American Journal of Critical Care最新文献_第8页

Mental Health Symptoms in Parents of Infants 3 Months After Discharge Following Neonatal Cardiac Surgery. 新生儿心脏手术后出院 3 个月婴儿父母的心理健康症状。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-01-01 DOI: 10.4037/ajcc2024404

Amy J Lisanti, Ryan Quinn, Jesse L Chittams, Megan Laubacher, Barbara Medoff-Cooper, Abigail C Demianczyk

{"title":"Mental Health Symptoms in Parents of Infants 3 Months After Discharge Following Neonatal Cardiac Surgery.","authors":"Amy J Lisanti, Ryan Quinn, Jesse L Chittams, Megan Laubacher, Barbara Medoff-Cooper, Abigail C Demianczyk","doi":"10.4037/ajcc2024404","DOIUrl":"10.4037/ajcc2024404","url":null,"abstract":"Background: Parents of newborns with congenital heart disease (CHD) are at risk for anxiety, depression, and post-traumatic stress. Few studies have examined whether modifiable factors that influence parents' mental health after discharge are present during postoperative care in the pediatric cardiac intensive care unit (PCICU).Objective: To describe mental health symptoms of parents of infants with CHD 3 months after PCICU discharge and to determine factors during the PCICU stay that are predictors of such symptoms.Methods: A longitudinal cohort pilot study of 56 parents (28 mother-father dyads) of 28 infants with CHD. During the first postoperative week after cardiac surgery, parents completed questionnaires measuring factors potentially influencing mental health. Three months after discharge, 42 parents of 22 infants completed validated measures of anxiety, depression, and posttraumatic stress.Results: Three months after discharge, 26% of parents had clinically elevated levels of anxiety symptoms, 21% had clinically significant levels of depressive symptoms, and 19% had posttraumatic stress symptoms. In multi-variable analysis, parental role alteration in the PCICU was predictive of anxiety (P = .002), depressive (P = .02), and posttraumatic stress (P = .02) symptoms 3 months after discharge. Higher education level was predictive of anxiety symptoms (P = .009). Postnatal CHD diagnosis was predictive of posttraumatic stress symptoms (P = .04).Conclusions: Parental role alteration perceived by parents during the PCICU stay is a modifiable stressor contributing to adverse mental health symptoms 3 months after discharge. Interventions targeting parental role alteration in the PCICU are critically needed.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 1","pages":"20-28"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073091","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

Association of Lack of Fear of Dying With New Organ Failure: Results of a Multicenter Prospective Cohort Study. 缺乏对死亡的恐惧与新器官衰竭的关系：一项多中心前瞻性队列研究的结果

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-01-01 DOI: 10.4037/ajcc2024517

Aurélien Mazeraud, Guillaume Turc, Sivanthiny Sivanandamoorthy, Raphaël Porcher, Annabelle Stoclin, Marion Antona, Andrea Polito, Cassia Righy, Fernando A B Bozza, Shidasp Siami, Tarek Sharshar

{"title":"Association of Lack of Fear of Dying With New Organ Failure: Results of a Multicenter Prospective Cohort Study.","authors":"Aurélien Mazeraud, Guillaume Turc, Sivanthiny Sivanandamoorthy, Raphaël Porcher, Annabelle Stoclin, Marion Antona, Andrea Polito, Cassia Righy, Fernando A B Bozza, Shidasp Siami, Tarek Sharshar","doi":"10.4037/ajcc2024517","DOIUrl":"10.4037/ajcc2024517","url":null,"abstract":"Background: Patients' anxiety on intensive care unit (ICU) admission is associated with subsequent deterioration.Objective: To assess whether patients' fears/anxiety are predictive of new organ failure within 7 days of ICU admission.Methods: In a prospective 3-center cohort study of non-comatose patients without delirium or invasive mechanical ventilation, 9 specific fears were evaluated through yes/no questions. Illness severity was assessed using the Simplified Acute Physiology Score II (SAPS II) and the Sequential Organ Failure Assessment (SOFA). Intensity of acute and chronic anxiety was assessed with the state and trait components of the State-Trait Anxiety Inventory (STAI). Patients were followed up for 7 days.Results: From April 2014 to December 2017, 373 patients (median [IQR] age, 63 [48-74] years; 152 [40.8%] women; median (IQR) SAPS II, 27 [19-37]) were included. Feelings of vulnerability and fear of dying were reported by 203 (54.4%) and 172 (46.1%) patients, respectively. The STAI-State score was 40 or greater in 192 patients (51.5%). Ninety-four patients (25.2%) had new organ failure. Feelings of vulnerability (odds ratio, 1.96 [95% CI, 1.12-3.43]; P=.02) and absence of fear of dying (odds ratio, 2.38 [95% CI, 1.37-4.17]; P=.002) were associated with new organ failure after adjustment for STAI-State score (≥40), SAPS II, and SOFA score.Conclusion: Absence of fear of dying is associated with new organ failure within the first 7 days after ICU admission. Fear of dying may protect against subsequent deterioration by mobilizing patients' homeostatic resources. ClinicalTrials.gov Identifier: NCT02355626.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 1","pages":"36-44"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073084","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

Fluid Resuscitation and Sepsis Management in Patients with Chronic Kidney Disease or End-Stage Renal Disease: Scoping Review. 慢性肾病或终末期肾病患者的液体复苏和败血症管理：范围界定综述。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-01-01 DOI: 10.4037/ajcc2024756

Matt Haley, Nasim Khosravi Foroutan, Juliann M Gronquist, Raju Reddy, Raghav Wusirika, Akram Khan

{"title":"Fluid Resuscitation and Sepsis Management in Patients with Chronic Kidney Disease or End-Stage Renal Disease: Scoping Review.","authors":"Matt Haley, Nasim Khosravi Foroutan, Juliann M Gronquist, Raju Reddy, Raghav Wusirika, Akram Khan","doi":"10.4037/ajcc2024756","DOIUrl":"10.4037/ajcc2024756","url":null,"abstract":"Managing sepsis and fluid resuscitation in patients with chronic kidney disease or end-stage renal disease is challenging for health care providers. Nurses are essential for early identification and treatment of these patients. Nurse education on assessing perfusion and implementing 3-hour bundled care can improve mortality rates in patients with sepsis. In this scoping review, initial screening identified 1176 articles published from 2015 through 2023 in the National Library of Medicine database; 29 articles were included in the literature summary and evidence synthesis. A systematic review meta-analysis was not possible because of data heterogeneity. The review revealed that most patients with chronic kidney disease or end-stage renal disease received more conservative resuscitation than did the general population, most likely because of concerns about volume overload. However, patients with chronic kidney disease or end-stage renal disease could tolerate the standard initial fluid resuscitation bolus of 30 mL/kg for sepsis. Outcomes in patients with chronic kidney disease or end-stage renal disease were similar to outcomes in patients without those conditions, whether they received standard or conservative fluid resuscitation. Patients who received the standard (higher) fluid resuscitation volume did not have increased rates of complications such as longer duration of mechanical ventilation, increased mortality, or prolonged length of stay. Using fluid responsiveness to guide resuscitation was associated with improved outcomes. The standard initial fluid resuscitation bolus of 30 mL/kg may be safe for patients with chronic kidney disease or end-stage renal disease and sepsis. Fluid responsiveness could be a valuable resuscitation criterion, promoting better decision-making by multidisciplinary teams. Further research is required.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 1","pages":"45-53"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073088","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

Recognizing 12-Lead Electrocardiographic Patterns in Patients at Risk for Lethal Arrhythmias. 识别有致命心律失常风险的患者的 12 导联心电图模式。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-01-01 DOI: 10.4037/ajcc2024601

Sukardi Suba, Teri M Kozik, Michele M Pelter

引用次数: 0

Discussion Guide for the Woods Article. 森林》文章讨论指南。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-01-01 DOI: 10.4037/ajcc2024895

Grant A Pignatiello

引用次数: 0

Human Suffering and Armed Conflict. 人类苦难与武装冲突。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-01-01 DOI: 10.4037/ajcc2024997

Cindy L Munro, Aluko A Hope

引用次数: 0

Patients' Perceptions of Virtual Live Music in the Intensive Care Unit. 病人对重症监护室虚拟现场音乐的看法。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-01-01 DOI: 10.4037/ajcc2024140

Alexandra L Bruder, Akash Gururaja, Nikita Narayani, Ruth Kleinpell, Joseph J Schlesinger

{"title":"Patients' Perceptions of Virtual Live Music in the Intensive Care Unit.","authors":"Alexandra L Bruder, Akash Gururaja, Nikita Narayani, Ruth Kleinpell, Joseph J Schlesinger","doi":"10.4037/ajcc2024140","DOIUrl":"10.4037/ajcc2024140","url":null,"abstract":"Background: Implementing music in the intensive care unit has increased in popularity because the environment can be stressful and anxiety inducing for many patients. In hospital settings, therapeutic music can be beneficial for patients' well-being and recovery. Although live music typically involves a face-to-face encounter between the musician and patient, the COVID-19 pandemic has prompted a change to virtual live therapeutic music, using technology to present music in real time (eg, with a tablet computer).Objective: To generate novel findings regarding patients' perceptions of virtual live therapeutic music, which has been little studied compared with live or recorded music..Methods: Fifty patients in Vanderbilt University Medical Center intensive care units listened to virtual live music played by a volunteer musician via an online video communication platform. Patients' responses to 5 survey questions were transcribed and analyzed qualitatively and quantitatively using data analysis software.Results: Seven major themes describing the familiarity and significance of music for patients were identified. Forty-seven patients (94%) experienced positive emotions from the music, 46 (92%) indicated that music was a significant part of their lives, 28 (56%) accessed a cherished memory, and 45 (90%) indicated that they would not change anything.Conclusions: Therapeutic virtual music was well received and provided tangible benefits to patients. Additional research would provide information on patients' outcomes and differences between live and virtual live music.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 1","pages":"54-59"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073093","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

Use of the 3 Wishes Project to Help Individualize End-of-Life Care in a Medical Intensive Care Unit. 利用 "3 个愿望 "项目帮助医疗重症监护室实现个性化临终关怀。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2024-01-01 DOI: 10.4037/ajcc2024985

Brittany H Harrison, Elizabeth Hundt, Clareen Wiencek

{"title":"Use of the 3 Wishes Project to Help Individualize End-of-Life Care in a Medical Intensive Care Unit.","authors":"Brittany H Harrison, Elizabeth Hundt, Clareen Wiencek","doi":"10.4037/ajcc2024985","DOIUrl":"10.4037/ajcc2024985","url":null,"abstract":"Background: Multiple organizations recommend that individualized end-of-life (EOL) care should be standard practice. However, a standardized approach does not exist because EOL care should be individually tailored. The 3 Wishes Project is an EOL intervention that provides direction for individualized care with 3 goals: dignify death, celebrate the patient's life, and support family members and the intensive care unit clinicians caring for the patient. Patients and families are given the opportunity to choose 3 wishes during the dying process.Objective: To ascertain if the implementation of the 3 Wishes Project allowed the medical team to provide individualized EOL care.Methods: The Iowa Model was used for this evidence-based project. The project was implemented in the medical intensive care unit at an academic medical center. Outcomes were evaluated by the collection and analysis of qualitative and quantitative data.Results: From the 57 patients who died during the 2-month implementation period, 32 wish forms were collected; 31 patients participated and 1 declined. Overall participation among patients was 56%. The top 5 wishes were cloth hearts, blankets, heartbeat printouts, fingerprints and handprints, and music. The total cost was $992, and the average cost per wish was $6.98. Eighty-five percent (33 of 39) of the respondents to the medical team survey indicated that they either agreed or strongly agreed that the project allowed the medical team to consistently provide individualized EOL care.Conclusions: The survey data support the 3 Wishes Project as a method that allowed the medical team to individualize EOL care and as a valuable tool for incorporation at the bedside.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"33 1","pages":"9-17"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073095","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

Barriers to and Facilitators of Family Caregiving of Patients With COVID-19 Early in the Pandemic. 大流行早期新冠肺炎患者家庭护理的障碍和推动者。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023364

Amanda N Leggett, Sheria G Robinson-Lane, Grace Oxford, Natalie Leonard, Alicia G Carmichael, Elaina Baker, Janeann Paratore, Amanda C Blok, Hallie C Prescott, Theodore J Iwashyna, Richard Gonzalez

{"title":"Barriers to and Facilitators of Family Caregiving of Patients With COVID-19 Early in the Pandemic.","authors":"Amanda N Leggett, Sheria G Robinson-Lane, Grace Oxford, Natalie Leonard, Alicia G Carmichael, Elaina Baker, Janeann Paratore, Amanda C Blok, Hallie C Prescott, Theodore J Iwashyna, Richard Gonzalez","doi":"10.4037/ajcc2023364","DOIUrl":"10.4037/ajcc2023364","url":null,"abstract":"Background: In 2020, many family members were thrust into the role of caregiving for a relative with COVID-19 with little preparation, training, or understanding of the disease and its symptoms.Objectives: To explore the barriers to and facilitators of caregiving experienced by family caregivers of patients with COVID-19 who had been in intensive care in the pandemic's earliest months.Methods: In-depth qualitative interviews were conducted by web conference with 16 adults recovering at home after intubation for COVID-19 in an intensive care unit at a major academic medical center and their primary caregivers from March to August 2020 (N = 32). Thematic qualitative analysis was done using Watkins' rigorous and accelerated data reduction technique with MAXQDA software.Results: Seven themes emerged regarding factors that facilitated or posed barriers to care: other health conditions that increased complexity of care, interactions and experiences in the health care system, COVID-19's proliferation into other areas of life, the psychological well-being of the patient-caregiver dyad, experience of support from the dyad's network, the role of caregiving in the dyad, and contextual circumstances of the dyad. The themes often included both barriers and facilitators, depending on the experience of the dyad (eg, feeling encouraged vs fatigued by their support network).Conclusions: Understanding how patients with COVID-19 and their caregivers experience illness management across the recovery journey can help clarify the COVID-19 care-giving process and identify intervention targets to improve overall health and well-being of the care dyad.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"32 6","pages":"431-439"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71419703","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

Skin Pigmentation and Accuracy of Pulse Oximetry Values. 皮肤色素沉着和脉搏血氧测定值的准确性。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023292

Margo A Halm

引用次数: 0