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

Differential Diagnoses in a Patient With Palpitations and Global Electrocardiographic Changes. 心悸和全身心电图改变患者的鉴别诊断。

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-07-01 DOI: 10.4037/ajcc2026465

Dillon J Dzikowicz, Salah Al-Zaiti, Michele M Pelter

引用次数: 0

Beyond Survival: Lessons From a Research Journey in Critical Care Recovery Science. 超越生存：重症监护康复科学研究之旅的经验教训。

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-07-01 DOI: 10.4037/ajcc2026762

Leanne M Boehm

{"title":"Beyond Survival: Lessons From a Research Journey in Critical Care Recovery Science.","authors":"Leanne M Boehm","doi":"10.4037/ajcc2026762","DOIUrl":"10.4037/ajcc2026762","url":null,"abstract":"My research journey began while caring for critically ill patients and questioning what happens after they leave the intensive care unit (ICU). This curiosity evolved into a systematic program of research on post-intensive care syndrome and evidence-based recovery interventions that has influenced how nurses approach the transition from critical illness survival to meaningful recovery. The goal of my research has been to eliminate delirium, oversedation, and immobilization in intensive care and to maximize the quality of survivorship for patients and family members after critical illness. I have led investigations into implementation of the ABCDEF bundle (assess, prevent, and manage pain; both spontaneous awakening and spontaneous breathing trials; choice of analgesia and sedation; delirium: assess, prevent, and manage; early mobility; family engagement and empowerment), demonstrating how organizational factors like workload burden, unit leadership, and interprofessional coordination influence implementation adherence and patient outcomes. My work in telemedicine-enhanced follow-up care of patients with post-intensive care syndrome addresses the cognitive, physical, and psychological impairments that affect more than half of ICU survivors. Work implementing ICU diary and peer support programs has shown how evidence-based interventions can support patients and family members when barriers to implementation are systematically addressed. My efforts embody interdisciplinary collaboration, integrating nursing science with implementation science, health services research, and clinical psychology. My journey illustrates how bedside observations, when coupled with rigorous inquiry, collaborative partnerships, and intentionality to let patient and family voices reshape thinking, can drive meaningful contributions that improve outcomes for patients and families beyond survival.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"35 4","pages":"250-258"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ableism and Accommodation in the Intensive Care Unit. 特护病房的残疾和住宿。

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-07-01 DOI: 10.4037/ajcc2026495

Lakshman Swamy, Cindy L Munro

引用次数: 0

Predicting Nonrecovery of Muscle Strength in Critically Ill Patients with Intensive Care Unit-Acquired Weakness. 预测重症监护病房获得性虚弱的危重病人肌肉力量的不恢复。

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-07-01 DOI: 10.4037/ajcc2026710

Hiroki Nagura, Masato Oikawa, Masatoshi Hanada, Yudai Yano, Tsubasa Watanabe, Yasutomo Tanaka, Rina Takeuchi, Shuntaro Sato, Motohiro Sekino, Tetsuya Hara, Ryo Kozu

{"title":"Predicting Nonrecovery of Muscle Strength in Critically Ill Patients with Intensive Care Unit-Acquired Weakness.","authors":"Hiroki Nagura, Masato Oikawa, Masatoshi Hanada, Yudai Yano, Tsubasa Watanabe, Yasutomo Tanaka, Rina Takeuchi, Shuntaro Sato, Motohiro Sekino, Tetsuya Hara, Ryo Kozu","doi":"10.4037/ajcc2026710","DOIUrl":"10.4037/ajcc2026710","url":null,"abstract":"Background: Individual differences exist in the recovery of muscle strength in critically ill patients with intensive care unit (ICU)-acquired weakness, but the characteristics of patients who do not recover muscle strength are unclear.Objective: To elucidate the factors associated with the nonrecovery of muscle strength in patients with ICU-acquired weakness.Methods: This prospective cohort study involved critically ill patients with ICU-acquired weakness. The patients' outcomes were categorized as recovery (Medical Research Council Sum Score [MRC-SS] ≥48 until hospital discharge or the time of stroke, death, or ICU readmission) or nonrecovery (MRC-SS <48). Separate logistic regression analyses adjusted for age and sex were performed for each candidate factor to identify factors associated with nonrecovery of muscle strength.Results: A total of 111 patients were included in the analysis. Thirty patients were classified as having nonrecovery. Analysis using a logistic regression model showed that septic shock, duration of deep sedation, corticosteroid use, total amount of corticosteroids used, duration of mechanical ventilation, duration of renal replacement therapy, day of first out-of-bed mobilization, initial evaluation of MRC-SS, and length of ICU stay were age- and sex-adjusted predictors of nonrecovery of muscle strength.Conclusions: Patients with ICU-acquired weakness with the predictors identified in this study may not recover muscle strength. Future multicenter interventional studies should assess not only the timing of rehabilitation but also its intensity and the muscle groups specifically targeted.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"35 4","pages":"276-285"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358852","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

Exploring Intensive Care Unit Nurses' Resilience During the COVID-19 Pandemic: A Qualitative Research Study. 探索重症监护室护士在COVID-19大流行期间的复原力：一项定性研究

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-07-01 DOI: 10.4037/ajcc2026330

Teenu Xavier, Beverly M Hittle, Liliana Rojas-Guyler, Rebecca C Lee

{"title":"Exploring Intensive Care Unit Nurses' Resilience During the COVID-19 Pandemic: A Qualitative Research Study.","authors":"Teenu Xavier, Beverly M Hittle, Liliana Rojas-Guyler, Rebecca C Lee","doi":"10.4037/ajcc2026330","DOIUrl":"10.4037/ajcc2026330","url":null,"abstract":"Background: Intensive care unit (ICU) nurses faced numerous demands and adversities during the COVID-19 pandemic that markedly affected their well-being. Developing strategies to promote resilience was crucial for ICU nurses to overcome these workplace adversities.Objectives: To explore the strategies used by ICU nurses to promote their resilience and cope with the additional stressors brought on by the COVID-19 pandemic.Methods: A focused ethnographical approach provided the overarching framework for this research project. Nurses working in adult ICUs who had cared for patients with COVID-19 during the pandemic were recruited using a purposive sampling technique, and semistructured interviews were conducted individually using an online videoconference application. A systematic approach as proposed by Roper and Shapira was used to analyze the interviews.Results: The exploration of strategies used to cope with stressors and to promote resilience during the COVID-19 pandemic led to the identification of 3 categories: (1) changes in coping strategies to enhance resilience; (2) individual resilience strategies; and (3) workplace strategies. The individual resilience strategies were classified into subcategories: physical health-focused strategies and mental health-focused strategies.Conclusions: Understanding the strategies used by ICU nurses to promote their resilience and cope with stressors during the COVID-19 pandemic can help organizations and policymakers develop effective interventions to support health care workers' mental health and well-being during future public health emergencies.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"35 4","pages":"260-267"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358809","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

Humanizing Critical Care and Promoting Person-Centered Nursing Practice. 人性化重症护理促进以人为本的护理实践。

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-07-01 DOI: 10.4037/ajcc2026357

Kathryn A Connell, Sadia Rahman, Kelly Toth

引用次数: 0

Incidence of Nasogastric Tube-Related Pressure Injuries in Intensive Care Unit and Internal Medicine Ward. 重症监护病房及内科病房鼻胃管相关压力损伤的发生率。

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-07-01 DOI: 10.4037/ajcc2026583

Michael Kuniavsky, Anatoly Bronshtein, Evgeny Vilenchik, Elina Lubenets, Miri Kagan, Natasha Shepelevich, Nika Gorkliansky

{"title":"Incidence of Nasogastric Tube-Related Pressure Injuries in Intensive Care Unit and Internal Medicine Ward.","authors":"Michael Kuniavsky, Anatoly Bronshtein, Evgeny Vilenchik, Elina Lubenets, Miri Kagan, Natasha Shepelevich, Nika Gorkliansky","doi":"10.4037/ajcc2026583","DOIUrl":"10.4037/ajcc2026583","url":null,"abstract":"Background: Incidence data for medical device-related pressure injuries caused by nasogastric tubes are limited. Rates may be higher in intensive care units (ICUs) than internal medicine wards because of the increased vulnerability of ICU patients.Objective: To determine incidence and contributing factors of nasogastric tube-related pressure injuries among ICU and internal medicine ward patients.Methods: This prospective cohort study included adults admitted to the ICU or internal medicine ward with a nasogastric tube placed during or within 4 hours before admission. Patients with facial injuries, wounds, or ulcers were excluded. Patients were monitored daily for nasogastric tube-related pressure injuries; location and stage of pressure injuries were documented.Results: Data were collected July 2022 to July 2024 in the ICU (88 patients) and internal medicine ward (48 patients) of a 900-bed general medical center. The nasogastric tube-related pressure injury incidence was significantly lower in the ICU (4 patients; 0.47 per 100 patient-days) than in the internal medicine ward (13 patients; 3.02 per 100 patientdays) (P < .001). Charlson Comorbidity Index was higher in internal medicine ward patients than ICU patients (mean [SD], 7.7 [2.39] vs 3 [2.41]; P = .02). Nasogastric tube fixation methods differed between departments.Conclusions: Unlike previous reports, nasogastric tube- related pressure injury incidence was higher in the internal medicine ward than the ICU. Possible contributors include comorbidity burden, nurse to patient ratios, and nasogastric tube fixation techniques. These confounding variables warrant further investigation.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"35 4","pages":"268-274"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358723","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

Ventilator-Associated Pneumonia According to Chlorhexidine Oral Care Exposure in Patients With New Tracheostomy. 新气管切开术患者氯己定口腔护理暴露对呼吸机相关性肺炎的影响。

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-07-01 DOI: 10.4037/ajcc2026305

Hailey Thompson, Andrea Nei, Kirstin Kooda, Aditya Shah, Sarah Chalmers, Kristin Cole, Nicholas Vollmer

{"title":"Ventilator-Associated Pneumonia According to Chlorhexidine Oral Care Exposure in Patients With New Tracheostomy.","authors":"Hailey Thompson, Andrea Nei, Kirstin Kooda, Aditya Shah, Sarah Chalmers, Kristin Cole, Nicholas Vollmer","doi":"10.4037/ajcc2026305","DOIUrl":"10.4037/ajcc2026305","url":null,"abstract":"Background: Chlorhexidine is commonly used in prevention bundles for ventilator-associated pneumonia. Results for use of chlorhexidine in critically ill patients requiring mechanical ventilation via an endotracheal tube are mixed, and data for patients using a tracheostomy are lacking.Objectives: To assess the risk for ventilator-associated pneumonia according to chlorhexidine exposure in patients requiring a new tracheostomy for mechanical ventilation.Methods: This single-center, retrospective cohort study compared the development of ventilator-associated pneumonia according to chlorhexidine exposure in adult intensive care unit patients requiring new tracheostomy at a large academic medical center. Adults who received a new tracheostomy and required ventilator support for at least 48 hours were included. Patients treated for pneumonia at the time of tracheostomy or who met additional exclusion criteria were excluded.Results: Of 235 patients who met the inclusion criteria, 203 received chlorhexidine and 32 did not. The cohort was predominantly White, male, and admitted to a surgical intensive care unit. Incidence of ventilator-associated pneumonia did not differ significantly between patients exposed or not to chlorhexidine (by 30 days, 32.5% vs 35.7%, P = .87). Time to development of ventilator-associated pneumonia also did not differ significantly between patients exposed or not (9 vs 12 days, respectively, P = .34).Conclusions: Chlorhexidine exposure was not associated with a difference in the incidence of or time to ventilator-associated pneumonia after new tracheostomy. Further study is needed on the role of chlorhexidine in preventing ventilator-associated pneumonia after a new tracheostomy.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"35 4","pages":"289-297"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358822","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

Electronic Health Record-Derived Measures of Sleep After Surgical Aortic Valve Replacement. 主动脉瓣置换术后电子健康记录衍生的睡眠测量。

IF 2.6 3区医学

American Journal of Critical Care Pub Date : 2026-05-01 DOI: 10.4037/ajcc2026195

Mark A Oldham, Lisa Pink, Sullafa Kadura

{"title":"Electronic Health Record-Derived Measures of Sleep After Surgical Aortic Valve Replacement.","authors":"Mark A Oldham, Lisa Pink, Sullafa Kadura","doi":"10.4037/ajcc2026195","DOIUrl":"10.4037/ajcc2026195","url":null,"abstract":"Background: Postoperative sleep disturbances, often due to overnight patient-staff interactions (PSIs), are common. Electronic health record (EHR) data were used to derive proxy measures of sleep opportunity and interruptions to characterize patients' sleep.Methods: A total of 208 eligible patient-nights in adults having surgical aortic valve replacement were analyzed. Patients completed the Richards-Campbell Sleep Questionnaire daily after surgery. Any PSIs expected to disrupt sleep were retrieved from the EHR and aggregated into interruptive episodes. Nightly PSIs and periods of uninterrupted sleep opportunity were characterized. Associations between EHR-derived measures of sleep opportunity and self-reports of sleep were examined.Results: Fifty-three patients (mean age, 66.6 years; 64% male) had a median of 7 PSIs (4 interruptive episodes) per night. Median PSIs declined from 21 (7 interruptive episodes) on postoperative night 1 to 4 (3 interruptive episodes) on postoperative night 5. Every patient-night had at least 1 PSI/interruptive episode. The EHR-derived measure most strongly correlated with Richards-Campbell Sleep Questionnaire mean score was total uninterrupted sleep opportunity (Pearson r = 0.39, P < .001).Discussion: Electronic health record-derived measures of sleep opportunity, especially total uninterrupted sleep opportunity, correlated with patients' perceptions of sleep quality and captured changes across the postoperative period. These findings indicate that EHR data can be used to monitor sleep opportunity and that improved sleep opportunities can be an outcome measure for sleep-focused quality improvement projects.Conclusions: Measures of sleep opportunity derived from the EHR may be objective, scalable proxies for self-rated sleep.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"35 3","pages":"205-213"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809669","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

Posttraumatic Growth in Intensive Care Unit Survivors. 重症监护病房幸存者的创伤后成长。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2026-05-01 DOI: 10.4037/ajcc2026118

Sarah K Wells

引用次数: 0