Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyz...Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare systems.The practice of direct discharge from the ICU presents both opportunities and complexities.While it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support mechanisms.Implementing this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the transition.Through critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal recovery.The insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare processes.Ultimately,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies.展开更多
Perioperative acute lung injury（ALI） is a syndrome characterised by hypoxia and chest radiograph changes.It is a serious post-operative complication,associated with considerable mortality and morbidity.In addition t...Perioperative acute lung injury（ALI） is a syndrome characterised by hypoxia and chest radiograph changes.It is a serious post-operative complication,associated with considerable mortality and morbidity.In addition to mechanical ventilation,remote organ insult could also trigger systemic responses which induce ALI.Currently,there are limited treatment options available beyond conservative respiratory support.However,increasing understanding of the pathophysiology of ALI and the biochemical pathways involved will aid the development of novel treatments and help to improve patient outcome as well as to reduce cost to the health service.In this review we will discuss the epidemiology of peri-operative ALI;the cellular and molecular mechanisms involved on the pathological process;the clinical considerations in preventing and managing perioperative ALI and the potential future treatment options.展开更多
Background Patients with cardiovascular disease（CVD） have a reduced quality of life（QOL） partly due to their limited range of physical activity and independence. The objective of this study was to investigate whet...Background Patients with cardiovascular disease（CVD） have a reduced quality of life（QOL） partly due to their limited range of physical activity and independence. The objective of this study was to investigate whether the nurse based early cardiac rehabilitation will be improved QOL in elderly patients with CVD after8-week treatment from baseline and post intervention, compared with conventional care. Methods Sixty-six elderly patients with CVD were randomly assigned（using the coin tossing method） to either the ‘early cardiac rehabilitation＇ group（i.e. the experimental group）, and the control group（i.e. routine care group） for 8weeks between June 2013 and June 2014, with 33 participants in each group. The control group received routine CVD care, and the experiment group received early rehabilitation care in addition to routine CVD care.The outcome measures included the Short Form-36 Health Survey（SF-36）, and Self-rating Anxiety Scale（SAS）. Results There were non-significant differences between the groups at baseline in age, sex, duration of the disease, length of hospitalization, total number of comorbid conditions, and total number of medications（P 〉 0.05）. Following 8-week treatment, all groups improved their QOL scores and SAS anxiety scores（P 〈 0.05）. In addition, the nursing based on early cardiac rehabilitation group was significantly improved in QOL and SAS anxiety scores（P 〈 0.05）, when compared with the control group. Conclusions This study has demonstrated that the nurse based early cardiac rehabilitation is effective in increasing selected aspects of a general QOL and improved the anxiety situation in elderly patients with CVD. It is worthwhile to be widely used in clinical practice.展开更多
文摘Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare systems.The practice of direct discharge from the ICU presents both opportunities and complexities.While it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support mechanisms.Implementing this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the transition.Through critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal recovery.The insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare processes.Ultimately,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies.
文摘Perioperative acute lung injury（ALI） is a syndrome characterised by hypoxia and chest radiograph changes.It is a serious post-operative complication,associated with considerable mortality and morbidity.In addition to mechanical ventilation,remote organ insult could also trigger systemic responses which induce ALI.Currently,there are limited treatment options available beyond conservative respiratory support.However,increasing understanding of the pathophysiology of ALI and the biochemical pathways involved will aid the development of novel treatments and help to improve patient outcome as well as to reduce cost to the health service.In this review we will discuss the epidemiology of peri-operative ALI;the cellular and molecular mechanisms involved on the pathological process;the clinical considerations in preventing and managing perioperative ALI and the potential future treatment options.
文摘Background Patients with cardiovascular disease（CVD） have a reduced quality of life（QOL） partly due to their limited range of physical activity and independence. The objective of this study was to investigate whether the nurse based early cardiac rehabilitation will be improved QOL in elderly patients with CVD after8-week treatment from baseline and post intervention, compared with conventional care. Methods Sixty-six elderly patients with CVD were randomly assigned（using the coin tossing method） to either the ‘early cardiac rehabilitation＇ group（i.e. the experimental group）, and the control group（i.e. routine care group） for 8weeks between June 2013 and June 2014, with 33 participants in each group. The control group received routine CVD care, and the experiment group received early rehabilitation care in addition to routine CVD care.The outcome measures included the Short Form-36 Health Survey（SF-36）, and Self-rating Anxiety Scale（SAS）. Results There were non-significant differences between the groups at baseline in age, sex, duration of the disease, length of hospitalization, total number of comorbid conditions, and total number of medications（P 〉 0.05）. Following 8-week treatment, all groups improved their QOL scores and SAS anxiety scores（P 〈 0.05）. In addition, the nursing based on early cardiac rehabilitation group was significantly improved in QOL and SAS anxiety scores（P 〈 0.05）, when compared with the control group. Conclusions This study has demonstrated that the nurse based early cardiac rehabilitation is effective in increasing selected aspects of a general QOL and improved the anxiety situation in elderly patients with CVD. It is worthwhile to be widely used in clinical practice.
