Intensive care

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BACKGROUND: Long-term data on ICU-survivors reveal persisting sequalae and a reduced quality-of-life even after years. Major complaints are neuromuscular dysfunction due to Intensive care unit acquired weakness (ICUAW). Quantitative MRI (qMRI) protocols can quantify muscle alterations in contrast to standard qualitative MRI-protocols. METHODS: Using qMRI, the aim of this study was to analyse persisting myostructural abnormalities in former ICU patients compared to controls and relate them to clinical assessments...

INTRODUCTION: This bibliographic review is carried out in order to obtain answers about aspects related to techniques and treatments, as well as care associated with the critically ill patient diagnosed with Covid-19. OBJECTIVE: To analyze the available scientific evidence on the effectiveness of the use of invasive mechanical ventilation together with other adjuvant techniques, in reducing the mortality rate in patients with Acute Respiratory Distress Syndrome and clinical trial of Covid-19 treated in intensive care units...

OBJECTIVE: To identify adverse events related to prone positioning in COVID-19 patients with severe disease and acute respiratory distress syndrome, to analyze the risk factors associated with the development of anterior pressure ulcers, to determine whether the recommendation of prone positioning is associated with improved clinical outcomes. METHODS: Retrospective study performed in 63 consecutive patients with COVID-19 pneumonia admitted to intensive care unit on invasive mechanical ventilation and treated with prone positioning between March and April 2020...

INTRODUCTION: Outpatient intensive care for people on home mechanical ventilation (HMV) is a complex area of care with high demands on the nurses specialised in this field. Internationally, academic qualification as an Advanced Practice Nurse (APN) has become established in these fields of specialised care. Despite the large number of further training opportunities, there is no university qualification for home mechanical ventilation in Germany. Based on a demand- and curriculum analysis, this study therefore defines the role of an APN for home mechanical ventilation (APN-HMV)...

BACKGROUND: The overall purpose of diaries written during an intensive care stay is to help patients fill in memory gaps from the illness trajectory, which might promote long-term psychological recovery. Diaries have also been shown to benefit nurses in maintaining a view of the patient as a person in the highly technical environment and to promote reflection. There is a lack of research on how nurses might be affected by writing a diary for critically ill patients with a poor prognosis...

BACKGROUND: Post-intensive care syndrome (PICS) requires the use of multiple assessment tools because it affects multiple domains: Cognitive, Functional, and Behavioural/Psychological. Therefore, this study translated the self-report (SR) version of the Healthy Aging Brain Care Monitor (HABC-M), spanning multiple domains, into Japanese and analysed its reliability and validity in a post-intensive care setting. METHODS: Patients aged 20 years or older and admitted to the adult intensive care unit from August 2019 to January 2021 were included and surveyed by questionnaire...

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of patients with refractory hypoxaemic respiratory failure being admitted to the intensive care unit (ICU). Prone positioning can improve oxygenation but requires a team of skilled personnel to complete safely. Critical care physiotherapists (PTs) are ideally suited to lead proning teams, due to their expertise in moving critically unwell, invasively ventilated patients. OBJECTIVES: The aim of this study was to describe the feasibility of implementing a physiotherapy-led intensive proning (PhLIP) team to support the critical care team during surges...

PURPOSE: To reveal factors related to gender parity on editorial boards of critical care journals indexing in SCI-E. METHODS: The genders were defined according to data obtained from journals' websites between 01-30 September 2022. Publisher properties and journal metrics were analyzed by using Chi-square, Fisher exact, Mann-Whitney U tests, and Spearman's correlation coefficient. Logistic regression analysis was used to reveal independent factors. RESULTS: Women's representation on editorial boards was 23...

BACKGROUND: The leading global cause of death for people aged 5-29 years is road traffic injury, a quarter of which is borne by pedestrians. The epidemiology of major hospitalised pedestrian injury across Australia is not reported. This study aims to address this gap using data from the Australia New Zealand Trauma Registry. METHODS: The registry hosts information on patients admitted to 25 major trauma centres across Australia who sustain a major injury (ISS > 12) or die following injury...

OBJECTIVES: The authors investigated the management of neuromuscular blocking agents (NMBAs) for pediatric patients after cardiac surgery, and compared the outcomes of patients who received prophylactic NMBA (pNMBA) infusions and patients without pNMBA infusions. DESIGN: A retrospective cohort study. SETTING: At a tertiary teaching hospital. PARTICIPANTS: Patients younger than 18, with congenital heart disease, who underwent cardiac surgery...

BACKGROUND: Right ventricular (RV) dysfunction is an independent predictor of poor outcomes in patients with tetralogy of Fallot (TOF) and global longitudinal strain (GLS) is a well-validated echocardiographic technique to measure RV function. While trends in RV GLS have been examined in patients with TOF they have not been studied specifically in ductal dependent TOF, a group in which there is not a clear consensus on the best surgical strategy. We sought to assess the mid-term trajectory of RV GLS in ductal dependent TOF patients, drivers of this trajectory, and differences in RV GLS between repair strategies...

OBJECTIVE: The aim of this study was to assess the Neonatal Resuscitation and Adaptation Score (NRAS) value compared to the conventional and combined Apgar scores in predicting neonatal morbidity and mortality. DESIGN: A prospective cohort study was conducted on 289 neonates delivered at Menoufia University Hospitals. Trained physicians measured conventional Apgar score, combined Apgar score, and NRAS for the neonates at 1 and 5 minutes after delivery in the delivery room...

Brain injury is accompanied by neuroinflammation, accumulation of extracellular glutamate and mitochondrial dysfunction, all of which cause neuronal death. The aim of this study was to investigate the impact of these mechanisms on neuronal death. Patients from the neurosurgical intensive care unit suffering aneurysmal subarachnoid hemorrhage (SAH) were recruited retrospectively from a respective database. In vitro experiments were performed in rat cortex homogenate, primary dissociated neuronal cultures, B35 and NG108-15 cell lines...

OBJECTIVE: To simulate the magnetic and electric fields produced by RF coil geometries commonly used at low field. Based on these simulations, the specific absorption rate (SAR) efficiency can be derived to ensure safe operation even when using short RF pulses and high duty cycles. METHODS: Electromagnetic simulations were performed at four different field strengths between 0.05 and 0.1 T, corresponding to the lower and upper limits of current point-of-care (POC) neuroimaging systems...

BACKGROUND: In France, physician-assisted suicide or euthanasia are not legal but are still debated. French intensive care unit (ICU) health care workers (HCWs) have an insider's perspective on the global quality of the patient's end-of-life, whether it occurs in ICU or not. However, their opinion about euthanasia/physician-assisted suicide remains unknown. The aim of this study is to investigate the opinion of French ICU HCWs about physician-assisted suicide/euthanasia. RESULTS: A total of 1149 ICU HCWs participated to a self-administered anonymous questionnaire: 411 (35...

In children with congenital heart disease (CHD), pulmonary blood flow (Qp) contributes to alterations of pulmonary mechanics and gas exchange, while cardiopulmonary bypass (CPB) induces lung edema. We aimed to determine the effect of hemodynamics on lung function and lung epithelial lining fluid (ELF) biomarkers in biventricular CHD children undergoing CPB. CHD children were classified as high Qp (n = 43) and low Qp (n = 17), according to preoperative cardiac morphology and arterial oxygen saturation...

WHAT IS KNOWN ON THE SUBJECT: Police and ambulance staff are increasingly asked to help people experiencing mental health crises, but they often feel under-prepared. The single frontline service approach is time-intensive and risks a coercive pathway to care. The emergency department is the default location for transfers by police or ambulance involving a person involved in a mental health crisis, despite being viewed as suboptimal. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: Police and ambulance staff struggled keeping up with the mental health demand, reporting inadequate mental health training, little enjoyment and negative experiences when trying to access help from other services...

OBJECTIVE: To explore the feasibility and acceptability of a novel hospital-at-home (HaH) program for adolescent patients with a severe eating disorder (ED). METHOD: Retrospective description of the program during its first year of activity. The feasibility construct is based on accessibility, recruitment, rate of retention, avoidance of hospital stays, and management of crisis situations. Caregivers completed a satisfaction questionnaire on discharge, including an item on perceived safety...

Intensive outpatient (IOP) psychiatric treatment is increasingly deployed to meet the needs of psychiatrically high-risk youth; however, documentation of treatment disposition for in-person and/or telehealth modalities following treatment referral is largely unknown. The current study examined psychiatrically high-risk youth baseline treatment disposition patterns and explored variations according to treatment modality (telehealth vs. in-person). Using archival records of 744 adolescents ( M age = 14.91, SD = 1...