Intensive & critical care nursing最新文献

{"title":"The utilization of a prone position model based on big data is deemed essential - Response to Liang et al.","authors":"Yuhang Yan, Hongbin Hu, Zhongqing Chen","doi":"10.1016/j.iccn.2024.103912","DOIUrl":"10.1016/j.iccn.2024.103912","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103912"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential issues related to subsyndromal delirium in the intensive care unit - Letter on Ma et al.","authors":"Ziyi Wang, Zihan Wang","doi":"10.1016/j.iccn.2024.103911","DOIUrl":"10.1016/j.iccn.2024.103911","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"87 ","pages":"103911"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do we still need central venous pressure monitoring in the ICU? Yes!","authors":"Antonio Pesenti, Michael R Pinsky","doi":"10.1016/j.iccn.2025.103990","DOIUrl":"https://doi.org/10.1016/j.iccn.2025.103990","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103990"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the ICU: Long-term psychological effect of patient restraints.","authors":"Shelly Ashkenazy, Julie Benbenishty","doi":"10.1016/j.iccn.2025.103993","DOIUrl":"https://doi.org/10.1016/j.iccn.2025.103993","url":null,"abstract":"","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103993"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding adherence and deviations in potassium replacement protocols: A mixed method study.","authors":"Kylie O'Neill, Jason Meyer, Elizabeth Manias, Gordon Laurie, Stewart Mealing, Kellie Sosnowski, Belinda Badman, Melissa J Bloomer","doi":"10.1016/j.iccn.2025.104013","DOIUrl":"https://doi.org/10.1016/j.iccn.2025.104013","url":null,"abstract":"<p><strong>Background: </strong>Potassium replacement protocols are commonly used in ICUs to standardise replacement and minimise harm. Yet, there is variability in potassium replacement practices.</p><p><strong>Aims: </strong>(i) To examine relationships between potassium levels, potassium administration, and the potassium replacement protocol; and (ii) to explore factors influencing potassium replacement decision-making.</p><p><strong>Methods: </strong>An exploratory mixed methods approach using retrospective audit and interviews was undertaken. Clinical data from two ICUs were extracted about potassium results, potassium administration and other related data from the first 72 h of ICU admission, for all patients admitted between January 2015 and December 2022. Critical care nurses were interviewed between January and March 2024, with interviews professionally transcribed and analysed using inductive content analysis.</p><p><strong>Results: </strong>From the sample of N = 10,613 patients, n = 132,507 potassium results were analysed. Potassium replacement was indicated for 39.7 % (n = 52,592) of potassium results. When replacement was indicated, potassium was administered within 2 h in 59.9 % (n = 31,508) of cases. Interviews with critical care nurses (n = 21) lasted 5-28 min (mean 12 min). Interview participants indicated that potassium replacement decisions were influenced by the patient's history and current condition, and colleague consultation. There was little concern over potential risks associated with potassium replacement. Greater clarity around the purpose and compulsoriness of potassium replacement protocols was desired.</p><p><strong>Conclusion: </strong>These findings offer valuable insights into the intricacies of protocolised potassium replacement adherence and deviations across two ICU settings. Autonomy and interprofessional collaboration emerged as a key factor, with nurses exercising decision-making ability underpinned by patient specific considerations, assessment, and clinical judgement.</p><p><strong>Implications for clinical practice: </strong>When protocols are used to guide potassium replacement and other electrolytes, clear guidance as to the compulsoriness of the protocol is needed. Alternately, with safety a priority, when and how clinicians may use their clinical judgement and discretion in potassium replacement must also be explicit.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"104013"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative risks and clinical outcomes of midazolam versus other intravenous sedatives in critically ill mechanically ventilated patients: A systematic review and meta-analysis of randomized trials.","authors":"Yu-Xin Chen, Mu-Hsing Ho","doi":"10.1016/j.iccn.2025.103945","DOIUrl":"https://doi.org/10.1016/j.iccn.2025.103945","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review synthesized literature evidence and compared midazolam's risks and clinical outcomes with other sedatives in critically ill mechanically ventilated patients.</p><p><strong>Methods: </strong>We included randomized controlled trials (RCTs) from databases of PubMed, Embase, Cochrane Library, Web of Science, and CINAHL without language restrictions. We used relative risk (RR) for binary outcomes and standardized mean difference (SMD) for continuous outcomes, with corresponding 95% confidence interval (CI).</p><p><strong>Results: </strong>17 RCTs involving 1509 patients were included. Compared to other sedatives, midazolam significantly increased the incidence of delirium (RR 2.39, 95 % CI, 1.75 to 3.26), the time up to extubation (SMD 1.99, 95 % CI, 0.81 to 3.16) and ICU length of stay (SMD 0.63, 95 % CI, 0.20 to 1.08), but significantly reduced the incidence of bradycardia (RR 0.52, 95 % CI, 0.36 to 0.76). No differences were identified in hypotension incidence (RR 0.69, 95 % CI, 0.37 to 1.31) or duration of mechanical ventilation (SMD 0.28, 95 % CI, -0.22 to 0.78).</p><p><strong>Conclusions: </strong>Midazolam caused a higher risk of delirium, a longer time up to extubation, and ICU length of stay, but a lower incidence of bradycardia. No significant evidence indicated midazolam was associated with a higher risk of hypotension or increased duration of mechanical ventilation.</p><p><strong>Implications for clinical practice: </strong>Clinicians should balance midazolam's potential risks with its benefits. While other sedatives may be catering to patients at a higher delirium risk, midazolam remains indispensable for hemodynamically compromised patients, such as those with bradycardia. Precise sedation management is crucial for patient safety and outcomes.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103945"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for acquired weakness in intensive care unit patients: An umbrella review.","authors":"Yimei Zhang, Qiulan Hu, Min Zhou, Yu Wang, Jingran Yang, Xiaorong Jin, Xiong Zhang, Fang Ma","doi":"10.1016/j.iccn.2025.103940","DOIUrl":"https://doi.org/10.1016/j.iccn.2025.103940","url":null,"abstract":"<p><strong>Objective: </strong>This umbrella review aims to summarize and synthesize the evidence on risk factors related to intensive care unit-acquired weakness in systematic reviews to create prevention strategies and intervention measures for intensive care unit-acquired weakness.</p><p><strong>Methodology: </strong>Eight databases were searched systematically from inception to 1st November 2023. Two researchers independently screened and extracted data based on predefined inclusion and exclusion criteria. The methodological quality, risk of bias and certainty of evidence of reviews included were evaluated using version 2 of the Measurement Tool for Evaluation System Review (AMSTAR-2) and the Risk of Bias in Systematic Reviews (ROBIS), and the Grading of Recommendations Assessment, Development and Evaluation(GRADE) respectively.</p><p><strong>Results: </strong>This review included 10 systematic reviews, reporting a total of 42 factors and 22 associations with meta-analysis. Overall, among these associations, the methodological and evidence quality of the majority ofstudies was rated as low or extremely low. Most systematic reviews and/or meta-analyses exhibited a high risk of bias.</p><p><strong>Conclusion: </strong>This umbrella review comprehensively summarized the risk factors related to intensive care unit-acquired weakness and evaluated the methodological quality, risk of bias, and evidence quality of reviews included. Future studies with high-quality research such as cohort studies are needed, to better update and synthesize the risk factors of intensive care unit-acquired weakness.</p><p><strong>Implications for clinical practice: </strong>Inconsistent or even contradictory findings exist among multiple systematic reviews regarding intensive care unit-acquired weakness. The present study offers a comprehensive and readily comprehensible overview of the risk factors linked to intensive care unit-acquired weakness, which is conducive to develop assessment tools for the condition and identify intervention targets.</p>","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":" ","pages":"103940"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive care nurses' experiences of caring. Part 1: Consideration of the concept of caring.","authors":"J. Beeby","doi":"10.1054/ICCN.2000.1489","DOIUrl":"https://doi.org/10.1054/ICCN.2000.1489","url":null,"abstract":"Curiosity as to what other intensive care nurses experienced as caring practice in a high-tech environment such as intensive care was prompted by a dilemma that arose in the author's own clinical practice. One consequence was this study which took place in a 12-bedded intensive and coronary care unit (ICU). Although there is a vast body of literature discussing caring in nursing, little is related to the intensive care environment. The first part of this paper contains discussion of the concept of caring related to this aspect of nursing, thus addressing the initial stages of the research process. This was guided by the research question 'What is caring?' Part two of this paper will present the phenomenological research study designed to answer this question.","PeriodicalId":94043,"journal":{"name":"Intensive & critical care nursing","volume":"25 1","pages":"76-83"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79411530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}