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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 *** patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep *** situation has garnered significant attention within the medical *** To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU *** One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)*** 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 *** 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 *** Patient satisfaction in the observation group was significantly higher than in the control *** 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 *** 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 *** 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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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 *** include the need for prolonged mechanical ventilation and ICU stay;higher ICU,in-hospital,and 1-year mortality;and increased in-hospital ***-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 *** pathological mechanism of ICUAW remains unclear and may be considerably *** 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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Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

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World Journal of Clinical Cases 2024年第7期12卷 1235-1242页

作者： Ling Wang Deng-Yan Long Intensive care unit People's Hospital of Qiandongnan Miao and Dong Autonomous PrefectureKaili 556000Guizhou ProvinceChina

BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse ***,there is a lack of effective preventive *** To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and *** Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU *** data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were *** relationships between these variables and ICU-AW were *** iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic *** Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW ***,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical *** most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechani

关键词： Intensive care unit-acquired weakness Risk factors Machine learning Prevention Strategies

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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 *** of the morbidity and mortality reported are from Sub-Saharan Africa and Asia,where the disease is *** 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 *** malaria often requires intensive care unit admission and can be complicated by cerebral malaria,respiratory distress,acute kidney injury,bleeding complications,and *** care management includes prompt diagnosis and early initiation of effective antimalarial therapy,recognition of complications,and appropriate supportive ***,the lack of diagnostic capacities due to limited advances in equipment,personnel,and infrastructure presents a challenge to the effective diagnosis and management of *** 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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Extracorporeal membrane oxygenation as a bridging therapy for patients with thiamine deficiency-induced pulmonary arterial hypertension

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World Journal of Emergency Medicine 2024年第2期15卷 147-149页

作者： Fangfang Qiu Weixing Dai Tengyue Huang Min Li Department of Intensive care unit the Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu 322000China Department of Intensive care unit the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve *** deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 *** clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.

关键词： vitamin hypertension arterial

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Prediction of mechanical ventilation outcome by early abdominal-visceral-blood-flow-and-function score in critically ill patients after cardiopulmonary bypass in the ICU: A prospective observational study

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Journal of Intensive Medicine 2024年第1期4卷 101-107页

作者： Chaofu Yue Longxiang Su Jun Wang Na Cui Yuankai Zhou Wei Cheng Bo Tang Xi Rui Huaiwu He Yun Long Department of Intensive care unit Peking Union Medical College HospitalBeijingChina Department of Intensive care unit Qujing First People’s HospitalQujingYunnanChina Department of Intensive care unit Shiyan People’s Hospital of Bao’an DistrictShenzhenGuangdongChina

Background:Abdominal organs are important organs that sense and respond to ischemia and hypoxia,but there are few evaluation *** use ultrasonography to evaluate abdominal organ function and blood flow in patients with mechanical ventilation(MV)after cardiopulmonary bypass and to obtain a semiquantitative score for abdominal organ function and blood ***:Patients with cardiopulmonary bypass in the Critical care Department of Peking Union Medical College Hospital in China from March to July 2021 were enrolled in this prospective observational *** correlation of the abdominal-visceral-blood-flow-and-function score(AVBFS)with the duration of MV,number of days spent in the intensive care unit(ICU),acute physiology and chronic health evaluation II(APACHE-II),sequential organ failure assessment(SOFA),lactate,epinephrine,and norepinephrine use was analyzed,and the results were used to assess the predictive value of the receiver operating characteristic curve(ROC)regression analysis score for the duration of ***:Of the 92 patients who underwent cardiopulmonary bypass,41 were finally *** AVBFS were significantly correlated with the duration of MV,number of days spent in the ICU,APACHE-II score,SOFA score,and norepinephrine use *** AVBFS in a group of patients using ventilators≥36 h were significantly higher than those obtained for a group of patients using ventilators<36 h(P<0.05).The evaluation results for the AVBFS at 0-12 h after ICU admission were as follows:area under the ROC curve(AUC)=0.876(95%confidence interval[CI]:0.767 to 0.984),cut-off value=2.5,specificity=0.842,and sensitivity=***:Abdominal visceral organ function and blood perfusion can be used to evaluate gastrointestinal *** is related to early and late extubation after cardiac surgery.

关键词： Ultrasonic evaluation Abdominal-visceral-blood-flow-and-function score(AVBFS) Gastrointestinal dysfunction Mechanical ventilation Cardiopulmonary bypass

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A retrospective analysis of carbapenem-resistant Acinetobacter baumannii infections in critically ill patients:Experience at a tertiary-care teaching hospital ICU

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Journal of Intensive Medicine 2024年第2期4卷 181-186页

作者： Leyla Ferlicolak Neriman Defne Altintas Fugen Yoruk Department of Internal Medicine Division of Intensive care unit Ankara University Faculty of MedicineAnkaraTurkey Department of Infectious Diseases and Clinical Microbiology Ankara University Faculty of MedicineAnkaraTurkey

Background Acinetobacter baumannii is a clinically significant pathogen with a high incidence of multidrug resistance that is associated with life-threatening nosocomial ***,we aimed to provide an insight into the clinical characteristics and outcomes of a unique group of *** infections in which the isolates were resistant to carbapenems and most other antibiotic groups in a tertiary-care intensive care unit(ICU).Methods We performed a retrospective observational study in which records of patients hospitalized in the ICU between June 1,2021 and June 1,2023 were *** checked the clinical,laboratory,and microbiological records of all adult patients who had carbapenem-resistant ***(CRAB)*** antibiotic treatments and definitive antibiotic treatments after culture positivity and susceptibility test results were recorded.C-reactive protein(CRP)and procalcitonin levels and leukocyte counts were *** of ICU stay and 30-day mortality were defined as the outcome *** During the study period,57 patients were diagnosed with CRAB *** respiratory tract was the leading infection site(80.7%).In non-survivors,bloodstream infections(21.9%vs.4.0%P=0.05)and colistin-resistant(col-R)CRAB infections(43.8%vs.24.0%,P=0.12)were more common than in survivors,but these parameters were not statistically *** length of ICU stay was not different between survivors and ***,the rate of col-R among CRAB clinical isolates was 35.1%.The 30-day mortality in all patients with CRAB infection was 56.1%.Mortality in col-R CRAB and colistin-susceptible(col-S)CRAB infections was 70.0%and 48.6%,respectively(P=0.12).Prior carbapenem use was 56.1%.Prior colistin use before col-R and col-S CRAB infections was not significant(35.0%vs.27.0%,P=0.53).Conclusions Our study provides real-world data on highly resistant *** infections and shares the characteristics of infections with such resistant stra

关键词： Mortality Colistin-resi stant Gram-negative bacteria MDR Intensive care unit

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The 6-hour lactate clearance rate in predicting 30-day mortality in cardiogenic shock

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Journal of Intensive Medicine 2024年第3期4卷 393-399页

作者： Junfeng Wang Mingxia Ji Department of Intensive care unit Yiwu Central HospitalYiwuZhejiangChina

Background Early evaluation of prognosis in cardiogenic shock(CS)is crucial for tailored treatment *** lactate clearance and lactate levels are considered useful prognostic biomarkers in patients with ***,there is yet no literature comparing the 6-hour lactate clearance rate(Δ6Lac)with lactate levels measured at admission(L1)and after 6 h(L2)to predict 30-day mortality in *** In this observational cohort study,95 patients with CS were treated at Department of Intensive care unit,Yiwu Central Hospital between January 2020 and December *** these,88 patients met the eligibility *** lactate levels were measured after admission(L1)as the baseline lactate value,and were measured after 6 h(L2)following *** primary endpoint of the study was survival rate at 30 days.A receiver operating characteristic curve was used for data *** and multivariate Cox regression analyses were performed based onΔ***–Meier(KM)survival curves were generated to compare the 30-day survival rates among L1,L2,andΔ*** TheΔ6Lac model showed the highest area under the curve value(0.839),followed by the L2(0.805)and L1(0.668)***Δ6Lac model showed a sensitivity of 84.2%and specificity of 75.4%.The L1 and L2 models had sensitivities of 57.9%each and specificities of 89.9%and 98.6%,*** cut-off values forΔ6Lac,L1,and L2 were 18.2%,6.7 mmol/L,and 6.1 mmol/L,*** Cox regression analysis revealed a significant association betweenΔ6Lac and 30-day *** adjusting for five models in multivariate Cox regression,Δ6Lac remained a significant risk factor for 30-day mortality in patients with *** our fifth multivariate Cox regression model,Δ6Lac remained a risk factor associated with 30-day mortality(hazard ratio[HR]=5.14,95%confidence interval[CI]:1.48 to 17.89,P=0.010)as well as L2(HR=8.42,95%CI:1.26 to 56.22,P=0.028).The KM survival curve analysis revealed that L1>6.7 mmol/L(HR=8.08,95%

关键词： Lactates The 6-h lactate clearance rate Cardiogenic shock Mortality Cox regression

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Implementation of gastrointestinal function protection in severe acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 521-522页

作者： Fu-Zheng Tao Rong-Lin Jiang Shui-Fang Jin Intensive care unit Taizhou Integrated Traditional Chinese and Western Medicine HospitalTaizhou 310075China Intensive care unit the First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Hangzhou 310006China

Severe acute pancreatitis(SAP)is a serious systemic disease associated with strong local inflammatory reactions and serious systemic pathophysiological disorders caused by trypsin *** with SAP are prone to exhibit gastrointestinal ***,gastrointestinal dysfunction further aggravates the systemic inflammatory response and metabolic abnormalities,resulting in a more critical condition of *** dysfunction is considered to be the“trigger”of multiple organ dysfunction syndrome[1].Thus,it is important to maintain gastrointestinal homeostasis in the treatment of SAP.

关键词： gastrointestinal pancreatitis acute

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Predictive performance of the variation rate of the driving pressure on the outcome of invasive mechanical ventilation in patients with acute respiratory distress syndrome

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Chinese Journal of Traumatology 2024年第2期27卷 107-113页

作者： Hui-Dan Jing Jun-Ying Tian Wei Li Bing-Ling He Hong-Chao Li Fu-Xia Jian Cui Shang Feng Shen Department of Intensive care unit The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550004China Department of Intensive care unit Army Medical Center of PLAChongqing400042China College of Foreign Languges Chongqing Medical UniversityChongqing400016China

Purpose:To assess the value of the driving pressure variation rate(ΔP%)in predicting the outcome of weaning from invasive mechanical ventilation in patients with acute respiratory distress ***:In this case-control study,a total of 35 patients with moderate-severe acute respiratory distress syndrome were admitted to the intensive care unit between January 2022 and December 2022 and received invasive mechanical ventilation for at least 48 h were *** were divided into successful weaning group and failed weaning group depending on whether they could be removed from ventilator support within 14 *** measures including driving pressure,PaO2:FiO2,and positive end-expiratory pressure,*** assessed every 24 h from day 0 to day 14 until successful weaning was *** measurement data of non-normal distribution were presented as median(Q1,Q3),and the differences between groups were compared by Wilcoxon rank sum *** categorical data use the Chi-square test or Fisher's exact test to *** predictive value ofΔP%in predicting the outcome of weaning from the ventilator was analyzed using receiver operating characteristic ***:Of the total 35 patients included in the study,17 were successful vs.18 failed in weaning from a ventilator after 14 days of mechanical *** cut-off values of the medianΔP%measured by Operator 1 *** 2 in the first 4 days were≥4.17%and 4.55%,respectively(p<0.001),with the area under curve of 0.804(sensitivity of 88.2%,specificity of 64.7%)and 0.770(sensitivity of 88.2%,specificity of 64.7%),*** was a significant difference in mechanical ventilation duration between the successful weaning group and the failure weaning group(8(6,13)vs.12(7.5,17.3),p=0.043).The incidence of ventilator-associated pneumonia in the successful weaning group was significantly lower than in the failed weaning group(0.2‰vs.2.3‰,p=0.001).There was a significant difference noted between these

关键词： Driving pressure Driving pressure variation rate Acute respiratory distress syndrome Mechanical ventilation

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