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Effects of strengthening prospective nursing practice on sleep quality,anxiety,and depression of awake patients in intensive care unit

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World Journal of Psychiatry 2024年第5期14卷 735-741页

作者： Fei Lin Lei Liu department of intensive care unit Dushu Lake Hospital Affiliated to Soochow UniversitySuzhou 215000Jiangsu ProvinceChina

BACKGROUND The intensive care unit(ICU)is a specialized hospital department.Awake patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep quality.This situation has garnered significant attention within the medical community.AIM To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU patients.METHODS One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)groups.Patients in the control group were cared for using the conventional nursing model,while patients in the observation group were cared for using the prospective nursing model.Sleep improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index(PSQI).The PSQI,Generalized Anxiety Disorder 7-item(GAD-7)scale,Self-Depression Scale(SDS),and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care models.RESULTS Patient satisfaction in the observation group was significantly higher than in the control group.The GAD-7 and SDS scores in the observation group were significantly lower than those in the control group,and the total effective rate of sleep improvement in the observation group was significantly higher than in the control group.After treatment,the PSQI scores of the two groups significantly decreased(P<0.05).The decrease in the observation group was more significan than that in the control group,and the difference between the two groups was statistically significant.CONCLUSION Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU,which is worthy of clinical application.

关键词： Prospective nursing intensive care unit Sobriety Mental health sleep quality Anxiety and depression

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Clinical and Microbiological Characteristics of Patients with Complicated Intra-abdominal Infections in intensive care unit

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Current Medical Science 2020年第1期40卷 104-109页

作者： Yang-mei XIONG Xin RAO department of intensive care unit Zhongnan Hospital of Wuhan UniversityWuhan 430071China

In order to investigate the clinical and microbiological characteristics of patients with complicated intra-abdominal infections(cIAIs)in intensive care unit(ICU),the clinical data of 612 cIAIs patients from January 2016 to December 2018 were retrospectively collected.Clinical characteristics,distribution of pathogens and drug resistance were statistically analyzed.It was found that patients with community-acquired intra-abdominal infections(CA-IAIs)made up a majority of cIAIs patients.The positive rate of abdominal drainage fluid culture was 55.56%.Gramnegative bacteria accounted for the majority,the most commonly isolated bacteria of which were Escherichia coli(20.96%),Klebsiella pneumoniae(10.20%)and Pseudomonas aeruginosa(5.57%).The most commonly isolated gram-positive bacteria were Enterococcus(16.88%)and Methicillinresistant staphylococcus aureus(MRSA,3.90%).Enterobacter isolates showed high resistance rate to most cephalosporins and low resistance rate to piperacillin/tazobactam and carbapenems.Extended spectrum beta-lactamase(ESBL)screen positive isolates from CA-IAIs patients showed an increasing trend in past three years.Enterococcus and MRSA showed high resistance rate to clindamycin,quinolone,erythromycin and tetracycline,while they showed high sensitivity rate to linezolid,tegacycline,teicoplanin and vancomycin.Our results indicate that isolated bacteria from abdominal drainage fluid show high resistance rates to commonly used antibiotics in ICU patients with cIAIs.The curative effects on diseases should be monitored continuously when antibiotics are used.Meanwhile,we should always keep eyes on drug-resistant bacteria,especially when the treatment efficacy is not good.

关键词： complicated intra-abdominal infection pathogens extended spectrum beta-lactamase screen positive isolates resistance rate

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intensive care unit-acquired weakness: Recent insights

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Journal of intensive Medicine 2024年第1期4卷 73-80页

作者： Juan Chen Man Huang department of General intensive care unit The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009ZhejiangChina

intensive care unit-acquired weakness(ICU-AW)is a common complication in critically ill patients and is associated with a variety of adverse outcomes.These include the need for prolonged mechanical ventilation and ICU stay;higher ICU,in-hospital,and 1-year mortality;and increased in-hospital costs.ICU-AW is associated with multiple risk factors including age,underlying disease,severity of illness,organ failure,sepsis,immobilization,receipt of mechanical ventilation,and other factors related to critical care.The pathological mechanism of ICUAW remains unclear and may be considerably varied.This review aimed to evaluate recent insights into ICU-AW from several aspects including risk factors,pathophysiology,diagnosis,and treatment strategies;this provides new perspectives for future research.

关键词： intensive care unit-acquired weakness Muscle weakness Muscle atrophy Risk factor Mechanism Treatment

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Attitudes of visitors at adult intensive care unit toward organ donation and organ support

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Chinese Medical Journal 2019年第3期132卷 373-376页

作者： Nga-Wing Tsai Yee-Man Leung Pauline Yeung Ng Ting Liong Sui-Fong Lee Chun-Wai Ngai Wai-Ching Sin Jenny Koo Wai-Ming Chan Adult intensive care unit Queen Mary HospitalHong Kong 999077China intensive care unit United Christian HospitalHong Kong 999077China intensive care unit Kwong Wah HospitalHong Kong 999077China Central Nursing department Queen Mary HospitalHong Kong 999077China

The concept of brain death was 1st introduced in the 1960s, providing an essential conceptual change to medical practice,[1] and its diagnosis is based on demonstrating the complete, irreversible cessation of brainste... 详细信息

关键词： brain death toward organ donation organ support

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Assessing and improving outcome of quality control of integrated in-hospital emergency department and intensive care unit systems:an eight-year survey in Shanghai

Assessing and improving outcome of quality control of integr...

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中华医学会急诊医学分会第十六次全国急诊医学学术年会

作者： wenfang li zhaofen lin department of Emergency and intensive care unit Changzheng Hospital Second Military Medical University

Objectives Evaluating data of quality control in a large cohort of integrated in-hospital emergency department (ED) and intensive care unit(ICU) projects to improve the outcome of rescue on acutely critical patients. ...

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Preventable readmission to intensive care unit in critically ill cancer patients

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World Journal of Emergency Medicine 2018年第3期9卷 211-215页

作者： Hai-jun Wang Yong Gao Shi-ning Qu Chu-lin Huang Hao Zhang Hao Wang Quan-hui Yang Xue-zhong Xing department of intensive care unit National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

BACKGROUND:Readmission to intensive care unit(ICU)after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay(LOS).The objective of this study was to investigate whether ICU readmission are preventable in critically ill cancer patients.METHODS:Data of patients who readmitted to intensive care unit(ICU)at National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences(CAMS)and Peking Union Medical College(PUMC)between January 2013 and November 2016 were retrospectively collected and reviewed.RESULTS:A total of 39 patients were included in the final analysis,and the overall readmission rate between 2013 and 2016 was 1.32%(39/2,961).Of 39 patients,32(82.1%)patients were judged as unpreventable and 7(17.9%)patients were preventable.There were no significant differences in duration of mechanical ventilation,ICU LOS,hospital LOS,ICU mortality and in-hospital mortality between patients who were unpreventable and preventable.For 24 early readmission patients,7(29.2%)patients were preventable and 17(70.8%)patients were unpreventable.Patients who were late readmission were all unpreventable.There was a trend that patients who were preventable had longer 1-year survival compared with patients who were unpreventable(100%vs.66.8%,log rank=1.668,P=0.196).CONCLUSION:Most readmission patients were unpreventable,and all preventable readmissions occurred in early period after discharge to ward.There were no significant differences in short term outcomes and 1-year survival in critically ill cancer patients whose readmissions were preventable or not.

关键词： Readmission Cancer Preventability Outcomes

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Diagnosis and management of malaria in the intensive care unit

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Journal of intensive Medicine 2024年第1期4卷 3-15页

作者： George Akafity Nicholas Kumi Joyce Ashong department of Research Monitoringand EvaluationCape Coast Teaching HospitalCape CoastGhana intensive care unit Department of Critical Care and AnesthesiaCape Coast Teaching HospitalCape Coast department of Paediatrics and Child Health Cape Coast Teaching HospitalCape CoastGhana

Malaria is responsible for approximately three-quarters of a million deaths in humans globally each year.Most of the morbidity and mortality reported are from Sub-Saharan Africa and Asia,where the disease is endemic.In non-endemic areas,malaria is the most common cause of imported infection and is associated with significant mortality despite recent advancements and investments in elimination programs.Severe malaria often requires intensive care unit admission and can be complicated by cerebral malaria,respiratory distress,acute kidney injury,bleeding complications,and co-infection.intensive care management includes prompt diagnosis and early initiation of effective antimalarial therapy,recognition of complications,and appropriate supportive care.However,the lack of diagnostic capacities due to limited advances in equipment,personnel,and infrastructure presents a challenge to the effective diagnosis and management of malaria.This article reviews the clinical classification,diagnosis,and management of malaria as relevant to critical care clinicians,highlighting the role of diagnostic capacity,treatment options,and supportive care.

关键词： Malaria intensive care unit Severe malaria Antimicrobial resistance Antimalarials Artemisinin-based combination therapy

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Severe dengue in the intensive care unit

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Journal of intensive Medicine 2024年第1期4卷 16-33页

作者： Alexandre Mestre Tejo Debora Toshie Hamasaki Letícia Mattos Menezes Yeh-Li Ho intensive care unit Department of Intensive Medicine of the Cancer Institute of the State of São PauloHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil Transfusion Medicine and Cell Therapy department A.C.Camargo Cancer CenterSão PauloBrazil intensive care unit of Infectious Disease department Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil

Dengue fever is considered the most prolific vector-borne disease in the world,with its transmission rate increasing more than eight times in the last two decades.While most cases present mild to moderate symptoms,5%of patients can develop severe disease.Although the mechanisms are yet not fully comprehended,immune-mediated activation leading to excessive cytokine expression is suggested as a cause of the two main findings in critical patients:increased vascular permeability that may shock and thrombocytopenia,and coagulopathy that can induce hemorrhage.The risk factors of severe disease include previous infection by a different serotype,specific genotypes associated with more efficient replication,certain genetic polymorphisms,and comorbidities such as diabetes,obesity,and cardiovascular disease.The World Health Organization recommends careful monitoring and prompt hospitalization of patients with warning signs or propensity for severe disease to reduce mortality.This review aims to update the diagnosis and management of patients with severe dengue in the intensive care unit.

关键词： Severe dengue intensive care units Shock Pathogenesis Diagnosis Management

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Being a Father of a Premature Newborn: The Parental Experience and the Father/Premature Newborn Relationship: A Study Carried out in the department of Neonatology intensive care unit of Mohammed VI University Hospital

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Open Journal of Pediatrics 2024年第2期14卷 412-419页

作者： Hasnae Elhaddadi Sahar Messaoudi Anass Ayyad Rim Amrani department of Neonatology intensive care unit Mohammed VI University Hospital Faculty of Medicine and Pharmacy of Oujda Mohammed First University Oujda Morocco

Introduction: Despite advances in obstetrics and pediatrics over the past 20 years, premature birth remains an unpredictable event that can have a devastating impact on parenthood. This study aimed to analyze the psycho-affective experiences of fathers of premature newborns. Methods: This was a descriptive cross-sectional study, carried out in the department of neonatology and neonatal intensive care unit of the CHU Mohamed VI in OUJDA, over 6 months from March 2022 to August 2022. It focused on 30 fathers of premature newborns hospitalized in our department. Results: The majority of fathers described a state of fear and stress, and attributed their negative experience to the unexpected nature of the premature birth. At the first meeting, half the fathers had a positive image of their newborn’s physical appearance, while 22% of fathers reported feeling uncomfortable about their newborn’s low weight. Most fathers reported that they appreciated the welcome they received, the skill with which they cared for their newborn, and the availability of the pediatrician to provide information on their child’s state of health. Two fathers enjoyed skin-to-skin contact with their newborns. None of the fathers met a psychologist. When they returned home, half the fathers had a positive outlook, marked by happiness at being able to fully invest in their role as fathers, the other half reported being torn between the desire to see their child integrated into the family cocoon and the fear of not being able to manage delicate situations properly without a medical team. Conclusion: Bringing a premature baby into the world can be a difficult experience, leading to the development of even minor psychological distress in some fathers, and hence the need for specific psychological care.

关键词： Prematurity Psychiatrist Emotional Disorder Depression

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Optimal indicator for changing the filter during the continuous renal replacement therapy in intensive care unit patients with acute kidney injury:A crossover randomized trial

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World Journal of Emergency Medicine 2022年第3期13卷 196-201页

作者： Cheng Hang Li-jun Liu Zhao-yun Huang Jian-liang Zhu Bao-chun Zhou Xiao-zhen Li intensive care unit Kunshan Hospital of TCMSuzhou 215300China intensive care unit the Second Affiliated Hospital of Soochow UniversitySuzhou 215004China

BACKGROUND:The study aims to investigate an optimal indicator for changing the filter during the continuous renal replacement therapy(CRRT)in intensive care unit(ICU)patients with acute kidney injury(AKI).METHODS:Patients with AKI requiring CRRT in an ICU were randomly divided into two groups for crossover trial,i.e.,groups A and B.Patients in the group A were firstly treated with continuous veno-venous hemofiltration(CVVH),followed by continuous veno-venous hemodiafiltration(CVVHDF).Patients in the group B were firstly treated with CVVHDF followed by CVVH.Delivered doses of solutes with different molecular weights at the indicated time points between groups were compared.A correlation analysis between the delivered dose and pre-filter pressure(P_(PRE))and transmembrane pressure(P_(TM))was performed.Receiver operating characteristic(ROC)curves were constructed to evaluate the accuracy of P_(TM) as an indicator for filter replacement.RESULTS:A total of 50 cases were analyzed,27 in the group A and 23 in the group B.Delivered doses of different molecular-weight solutes significantly decreased before changing the filter in both modalities,compared with those at the initiation of treatment(all P<0.05).In the late stage of CRRT,the possible rebound of serum medium-molecular-weight solute concentration was observed.P_(TM) was negatively correlated with the delivered dose of medium-molecular-weight solute in both modalities.The threshold for predicting the rebound of serum concentration of medium-molecularweight solute by P_(TM) was 146.5 mm Hg(1 mm Hg=0.133 k Pa).CONCLUSIONS:The filter can be used as long as possible within the manufacturer’s safe use time limits to remove small-molecular-weight solutes.P_(TM) of 146.5 mm Hg may be an optimal indicator for changing the filter in CRRT therapies to remove medium-molecular-weight solutes.

关键词： Acute kidney injury Continuous renal replacement therapy Solute removal efficiency Delivered dose

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