American Journal of Critical Care最新文献_第9页

Discussion Guide for the Tuozzo Article. 托佐文章讨论指南。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023678

Grant A Pignatiello

引用次数: 0

Through Diversity, Dignity; Through Belonging, Justice. 通过多样性、尊严；通过归属，正义。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023670

Aluko A Hope, Cindy L Munro

引用次数: 0

Anxiety Sensitivity in the Intensive Care Unit. 重症监护室的焦虑敏感性。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023383

Meredith Padilla

引用次数: 0

Cognitive Impairment, Physical Impairment, and Psychological Symptoms in Intensive Care Unit Survivors. 重症监护室幸存者的认知障碍、身体障碍和心理症状。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023946

Tracye Proffitt, Victoria Menzies, Mary Jo Grap, Tamara Orr, Leroy Thacker, Suzanne Ameringer

{"title":"Cognitive Impairment, Physical Impairment, and Psychological Symptoms in Intensive Care Unit Survivors.","authors":"Tracye Proffitt, Victoria Menzies, Mary Jo Grap, Tamara Orr, Leroy Thacker, Suzanne Ameringer","doi":"10.4037/ajcc2023946","DOIUrl":"10.4037/ajcc2023946","url":null,"abstract":"Background: Post-intensive care syndrome (PICS) affects 25% to 50% of adults who survive an intensive care unit (ICU) stay. Although the compounding of PICS impairments (cognitive, physical, and psychological) could intensify the syndrome, research on relationships among impairments is limited, particularly in patients with delirium.Objectives: To examine associations among PICS impairments and examine delirium status and its relationship to PICS impairments at ICU discharge and 1 month later.Methods: A descriptive, correlational study of adults who survived an ICU stay. Participants completed measures for depression, anxiety, posttraumatic stress, physical function, functional status, and cognition at ICU discharge and 1 month later. Relationships among PICS impairments were examined with Spearman correlations; differences in impairments by delirium status were assessed with t tests.Results: Of 50 enrolled participants, 46 were screened for PICS impairment at ICU discharge and 35 were screened 1 month later. Cognitive impairment was the most common impairment at both time points. A positive correlation was found between cognition and functional status at ICU discharge (ρ = 0.50, P = .001) and 1 month later (ρ = 0.54, P = .001). Cognition and physical functioning were positively correlated 1 month after discharge (ρ = 0.46, P = .006). The group with delirium had significantly lower functional status scores than the group without delirium at ICU discharge (P = .04).Conclusions: The findings suggest a moderate correlation between cognitive and physical impairments. This relationship should be explored further; ICU survivors with undiagnosed cognitive impairment may have delayed physical recovery and greater risk for injury.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"32 6","pages":"410-420"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71419707","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

Understanding and Managing Anxiety Sensitivity During Critical Illness and Long-Term Recovery. 了解和管理危重症和长期康复期间的焦虑敏感性。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023975

Leanne M Boehm, Claire M Bird, Ann Marie Warren, Valerie Danesh, Megan M Hosey, Joanne McPeake, Kelly M Potter, Han Su, Tammy L Eaton, Mark B Powers

{"title":"Understanding and Managing Anxiety Sensitivity During Critical Illness and Long-Term Recovery.","authors":"Leanne M Boehm, Claire M Bird, Ann Marie Warren, Valerie Danesh, Megan M Hosey, Joanne McPeake, Kelly M Potter, Han Su, Tammy L Eaton, Mark B Powers","doi":"10.4037/ajcc2023975","DOIUrl":"10.4037/ajcc2023975","url":null,"abstract":"Anxiety sensitivity is a fear of symptoms associated with anxiety (eg, rapid respiration and heart rate, perspiration), also known as \"fear of fear.\" This fear is a misinterpretation of nonthreatening symptoms as threatening across 3 domains: physical (\"When my heart rate increases, I'm afraid I may have a heart attack\"), social (\"If people see me perspire, I fear they will negatively evaluate me\"), and cognitive (\"When I feel these symptoms, I fear it means I'm going crazy or will lose control and do something dangerous like disconnect my IV\"). These thoughts stimulate the sympathetic nervous system, resulting in stronger sensations and further catastrophic misinterpretations, which may spiral into a panic attack. Strategies to address anxiety sensitivity include pharmacologic and nonpharmacologic interventions. In intensive care unit settings, anxiety sensitivity may be related to common monitoring and interventional procedures (eg, oxygen therapy, repositioning, use of urine collection systems). Anxiety sensitivity can be a barrier to weaning from mechanical ventilation when patients are uncomfortable following instructions to perform awakening or breathing trials. Fortunately, anxiety sensitivity is a malleable trait with evidence-based intervention options. However, few health care providers are aware of this psychological construct and available treatment. This article describes the nature of anxiety sensitivity, its potential impact on intensive care, how to assess and interpret scores from validated instruments such as the Anxiety Sensitivity Index, and treatment approaches across the critical care trajectory, including long-term recovery. Implications for critical care practice and future directions are also addressed.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"32 6","pages":"449-457"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71419713","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

Bed Rest Reduction Following Cardiac Catheterizations Using Vascular Closure Devices. 使用血管闭合装置进行心脏导管置入术后减少卧床休息。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023536

Kristin A Tuozzo, Reena Morris, Nicole Moskowitz, Kathleen McCauley, Anvar Babaev, Michael Attubato

{"title":"Bed Rest Reduction Following Cardiac Catheterizations Using Vascular Closure Devices.","authors":"Kristin A Tuozzo, Reena Morris, Nicole Moskowitz, Kathleen McCauley, Anvar Babaev, Michael Attubato","doi":"10.4037/ajcc2023536","DOIUrl":"10.4037/ajcc2023536","url":null,"abstract":"Background: Bed rest duration following deployment of a vascular closure device after transfemoral left-sided cardiac catheterization is not standardized. Despite research supporting reduced bed rest, many hospitals require prolonged bed rest. Delayed ambulation is associated with back pain, urine retention, difficulty eating, and longer stay.Objective: To study length of stay, safety, and opportunity cost savings of reduced bed rest at a large urban hospital.Methods: A single-site 12-week study of 1-hour bed rest after transfemoral cardiac catheterizations using vascular closure devices. Results were compared with historical controls treated similarly.Results: The standard bed rest group included 295 patients (207 male, 88 female; mean [SD] age, 64.4 [8.6] years). The early ambulation group included 260 patients (188 male, 72 female; mean [SD] age, 64 [9.3] years). The groups had no significant difference in age (t634 = 1.18, P = .21) or sex (χ12=0.2, P = .64). Three patients in the standard bed rest group and 1 in the early ambulation group had hematomas (P = .36). The stay for diagnostic cardiac catheterizations was longer in the standard bed rest group (mean [SD], 220.7 [55.2] minutes) than in the early ambulation group (mean [SD], 182.1 [78.5] minutes; t196 = 4.06; P < .001). Stay for percutaneous coronary interventions was longer in the standard bed rest group (mean [SD], 400.2 [50.8] minutes) than in the early ambulation group (mean [SD], 381.6 [54.7] minutes; t262 = 2.86; P = .005).Conclusion: Reduced bed rest was safe, shortened stays, and improved efficiency by creating opportunity cost savings.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"32 6","pages":"421-428"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71419704","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

Challenges Associated With Waveform Morphology Interpretation of 12-Lead Electrocardiograms. 与12导联心电图波形形态解释相关的挑战。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023896

Salah S Al-Zaiti, Sukardi Suba, Mary G Carey

引用次数: 0

Self-Care Mental Health App Intervention for Post-Intensive Care Syndrome-Family: A Randomized Pilot Study. 重症监护后综合征家庭的自我护理心理健康应用干预：一项随机试点研究。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023800

Amy B Petrinec, Cindy Wilk, Joel W Hughes, Melissa D Zullo, Richard L George

{"title":"Self-Care Mental Health App Intervention for Post-Intensive Care Syndrome-Family: A Randomized Pilot Study.","authors":"Amy B Petrinec, Cindy Wilk, Joel W Hughes, Melissa D Zullo, Richard L George","doi":"10.4037/ajcc2023800","DOIUrl":"10.4037/ajcc2023800","url":null,"abstract":"Background: Post-intensive care syndrome-family (PICS-F) is a constellation of adverse psychological symptoms experienced by family members of critically ill patients during and after acute illness. Cognitive behavioral therapy delivered using smartphone technology is a novel approach for PICS-F symptom self-management.Objective: To determine the efficacy of smartphone delivery of cognitive behavioral therapy in reducing the prevalence and severity of PICS-F symptoms in family members of critically ill patients.Methods: The study had a randomized controlled longitudinal design with control and intervention groups composed of family members of patients admitted to 2 adult intensive care units. The intervention consisted of a mental health app loaded on participants' personal smartphones. The study time points were upon enrollment (within 5 days of intensive care unit admission; time 1), 30 days after enrollment (time 2), and 60 days after enrollment (time 3). Study measures included demographic data, PICS-F symptoms, mental health self-efficacy, health-related quality of life, and app use.Results: The study sample consisted of 60 predominantly White (72%) and female (78%) family members (30 intervention, 30 control). Anxiety and depression symptom severity decreased significantly over time in the intervention group but not in the control group. Family members logged in to the app a mean of 11.4 times (range, 1-53 times) and spent a mean of 50.16 minutes (range, 1.87-245.92 minutes) using the app.Conclusions: Delivery of cognitive behavioral therapy to family members of critically ill patients via a smartphone app shows some efficacy in reducing PICS-F symptoms.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"32 6","pages":"440-448"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71419710","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 : 2023-11-01 DOI: 10.4037/ajcc2023192

Rhonda Board

引用次数: 0

Describing Anisocoria in Neurocritically Ill Patients. 描述神经危重症患者的嗅觉障碍。

IF 2.7 3区医学

American Journal of Critical Care Pub Date : 2023-11-01 DOI: 10.4037/ajcc2023558

Ciji Saju, Arianna Barnes, Joji B Kuramatsu, Jade L Marshall, Hirofumi Obinata, Ava M Puccio, Shoji Yokobori, DaiWai M Olson

{"title":"Describing Anisocoria in Neurocritically Ill Patients.","authors":"Ciji Saju, Arianna Barnes, Joji B Kuramatsu, Jade L Marshall, Hirofumi Obinata, Ava M Puccio, Shoji Yokobori, DaiWai M Olson","doi":"10.4037/ajcc2023558","DOIUrl":"10.4037/ajcc2023558","url":null,"abstract":"Background: Anisocoria (unequal pupil size) has been defined using cut points ranging from greater than 0.3 mm to greater than 2.0 mm for absolute difference in pupil size. This study explored different pupil diameter cut points for assessing anisocoria as measured by quantitative pupillometry before and after light stimulus.Methods: An exploratory descriptive study of international registry data was performed. The first observations in patients with paired left and right quantitative pupillometry measurements were included. Measurements of pupil size before and after stimulus with a fixed light source were used to calculate anisocoria.Results: The sample included 5769 patients (mean [SD] age, 57.5 [17.6] years; female sex, 2558 patients [51.5%]; White race, 3669 patients [75.5%]). Anisocoria defined as pupil size difference of greater than 0.5 mm was present in 1624 patients (28.2%) before light stimulus; 645 of these patients (39.7%) also had anisocoria after light stimulus (P < .001). Anisocoria defined as pupil size difference of greater than 2.0 mm was present in 79 patients (1.4%) before light stimulus; 42 of these patients (53.2%) also had anisocoria after light stimulus (P < .001).Discussion: The finding of anisocoria significantly differed before and after light stimulus and according to the cut point used. At most cut points, fewer than half of the patients who had anisocoria before light stimulus also had anisocoria after light stimulus.Conclusion: The profound difference in the number of patients adjudicated as having anisocoria using different cut points reinforces the need to develop a universal definition for anisocoria.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"32 6","pages":"402-409"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71419708","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