American Journal of Critical Care最新文献_第3页

Ethics Is Essential. 道德是必要的。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025767

Cindy L Munro, Lakshman Swamy

引用次数: 0

Beginning to Think About Ethical Issues in Critical Care. 开始思考重症监护中的伦理问题。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025435

Catherine Green

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Inflammatory Cardiac Disease in a Young Adult With Syncope. 青壮年晕厥并发炎症性心脏病

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025551

Sudhir K Mummidi, Mary G Carey, Sukardi Suba, Dillon J Dzikowicz

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Reducing Readmission for Sepsis by Improving Risk Prediction Algorithms. 通过改进风险预测算法减少败血症的再入院。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025455

Valerie J Renard, Parisa Farahani, Leanne M Boehm, Marianna LaNoue, Oluwatosin Akingbule, Hanzhang Xu, Amy L B Frazier, David Edelman, Truls Østbye, Lana Wahid

{"title":"Reducing Readmission for Sepsis by Improving Risk Prediction Algorithms.","authors":"Valerie J Renard, Parisa Farahani, Leanne M Boehm, Marianna LaNoue, Oluwatosin Akingbule, Hanzhang Xu, Amy L B Frazier, David Edelman, Truls Østbye, Lana Wahid","doi":"10.4037/ajcc2025455","DOIUrl":"https://doi.org/10.4037/ajcc2025455","url":null,"abstract":"Unplanned readmissions after sepsis, rates of which range from 17.5% to 32%, pose substantial challenges for health care systems. Associated costs for sepsis surpass those for other critical conditions. Existing readmission risk models rely primarily on clinical indicators, which limits their predictive accuracy for patients with sepsis. This review explores how integrating social determinants of health into readmission models can enhance model precision and applicability for predicting 30-day readmission among sepsis survivors. Although socioeconomic status, neighborhood deprivation, and access to health care are known to influence postdischarge outcomes, these social determinants of health are underused in current risk algorithms. Evidence shows that incorporating social determinants of health into predictive models significantly improves model performance. Furthermore, failure to account for health disparities driven by social determinants of health in high-risk populations can exacerbate existing inequities in health care outcomes. The integration of social determinants of health into sepsis readmission risk models offers a promising avenue for improving prediction accuracy, reducing readmissions, and optimizing care for vulnerable populations. Future research should focus on refining these models and exploring postdischarge monitoring strategies to further mitigate the burden of sepsis readmissions.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 3","pages":"230-235"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fostering a Spirit of Inquiry: Inspiring Nurses to Advance Practice Based on Best Evidence. 培养探究精神：激励护士基于最佳证据推进实践。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025618

Mary Beth Flynn Makic

引用次数: 0

Managing Coagulation Using the Sonoclot Analyzer in Patients With Disseminated Intravascular Coagulation. 在弥漫性血管内凝血患者中应用超声分析仪管理凝血。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025807

Peng Wan, Yan Geng, Lei Su, Jinghua Liu, Huasheng Tong, Zhifeng Liu, Wenda Chen, Baojun Yu, Na Peng

{"title":"Managing Coagulation Using the Sonoclot Analyzer in Patients With Disseminated Intravascular Coagulation.","authors":"Peng Wan, Yan Geng, Lei Su, Jinghua Liu, Huasheng Tong, Zhifeng Liu, Wenda Chen, Baojun Yu, Na Peng","doi":"10.4037/ajcc2025807","DOIUrl":"https://doi.org/10.4037/ajcc2025807","url":null,"abstract":"Background: Evidence for the effectiveness of the Sonoclot analyzer in improving clinical outcomes in disseminated intravascular coagulation (DIC) is lacking.Objective: To evaluate the effectiveness of an algorithm based on the Sonoclot analyzer in improving the short-term prognosis of patients with DIC.Methods: A total of 279 patients with overt DIC who were admitted to the hospital within 18 months before and after implementation of the new Sonoclot-based algorithm were enrolled in the study. They were assigned to either a conventional coagulation assay (CCA) group (n = 148) or a Sonoclot group (n = 131). Data associated with anti-coagulation and transfusion were collected and analyzed. The 30-day survival rate after hospital admission was compared between groups.Results: The Sonoclot group had a higher 30-day survival rate than the CCA group (78.45% vs 63.64%; P = .02). The heparin dose, anticoagulation course, and major bleeding rate were significantly reduced in the Sonoclot group compared with the CCA group for all patients and for patients undergoing continuous renal replacement therapy (all P < .001). Fresh frozen plasma, platelet, and cryoprecipitate requirements were substantially lower in the Sonoclot group than in the CCA group (P = .007, .03, and .02, respectively). In a stratified analysis, improved survival rate was seen mainly in patients with moderately severe sepsis and heatstroke, with an Acute Physiology and Chronic Health Evaluation II score of 20 to 29.Conclusion: The Sonoclot analyzer may be useful to guide coagulation management in patients with DIC. Use of the Sonoclot-based algorithm may improve outcomes for DIC patients with moderately severe sepsis or heatstroke.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 3","pages":"194-207"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Pearls. 临床珍珠。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025746

Rhonda Board

引用次数: 0

Use of Noninvasive vs Invasive Ventilation for Patients Hospitalized With Acute Exacerbation of COPD, 2010 to 2019. 2010 - 2019年慢性阻塞性肺病急性加重住院患者无创与有创通气的应用

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025261

Allison V Lange, David B Bekelman, Lyndsay DeGroot, Ivor S Douglas, Anuj B Mehta

{"title":"Use of Noninvasive vs Invasive Ventilation for Patients Hospitalized With Acute Exacerbation of COPD, 2010 to 2019.","authors":"Allison V Lange, David B Bekelman, Lyndsay DeGroot, Ivor S Douglas, Anuj B Mehta","doi":"10.4037/ajcc2025261","DOIUrl":"https://doi.org/10.4037/ajcc2025261","url":null,"abstract":"Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) contribute to morbidity and mortality. Noninvasive ventilation (NIV), a resource-intensive intervention, decreases mortality and the need for invasive mechanical ventilation.Objective: To study NIV and mechanical ventilation use, NIV failure, and hospital NIV case volumes for inpatients with AECOPD from 2010 to 2019.Methods: This retrospective cohort study used the Nationwide Readmissions Database (2010-2019) for adults (≥40 years old) hospitalized for AECOPD. Rates of NIV and mechanical ventilation use and NIV failure were compared per year. Multivariable hierarchical regression models were used. Hospital case volumes of NIV use (overall and for patients with AECOPD) were compared across years.Results: Patients with AECOPD accounted for 3.35% of admissions in 2010 and 3.20% in 2019. Risk-adjusted rate (95% CI) of mechanical ventilation use decreased from 6.0% (5.6%-6.4%) to 4.5% (4.2%-4.8%); NIV use increased from 6.2% (5.6%-6.9%) to 10.9% (9.9%-12.0%). Noninvasive ventilation failure rate (95% CI) decreased from 7.8% (6.9%-8.7%) to 5.6% (5.0%-6.2%). Mean (SD) hospital case volume for NIV increased overall from 207.3 (237.0) in 2010 to 360.4 (447.4) in 2019 (P < .001); for patients with AECOPD, from 39.5 (37.8) to 79.0 (78.7) (P < .001).Conclusions: From 2010 to 2019, mechanical ventilation use and NIV failure decreased; NIV use and hospital NIV case volumes increased. These results indicate greater need for monitored beds, equipment, and trained staff.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 3","pages":"220-229"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discussion Guide for the Rathbun Article. Rathbun文章的讨论指南。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025182

Grant A Pignatiello

引用次数: 0

2025 National Teaching Institute Research Abstracts. 《2025年全国教学院所研究摘要》

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2025-05-01 DOI: 10.4037/ajcc2025335

引用次数: 0