American Journal of Critical Care最新文献_第7页

Climate Change and the Intensive Care Unit. 气候变化与重症监护室。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024761

Lakshman Swamy, Cindy L Munro

引用次数: 0

Effects of Natural Sound Therapy on Pain and Agitation Induced by Endotracheal Suctioning: A Real-World Study. 自然声音疗法对气管内抽吸引起的疼痛和躁动的影响：真实世界研究

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024570

Qianwen Ruan, Chuanxiong Li, Meihua Qiu, Linjun Wan, Tong Sun

{"title":"Effects of Natural Sound Therapy on Pain and Agitation Induced by Endotracheal Suctioning: A Real-World Study.","authors":"Qianwen Ruan, Chuanxiong Li, Meihua Qiu, Linjun Wan, Tong Sun","doi":"10.4037/ajcc2024570","DOIUrl":"10.4037/ajcc2024570","url":null,"abstract":"Background: Music therapy has been used as a complementary intervention to provide synergistic analgesia for various procedures.Objective: To evaluate the effects of natural sound therapy on pain intensity and agitation scores in intubated adult Chinese patients who received endotracheal suctioning in a critical care unit.Methods: A prospective, real-world, randomized, double-blind, controlled study was conducted from July 2021 through February 2022 among intubated surgical intensive care unit patients in a Chinese hospital. Patients were randomly assigned to a control group receiving conventional treatment or an intervention group receiving natural sound therapy plus conventional treatment (50 patients in each group). Patients' pain intensity and agitation levels were analyzed before, during, immediately after, 5 minutes after, and 15 minutes after completion of endotracheal suctioning. Pain intensity was assessed with the Critical-Care Pain Observation Tool (CPOT); agitation was assessed with the Richmond Agitation-Sedation Scale (RASS).Results: According to CPOT scores, patients in the intervention group had significant relief of pain intensity during, immediately after, and 5 minutes after endotracheal suctioning compared with patients in the control group (all P < .001). The RASS scores showed that agitation levels were significant lower in the intervention group than in the control group during (P = .002) and immediately after (P < .001) endotracheal suctioning.Conclusions: In this real-world study, natural sound therapy was part of a holistic bundle of interventions used to reduce pain and agitation in surgical intensive care unit patients during endotracheal suctioning.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"299-303"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465592","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

Nurses' Understanding and Practice of Minimal Stimulation in the Pediatric Intensive Care Unit. 儿科重症监护室护士对最小刺激的理解和实践。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024104

Shelley Burcie, Angelica Morris, Virginia Young, Zara Sajwani-Merchant, Lindsey Patton

{"title":"Nurses' Understanding and Practice of Minimal Stimulation in the Pediatric Intensive Care Unit.","authors":"Shelley Burcie, Angelica Morris, Virginia Young, Zara Sajwani-Merchant, Lindsey Patton","doi":"10.4037/ajcc2024104","DOIUrl":"https://doi.org/10.4037/ajcc2024104","url":null,"abstract":"Background: Pediatric patients receiving neurologic and neurosurgical critical care undergo many procedures that result in stimulation of the sympathetic nervous system, which increases their risk of poor outcomes. Nurses typically implement a variety of interventions to minimize such stimulation; however, minimal stimulation has not been specifically defined in the literature or described as a standardized bundle of care.Objective: To examine pediatric intensive care unit nurses' interpretation and practice of minimal stimulation in patients with neurologic and neurosurgical conditions and specifically to triangulate nurses' descriptions of this practice with related findings in the literature.Methods: This was a qualitative, descriptive, exploratory study that used naturalistic inquiry.Results: A total of 13 pediatric intensive care unit nurses participated in the study. Three primary themes were identified regarding minimal stimulation: (1) new knowledge and practice, (2) communication, and (3) impact of minimal stimulation.Conclusions: The findings of this study help to establish a working definition of the nursing practice of minimal stimulation and provide a basis for future research. More detailed study is needed on the concept of a standardized minimal stimulation bundle and its impact on patient outcomes.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"272-279"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465596","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 Botsch Article. 博茨文章讨论指南。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024321

Grant A Pignatiello

引用次数: 0

Hospital-Based Electrocardiographic Monitoring: The Good, the Not So Good, and Untapped Potential. 医院心电监护：好的、不太好的和尚未开发的潜力。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024781

Michele M Pelter

{"title":"Hospital-Based Electrocardiographic Monitoring: The Good, the Not So Good, and Untapped Potential.","authors":"Michele M Pelter","doi":"10.4037/ajcc2024781","DOIUrl":"https://doi.org/10.4037/ajcc2024781","url":null,"abstract":"Continuous electrocardiographic (ECG) monitoring was first introduced into hospitals in the 1960s, initially into critical care, as bedside monitors, and eventually into step-down units with telemetry capabilities. Although the initial use was rather simplistic (ie, heart rate and rhythm assessment), the capabilities of these devices and associated physiologic (vital sign) monitors have expanded considerably. Current bedside monitors now include sophisticated ECG software designed to identify myocardial ischemia (ie, ST-segment monitoring), QT-interval prolongation, and a myriad of other cardiac arrhythmia types. Physiologic monitoring has had similar advances from noninvasive assessment of core vital signs (blood pressure, respiratory rate, oxygen saturation) to invasive monitoring including arterial blood pressure, temperature, central venous pressure, intracranial pressure, carbon dioxide, and many others. The benefit of these monitoring devices is that continuous and real-time information is displayed and can be configured to alarm to alert nurses to a change in a patient's condition. I think it is fair to say that critical and high-acuity care nurses see these devices as having a positive impact in patient care. However, this enthusiasm has been somewhat dampened in the past decade by research highlighting the shortcomings and unanticipated consequences of these devices, namely alarm and alert fatigue. In this article, which is associated with the American Association of Critical-Care Nurses' Distinguished Research Lecture, I describe my 36-year journey from a clinical nurse to nurse scientist and the trajectory of my program of research focused primarily on ECG and physiologic monitoring. Specifically, I discuss the good, the not so good, and the untapped potential of these monitoring systems in clinical care. I also describe my experiences with community-based research in patients with acute coronary syndrome and/or heart failure.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"247-259"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465593","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 Factors Associated With Mode of Death Following Cardiac Arrest. 与心脏骤停后死亡方式相关的临床因素。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024145

Blake Senay, Elochukwu Ibekwe, Yevgeniya Gokun, Jonathan Elmer, Archana Hinduja

{"title":"Clinical Factors Associated With Mode of Death Following Cardiac Arrest.","authors":"Blake Senay, Elochukwu Ibekwe, Yevgeniya Gokun, Jonathan Elmer, Archana Hinduja","doi":"10.4037/ajcc2024145","DOIUrl":"https://doi.org/10.4037/ajcc2024145","url":null,"abstract":"Background: Death after resuscitation from cardiac arrest is common. Although associated factors have been identified, knowledge about their relationship with specific modes of death is limited.Objective: To identify clinical factors associated with specific modes of death following cardiac arrest.Methods: This study involved a retrospective medical record review of patients admitted to a single health care center from January 2015 to March 2020 after resuscitation from cardiac arrest who died during their index hospitalization. Mode of death was categorized as either brain death, withdrawal of life-sustaining therapies due to neurologic causes, death due to medical causes, or withdrawal of life-sustaining therapies due to patient preference. Clinical characteristics across modes of death were compared.Results: The analysis included 731 patients. Death due to medical causes was the most common mode of death. Compared with the other groups of patients, those with brain death were younger, had fewer comorbidities, were more likely to have experienced unwitnessed and longer cardiac arrest, and had more severe acidosis and hyperglycemia on presentation. Patients who died owing to medical causes or withdrawal of life-sustaining therapies due to patient preference were older and had more comorbidities, fewer unfavorable cardiac arrest characteristics, and fewer days between cardiac arrest and death.Conclusions: Significant associations were found between several clinical characteristics and specific mode of death following cardiac arrest. Decision-making regarding withdrawal of care after resuscitation from cardiac arrest should be based on a multimodal approach that takes account of a variety of personal and clinical factors.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"290-297"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465590","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

Noninvasive Ventilation for Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-19. 无创通气治疗 COVID-19 引起的中重度急性呼吸窘迫综合征。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024663

Alexander A Botsch, Michael J Oravec, Brandon T Rapier, Laine M Goff, Ashley L Desmett

{"title":"Noninvasive Ventilation for Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-19.","authors":"Alexander A Botsch, Michael J Oravec, Brandon T Rapier, Laine M Goff, Ashley L Desmett","doi":"10.4037/ajcc2024663","DOIUrl":"https://doi.org/10.4037/ajcc2024663","url":null,"abstract":"Background: Use of noninvasive ventilation in patients with acute respiratory distress syndrome (ARDS) is debated. The COVID-19 pandemic posed challenges due to high patient volumes and worldwide resource strain.Objectives: To determine associations between use of noninvasive ventilation in adult patients with moderate to severe ARDS due to SARS-CoV-2 pneumonia, progression to intubation, and hospital mortality.Methods: This retrospective cohort study included patients in an institutional COVID-19 registry. Adult patients were included if they were admitted for COVID-19 between March 1, 2020, and March 31, 2022, and developed moderate to severe ARDS. Primary outcomes were progression to intubation and hospital mortality in patients who received noninvasive ventilation or mechanical ventilation. A secondary outcome was successful treatment with noninvasive ventilation without intubation.Results: Of 823 patients who met inclusion criteria, 454 (55.2%) did not receive noninvasive ventilation and 369 (44.8%) received noninvasive ventilation. Patients receiving noninvasive ventilation were more likely to require mechanical ventilation than were patients not receiving noninvasive ventilation. Among patients requiring endotracheal intubation, those receiving noninvasive ventilation had a higher likelihood of mortality. Patients receiving noninvasive ventilation had lower severity-adjusted odds of survival to discharge without intubation than did patients not receiving noninvasive ventilation.Conclusion: Patients with moderate to severe ARDS due to SARS-CoV-2 pneumonia treated with noninvasive ventilation had increased likelihood of progression to endotracheal intubation and hospital mortality.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 4","pages":"260-269"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465595","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

A Daily Dose of Communication to Improve Quality and Safety Outcomes. 每日交流，提高质量和安全成果。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-07-01 DOI: 10.4037/ajcc2024318

Margo A Halm

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 : 2024-05-01 DOI: 10.4037/ajcc2024232

Rhonda Board

引用次数: 0

Integrating Perspectives on Family Caregiving After Critical Illness: A Qualitative Content Analysis. 整合危重病后家庭护理的视角：定性内容分析。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-05-01 DOI: 10.4037/ajcc2024309

Amanda C Moale, Erica M Motter, Peter Eisenhauer, Nimit Gandhi, S Peter Kim, Tim D Girard, Charles F Reynolds, Natalie E Leland, Judy C Chang, Leslie P Scheunemann

{"title":"Integrating Perspectives on Family Caregiving After Critical Illness: A Qualitative Content Analysis.","authors":"Amanda C Moale, Erica M Motter, Peter Eisenhauer, Nimit Gandhi, S Peter Kim, Tim D Girard, Charles F Reynolds, Natalie E Leland, Judy C Chang, Leslie P Scheunemann","doi":"10.4037/ajcc2024309","DOIUrl":"10.4037/ajcc2024309","url":null,"abstract":"Background: To date, no intervention has definitively improved outcomes for families of critical illness survivors. An integrated perspective on caregivers' needs after critical illness could help identify high-priority intervention targets and improve outcomes.Objectives: To obtain diverse perspectives on the needs, barriers and facilitators, and social determinants of health associated with family caregiving across the critical illness continuum and assess the extent to which successful caregiving interventions in other populations may be adapted to the critical illness context.Methods: This qualitative content analysis of 31 semistructured interviews and 10 focus groups with family caregivers, health care providers, and health care administrators explored family caregivers' needs during post- intensive care unit (ICU) transitions and the barriers and facilitators associated with addressing them. Trained coders analyzed transcripts, identified patterns and categories among the codes, and generated themes.Results: Caregivers have 3 instrumental needs: formal and informal support, involvement in care planning, and education and training. Only caregivers described their self-care and mental health needs. Social determinants of health are the key barriers and facilitators shaping the caregivers' journey, and caregiving as a social determinant of health was a prominent theme.Conclusions: Caregivers have instrumental, self-care, and mental health needs after critical illness. Adapting hands-on and skills training interventions to the post-ICU setting, while tailoring interventions to caregivers' health-related social context, may improve caregiver outcomes.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 3","pages":"180-189"},"PeriodicalIF":2.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859569","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