classification. Preventive strategies on optimizing ventilation, sedative and neuromuscular blockade therapy, and restrictive fluid management are warranted. An ideal VAE bundle is likely to minimize the period of intubation. We believe that it is time to progress from just surveillance to clinical care. Therefore, with this review, we have aimed to provide a roadmap for future research on the subject.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/00/main.PMC10391577.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935872","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":"Recent advances in the study of sepsis-induced depression","authors":"Yunyun Wang,&nbsp;Youjia Zhu,&nbsp;Mi Tian,&nbsp;Yao Wang,&nbsp;Xu Pei,&nbsp;Junliang Jiang,&nbsp;Yu He,&nbsp;Ye Gong","doi":"10.1016/j.jointm.2022.12.002","DOIUrl":"10.1016/j.jointm.2022.12.002","url":null,"abstract":"<div><p>Progress in medicine such as the use of anti-infective drugs and development of the advanced life support equipment has greatly improved the survival rate of patients with sepsis. However, the incidence of sepsis-related diseases is increasing. These include severe neurologic and psychologic disorders, cognitive decline, anxiety, depression, and post-traumatic stress disorder. Cerebral dysfunction occurs via multiple interacting mechanisms, with different causative pathogens having distinct effects. Because sepsis-related diseases place a substantial burden on patients and their families, it is important to elucidate the underlying pathophysiologic mechanisms to develop effective treatments.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/c3/main.PMC10391568.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935874","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":"Red blood cell distribution width improves the prediction of 28-day mortality for patients with sepsis-induced acute kidney injury: A retrospective analysis from MIMIC-IV database using propensity score matching","authors":"Honghao Lai ,&nbsp;Guosheng Wu ,&nbsp;Yu Zhong ,&nbsp;Guangping Chen ,&nbsp;Wei Zhang ,&nbsp;Shengjun Shi ,&nbsp;Zhaofan Xia","doi":"10.1016/j.jointm.2023.02.005","DOIUrl":"10.1016/j.jointm.2023.02.005","url":null,"abstract":"<div><h3>Background</h3><p>The predictive value of red blood cell distribution width (RDW) for mortality in patients with sepsis-induced acute kidney injury (SI-AKI) remains unclear. The present study aimed to investigate the potential association between RDW at admission and outcomes in patients with SI-AKI.</p></div><div><h3>Methods</h3><p>The Medical Information Mart for Intensive Care (MIMIC)-IV (version 2.0) database, released in June of 2022, provides medical data of SI-AKI patients to conduct our related research. Based on propensity score matching (PSM) method, the main risk factors associated with mortality in SI-AKI were evaluated using Cox proportional hazards regression analysis to construct a predictive nomogram. The concordance index (C-index) and decision curve analysis were used to validate the predictive ability and clinical utility of this model. Patients with SI-AKI were classified into the high- and low-RDW groups according to the best cut-off value obtained by calculating the maximum value of the Youden index.</p></div><div><h3>Results</h3><p>A total of 7574 patients with SI-AKI were identified according to the filter criteria. Compared with the low-RDW group, the high-RDW group had higher 28-day (9.49% <em>vs.</em> 31.40%, respectively, <em>P</em> &lt;0.001) and 7-day (3.96% <em>vs.</em> 13.93%, respectively, <em>P</em> &lt;0.001) mortality rates. Patients in the high-RDW group were more prone to AKI progression than those in the low-RDW group (20.80% <em>vs.</em> 13.60%, respectively, <em>P</em> &lt;0.001). Based on matched patients, we developed a nomogram model that included age, white blood cells, RDW, combined hypertension and presence of a malignant tumor, treatment with vasopressor, dialysis, and invasive ventilation, sequential organ failure assessment, and AKI stages. The C-index for predicting the probability of 28-day survival was 0.799. Decision curve analysis revealed that the model with RDW offered greater net benefit than that without RDW.</p></div><div><h3>Conclusion</h3><p>The present findings demonstrated the importance of RDW, which improved the predictive ability of the nomogram model for the probability of survival in patients with SI-AKI.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/cb/main.PMC10391576.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9933778","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":"Expert consensus on blood pressure management in critically ill patients","authors":"Yuetian Yu ,&nbsp;Ye Gong ,&nbsp;Bo Hu ,&nbsp;Bin Ouyang ,&nbsp;Aijun Pan ,&nbsp;Jinglun Liu ,&nbsp;Fen Liu ,&nbsp;Xiu-Ling Shang ,&nbsp;Xiang-Hong Yang ,&nbsp;Guowei Tu ,&nbsp;Changsong Wang ,&nbsp;Shaolin Ma ,&nbsp;Wei Fang ,&nbsp;Ling Liu ,&nbsp;Jiao Liu ,&nbsp;Dechang Chen","doi":"10.1016/j.jointm.2023.06.001","DOIUrl":"10.1016/j.jointm.2023.06.001","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/18/main.PMC10391579.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929865","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":"The impact of daylight and window views on length of stay among patients with heart disease: A retrospective study in a cardiac intensive care unit","authors":"Roxana Jafarifiroozabadi ,&nbsp;Anjali Joseph ,&nbsp;William Bridges ,&nbsp;Andrea Franks","doi":"10.1016/j.jointm.2022.11.002","DOIUrl":"10.1016/j.jointm.2022.11.002","url":null,"abstract":"<div><h3>Background</h3><p>Heart disease is the leading cause of death in the United States. The length of stay (LOS) is a well-established parameter used to evaluate health outcomes among critically ill patients with heart disease in cardiac intensive care units (CICUs). While evidence suggests that the presence of daylight and window views can positively influence patients’ LOS, no studies to date have differentiated the impact of daylight from window views on heart disease patients. Also, existing research studies on the impact of daylight and window views have failed to account for key clinical and demographic variables that can impact the benefit of such interventions in CICUs.</p></div><div><h3>Methods</h3><p>This retrospective study investigated the impact of access to daylight <em>vs.</em> window views on CICU patients’ LOS. The study CICU is located in a hospital in the southeast United States and has rooms of the same size with different types of access to daylight and window views, including rooms with daylight and window views (with the patient bed located parallel to full-height, south-facing windows), rooms with daylight and no window views (with the patient bed located perpendicular to the windows), and windowless rooms. Data from electronic health records (EHRs) for the time-period September 2015 to September 2019 (<em>n</em>=2936) were analyzed to investigate the impact of room type on patients’ CICU LOS. Linear regression models were developed for the outcome of interest, controlling for potential confounding variables.</p></div><div><h3>Results</h3><p>Ultimately, 2319 patients were finally included in the study analysis. Findings indicated that patients receiving mechanical ventilation in rooms with access to daylight and window views had shorter LOS durations (16.8 h) than those in windowless rooms. Sensitivity analysis for a subset of patients with LOS ≤3 days revealed that parallel bed placement to the windows and providing access to both daylight and window views significantly reduced their LOS compared to windowless rooms in the unit (<em>P</em>=0.007). Also, parallel bed placement to the window significantly reduced LOS in this patient subset for those with an experience of delirium (<em>P</em>=0.019), dementia (<em>P</em>=0.008), anxiety history (<em>P</em>=0.009), obesity (<em>P</em>=0.003), and those receiving palliative care (<em>P</em>=0.006) or mechanical ventilation (<em>P</em>=0.033).</p></div><div><h3>Conclusions</h3><p>Findings from this study could help architects make design decisions and determine optimal CICU room layouts. Identifying the patients who benefit most from direct access to daylight and window views may also help CICU stakeholders with patient assignments and hospital training programs.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/d2/main.PMC10175739.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9530393","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}