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Discharging patients home from the intensive care unit:A new trend
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作者 Esraa M Hassan Abbas B Jama +4 位作者 Ahmed Sharaf Asim Shaikh Mohamad El Labban Salim Surani Syed A Khan 《World Journal of Clinical Cases》 SCIE 2024年第23期5313-5319,共7页
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
关键词 intensive care unit Critical care Early discharge Cost effective critical care Patient comfort Early recovery
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Study of the intensive care unit activity scale in the early rehabilitation of patients after direct cardiac surgery
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作者 Li Wang Jing-Ya Lu +1 位作者 Xiao-Xiao Ma Lan-Ou Ma 《World Journal of Clinical Cases》 SCIE 2024年第26期5930-5936,共7页
BACKGROUND Direct cardiac surgery often necessitates intensive post-operative care,and the intensive care unit(ICU)activity scale represents a crucial metric in assessing and guiding early rehabilitation efforts to en... BACKGROUND Direct cardiac surgery often necessitates intensive post-operative care,and the intensive care unit(ICU)activity scale represents a crucial metric in assessing and guiding early rehabilitation efforts to enhance patient recovery.AIM To clarify the clinical application value of the ICU activity scale in the early recovery of patients after cardiac surgery.METHODS One hundred and twenty patients who underwent cardiac surgery between September 2020 and October 2021 were selected and divided into two groups using the random number table method.The observation group was rated using the ICU activity scale and the corresponding graded rehabilitation interventions were conducted based on the ICU activity scale.The control group was assessed in accordance with the routine rehabilitation activities,and the postoperative rehabilitation indexes of the patients in both groups were compared(time of tracheal intubation,time of ICU admission,occurrence of complications,and activity scores before ICU transfer).The two groups were compared according to postoperative rehabilitation indicators(time of tracheal intubation,length of ICU stay,and occurrence of complications)and activity scores before ICU transfer.RESULTS In the observation group,tracheal intubation time lasted for 18.30±3.28 h and ICU admission time was 4.04±0.83 d,which were significantly shorter than the control group(t-values:2.97 and 2.038,respectively,P<0.05).The observation group also had a significantly lower number of complications and adverse events compared to the control group(P<0.05).Before ICU transfer,the observation group(6.7%)had few complications and adverse events than the control group(30.0%),and this difference was statistically significant(P<0.05).Additionally,the activity score was significantly higher in the observation(26.89±0.97)compared to the control groups(22.63±1.12 points)(t-value;-17.83,P<0.05).CONCLUSION Implementation of early goal-directed activities in patients who underwent cardiac surgery using the ICU activity scale can promote the recovery of cardiac function. 展开更多
关键词 Early recovery activities Goal orientated icu mobility scale intensive care unit Cardiac surgery
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Improvement of the nutritional support management system for patients in intensive care units
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作者 Yuan-Yuan Zhang Chun-Yi Wang +5 位作者 Dong-Xian Guo Hai-Nu Gao Xian-Shan Jin Yan-Li Wu Lu-Han Chen Zhi-Xian Feng 《World Journal of Psychiatry》 SCIE 2024年第1期44-52,共9页
BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modi... BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients. 展开更多
关键词 Closed-loop information Psychological counseling intensive care unit patients Nutritional support Management system
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Development and Evaluation of The Implementation of a Preceptorship Program for The Novice ICU Nurse Intensive Care Unit -A Secondary Publication
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作者 Annie Perron Manon Champagne Abir El-Haouly 《Journal of Clinical and Nursing Research》 2024年第3期158-175,共18页
This study focused on the development and evaluation of the implementation of a preceptorship program adapted to ICU practice in the Ab.-T.region to provide preceptors with tools to support novice nurses.This action r... This study focused on the development and evaluation of the implementation of a preceptorship program adapted to ICU practice in the Ab.-T.region to provide preceptors with tools to support novice nurses.This action research was made possible with the involvement of the centers,preceptors,and novice nurses throughout the development and implementation of the program.This approach enabled participants to take ownership of the training content and fully utilize various tools.The program was implemented throughout the CISSS,where this study was subsequently carried out.Several novices mentioned that the program reinforced their sense of security and made them feel more equipped to handle complex care situations.The preceptors said they were better equipped to offer clinical support and novices were better prepared to work in the ICU.It is important to evaluate the development of the novice nurses’skills following their participation in this program and the long-term impact of this preceptorship. 展开更多
关键词 Preceptorship program intensive care unit Novice icu nurses
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Family Care Centre Model Could Decrease Anxiety Level among Family Members of Patients Who Have Been Undergoing in the Intensive Care Unit (ICU)
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作者 Ali Hamzah   Sukarni Achmad Husni 《Open Journal of Nursing》 2017年第1期58-67,共10页
Critical illness/critical condition from any diseases and life-threatening event are the trigger factors of anxiety among family members of patients who are being cared in the intensive care unit. The anxiety is felt ... Critical illness/critical condition from any diseases and life-threatening event are the trigger factors of anxiety among family members of patients who are being cared in the intensive care unit. The anxiety is felt by patient’s family members who undergoes in ICU. It is generally triggered by uncertain patient’s conditions, room conditions, strict visiting time and cost factors. Unfortunately some nurses often fail to give attention to the family in such phenomenon and more focus to the physical patient condition. In that regard, giving attention to the family members of patients who are undergoing hospitalization in the ICU is very important and should be done by nurses by applying the Family Care Center (FCC) model. This study aims to determine the effect of the application of the model of family care center to decrease the anxiety level of family members. The results will be very useful to improve the quality of nursing care, especially in applying the model of the FCC as efforts to redeem any anxiety issues among family members. The method was used to quasi-experimental design with pre and post-test by using the control group. The total of 48 family members of patients who are undergoing hospitalization in the intensive care unit in Dr. Hasan Sadikin Hospital is willing to be used as samples in this study. It was obtained by purposive sampling technique. Data were collected by the Hamilton Anxiety Rating Scale (HARS) and analyzed by univariate analysis using mean and standard deviation, then in the bivariate analysis using paired t-test test and Independent t-test. The results showed that there was significant application of the FCC to decrease family member’s anxiety level in ICU. The conlusion of this study is: FCC can be implemented to reduce anxiety level of family members of patients who are undergoing in the intensive care unit. According to the results, this study suggested to the nurses who are working in the intensive care unit to apply FCC model in reducing anxiety level of families members so that they can use the constructive mechanisms to decrease their anxiety. 展开更多
关键词 Family CENTRE care (FCC) ANXIETY intensive care unit (icu)
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Unplanned intensive care admission leading to an adverse event:Incidence,preventability and feature analysis
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作者 Maria Fuster-Cabré Santiago Ezquerro-Sáenz +2 位作者 Pilar Sánchez-Chueca Antonio Tejada-Artigas Eduardo Esteban-Zubero 《Journal of Acute Disease》 2024年第4期135-141,共7页
Objective:To compare the characteristics of patients between adverse event(AE)group and non-AE group,and to assess the causes,preventability,and severity of AE.Methods:A retrospective triple-phase medical record study... Objective:To compare the characteristics of patients between adverse event(AE)group and non-AE group,and to assess the causes,preventability,and severity of AE.Methods:A retrospective triple-phase medical record study was conducted at a Spanish tertiary hospital.Data was collected over a 6-month period,including all patients with an unplanned intensive care admission.Demographic characteristics,APACHE栻,length of ICU stay,mortality were compare between AE and non-AE group causes,preventability and severity were analyzed in AE cases.Results:597 Patients were included in the study.The overall incidence of AEs was 17.3%(n=103),of which 83.5%were considered preventable.Mortality within the AE group was higher than in the non-AE group(23.3%vs.13.6%),making it 1.7 times more frequent in the AE group(95%CI:1.143-2.071).The primary cause of AE was associated with surgical procedures(43.7%).Of the AEs,18.4%were classified as mild,58.3%as moderate,and 23.3%as severe.Conclusions:The incidence of unplanned intensive care admissions due to AE is high and potentially preventable.This is concerning given the high mortality observed in patients admitted to the intensive care unit because of an AE,although direct causality cannot always be established.The findings emphasize the importance of patient safety and underscore the need for improved quality and management of care resources.They also indicate where efforts should be directed to enhance care risk management. 展开更多
关键词 Adverse effects intensive care unit Patient admission Patient outcome assessment
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Emergence of non-albicans Candida species and antifungal resistance in intensive care unit patients 被引量:1
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作者 Ravinder Kaur Megh Singh Dhakad +1 位作者 Ritu Goyal Rakesh Kumar 《Asian Pacific Journal of Tropical Biomedicine》 SCIE CAS 2016年第5期455-460,共6页
Objective: To evaluate the epidemiology of candidiasis and the antifungal susceptibility profile of Candida species isolated from the intensive care unit(ICU) patients.Methods: The study used a qualitative descriptive... Objective: To evaluate the epidemiology of candidiasis and the antifungal susceptibility profile of Candida species isolated from the intensive care unit(ICU) patients.Methods: The study used a qualitative descriptive design. Relevant samples depending on organ system involvement from 100 ICU patients were collected and processed.Identification and speciation of the isolates was conducted by the biochemical tests.Antifungal susceptibility testing was carried out as per CLSI-M27-A3 document.Results: Ninety Candida isolates were isolated from the different clinical samples: urine(43.3%), tracheal aspirate(31.1%), urinary catheter(12.2%), endotracheal tube(7.8%),abdominal drains(3.3%), sputum(2.2%). The incidence of candidiasis caused by nonalbicans Candida(NAC) species(63.3%) was higher than Candida albicans(36.7%).The various NAC species were isolated as: Candida tropicalis(41.1%), Candida glabrata(10%), Candida parapsilosis(6.7%), Candida krusei(3.3%) and Candida kefyr(2.2%). The overall isolation rate of Candida species from samples was 53.3%. Antifungal susceptibility indicated that 37.8% and 7.8% of the Candida isolates were resistant to fluconazole and amphotericin B, respectively.Conclusions: Predominance of NAC species in ICU patients along with the increasing resistance being recorded to fluconazole which has a major bearing on the morbidity and management of these patients and needs to be further worked upon. 展开更多
关键词 ANTIFUNGAL resistance CANDIDA SPECIES COLONIZATION intensive care unit patients
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Opening the doors of the intensive care unit to cancer patients: A current perspective 被引量:1
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作者 Silvio A ?amendys-Silva Erika P Plata-Menchaca +1 位作者 Eduardo Rivero-Sigarroa Angel Herrera-Gómez 《World Journal of Critical Care Medicine》 2015年第3期159-162,共4页
The introduction of new treatments for cancer and advances in the intensive care of critically ill cancer patients has improved the prognosis and survival. In recent years, the classical intensive care unit(ICU) admis... The introduction of new treatments for cancer and advances in the intensive care of critically ill cancer patients has improved the prognosis and survival. In recent years, the classical intensive care unit(ICU) admission comorbidity criteria used for this group of patients have been discouraged since the risk factors for death that have been studied, mainly the number and severity of organic failures, allow us to understand the determinants of the prognosis inside the ICU. However, the availability of intensive care resources is dissimilar by country, and these differences are known to alter the indications for admission to critical care setting. Three to five days of ICU management is warranted before making a final decision(ICU trial) to consider keep down intensive management of critically ill cancer patients. Nowadays, taking into account only the diagnosis of cancer to consider ICU admission of patients who need full-supporting management is no longer justified. 展开更多
关键词 intensive care unit Critical care setting CANCER patients Critically ILL CANCER patients ORGAN failures
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Cumulative radiation exposure from diagnostic imaging in intensive care unit patients
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作者 Fiachra Moloney Daniel Fama +7 位作者 Maria Twomey Ruth O'Leary Conor Houlihane Kevin P Murphy Siobhan B O'Neill Owen J O'Connor Dorothy Breen Michael M Maher 《World Journal of Radiology》 CAS 2016年第4期419-427,共9页
AIM:To quantify cumulative effective dose of intensive care unit(ICU)patients attributable to diagnostic imaging.METHODS:This was a prospective,interdisciplinary study conducted in the ICU of a large tertiary referral... AIM:To quantify cumulative effective dose of intensive care unit(ICU)patients attributable to diagnostic imaging.METHODS:This was a prospective,interdisciplinary study conducted in the ICU of a large tertiary referral and level 1 trauma center.Demographic and clinical data including age,gender,date of ICU admission,primary reason for ICU admission,APACHE Ⅱ score,length of stay,number of days intubated,date of death or discharge,and re-admission data was collected on all patients admitted over a 1-year period.The overall radiation exposure was quantified by the cumulative effective radiation dose(CED)in millisieverts(mS v)and calculated using reference effective doses published by the United Kingdom National Radiation Protection Board.Pediatric patients were selected for subgroupanalysis.RESULTS:A total of 2737 studies were performedin 421 patients.The total CED was 1704 m Sv with a median CED of 1.5 mS v(IQR 0.04-6.6 mS v).Total CED in pediatric patients was 74.6 mS v with a median CED of 0.07 mS v(IQR 0.01-4.7 mS v).Chest radiography was the most commonly performed examination accounting for 83% of all studies but only 2.7% of total CED.Computed tomography(CT)accounted for 16% of all studies performed and contributed 97% of total CED.Trauma patients received a statistically significant higher dose [median CED 7.7 mS v(IQR 3.5-13.8 mS v)] than medical [median CED 1.4 m Sv(IQR 0.05-5.4 m Sv)] and surgical [median CED 1.6 mS v(IQR 0.04-7.5 mS v)] patients.Length of stay in ICU [OR = 1.12(95%CI:1.079-1.157)] was identified as an independent predictor of receiving a CED greater than 15 mS v.CONCLUSION:Trauma patients and patients with extended ICU admission times are at increased risk of higher CEDs.CED should be minimized where feasible,especially in young patients. 展开更多
关键词 CUMULATIVE effective DOSE PEDIATRIC patients COMPUTED tomography Radiation DOSE intensive care unit
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Relationship between the incidence of non-hepatic hyperammonemia and the prognosis of patients in the intensive care unit
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作者 Zhi-Peng Yao Yue Li +1 位作者 Yang Liu Hong-Liang Wang 《World Journal of Gastroenterology》 SCIE CAS 2020年第45期7222-7231,共10页
BACKGROUND Ammonia is a normal constituent of body fluids and is found mainly through the formation of urea in the liver.Blood levels of ammonia must remain low as even slightly elevated concentrations(hyperammonemia)... BACKGROUND Ammonia is a normal constituent of body fluids and is found mainly through the formation of urea in the liver.Blood levels of ammonia must remain low as even slightly elevated concentrations(hyperammonemia)are toxic to the central nervous system.AIM To examine the relationship between the incidence of non-hepatic hyperammonemia(NHH)and the prognosis of patients who were admitted to the intensive care unit(ICU).METHODS This is a prospective,observational and single-center study.A total of 364 patients who were admitted to the ICU from November 2019 to February 2020 were initially enrolled.Changes in the levels of blood ammonia at the time of ICU admission and after ICU admission were continuously monitored.In addition,factors influencing the prognosis of NHH patients were analyzed.RESULTS A total of 204 patients who met the inclusion criteria were enrolled in this study,including 155 NHH patients and 44 severe-NHH patients.The incidence of NHH and severe-NHH was 75.98% and 21.57%,respectively.Patients with severe-NHH exhibited longer length of ICU stay and higher Acute Physiologic Assessment and Chronic Health Evaluation and Sequential Organ Failure Assessment scores compared to those with mild-NHH and non-NHH.Glasgow Coma Scale scores of patients with severe-NHH were than those of non-NHH patients.In addition,the mean and initial levels of ammonia in the blood might be helpful in predicting the prognosis of NHH.CONCLUSION High blood ammonia level is frequent among NHH patients admitted to the ICU,which is related to the clinical characteristics of patients.Furthermore,the level of blood ammonia may be helpful for prognosis prediction. 展开更多
关键词 Non-hepatic hyperammonemia Intestinal absorption Blood ammonia level Metabolism of amino acid Severe patients intensive care unit
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Mortality Rate and Outcome among Patients Admitted to General Intensive Care Unit during “Morning-Hour” Compared with “Off-Hour”
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作者 Shahram Ala Nasrin Pakravan Motahhare Ahmadi 《International Journal of Clinical Medicine》 2012年第3期171-177,共7页
Aim: This study aim to evaluate the effect of time of admission on mortality of patients admitted to the ICU. Method: This retrospective study included 391 of patients admitted to the ICU of an academic hospital durin... Aim: This study aim to evaluate the effect of time of admission on mortality of patients admitted to the ICU. Method: This retrospective study included 391 of patients admitted to the ICU of an academic hospital during one year. Patients were categorized according to time of admission: working-hours and off-hours. Mortality was compared in the groups and associated factors of mortality were examined. Results: Two third of patients were admitted during off-hours. There was no significant difference in the GCS, age and length of stay among patients admitted during working-hours and off-hours. There was no difference in mortality among patients admitted during working-hours and off-hours Mortality was significantly higher in older and more severe cases, regardless of time of admission. Conclusion: Time of ICU admission does not have significant effect on patient’s outcome. 展开更多
关键词 Critical care intensive care unit icu MORTALITY
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Pain Management and Factors Associated with Its Severity among Post Surgical Patients Admitted in the Intensive Care Unit at Muhimbili National Hospital, Tanzania
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作者 Rebecca Samwel Respicious Boniface 《Open Journal of Anesthesiology》 2019年第2期23-33,共11页
Background: Pain is the common experience among post operative patients admitted to the intensive care unit. Inadequate management can lead to undesired complications which can increase risk for morbidity and mortalit... Background: Pain is the common experience among post operative patients admitted to the intensive care unit. Inadequate management can lead to undesired complications which can increase risk for morbidity and mortality. Objective: The aim of this study was to assess pain management and factors associated with its severity among post surgical patients admitted in intensive care unit at MNH. Method: A prospective study was conducted from October 2017 to February 2018 involving a total of 123 post operative patients aged 18 years and above admitted to the surgical and obstetric intensive care units. Structured questionnaires were used to obtain the required perioperative information. Severity of pain was assessed by using the Numerical Rating Scale (NRS). Data was analyzed using SPSS version 23.0. Frequency, percentages, tables and charts were used to summarize the study findings. Bivariate analysis and multivariate logistic regression were done. P-value of Results: The prevalence of severe post operative pain within 24 and 72 hours was 32.1% and 41.5% respectively. Pre operative use of analgesia (OR: 2.66, CI: 1.15 - 6.12, P value = 0.02), abdominal surgery (OR: 4.12 CI: 1.12 - 15.88, P value = 0.03) and thoracic surgeries (OR;7.42, CI: 1.54 - 35.88, P value = 0.01) was significantly associated with severe pain. Age, sex, ASA class, duration of surgery, and level of education did not show significant association with pain severity. Opioids prescribed postoperatively were pethidine (70.7%), morphine (11.4%) and fentanyl (11.4%). Other analgesics used were paracetamol (60.2%) and diclofenac (22%). Conclusion: The magnitude of post operative pain was high. Pre operative uses of analgesia, abdominal and thoracic surgery were the factors associated with severe pain. Pethidine and paracetamol were the most prescribed drugs, however the prescription pattern used was inadequate to control pain. 展开更多
关键词 POST OPERATIVE PAIN intensive care unit (icu) PAIN SEVERITY Prescription Pattern ANALGESIA
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“Medioglycaemia”: A new concept in glycaemic control in intensive care (ICU) units?
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作者 Victoria H. Tomlinson Jane Langley +1 位作者 Andrew G. Meal Gary G. Adams 《Journal of Diabetes Mellitus》 2012年第4期361-368,共8页
Introduction: Critically ill patients can experience stress-induced hyperglycaemia. Glycaemic control therapy (GCT) is administered to control patients’ blood glycaemic levels and reduce the incidence of infection, m... Introduction: Critically ill patients can experience stress-induced hyperglycaemia. Glycaemic control therapy (GCT) is administered to control patients’ blood glycaemic levels and reduce the incidence of infection, myocardial infarctions and organ failure. However, there are many factors influencing the effectiveness of glycaemic control for patients. This investigation aimed to review the method of Glycaemic Control Therapy (GCT) used in two hospital settings, to assess the effectiveness of glycaemic control on patients’ blood glycaemic levels and examine any barriers that may be in place. Method: A retnrospective audit was carried out on patients’ case notes in Intensive Care Units (ICU) within the East Midlands, UK. This method prevents the study outcomes being swayed because GCT has already taken place. To reduce selection bias the most recent available case notes were selected. All the patients who were admitted to these adult ICU’s between March and April 2010 had their case notes examined, those who were administered GCT were included in the study, this involved 79 from Hospital A and 50 from Hospital B. The patients’ notes were retrospectively audited. Results: Different glycaemic control protocols were being implemented in each hospital, despite both belonging to the same ICU network. In most incidences, regardless of age, diabetes status or diagnosis, patients were administered the same sliding scale insulin (SSI). It was also found that GCT commenced for 41.9% (n = 52) of ICU patients (across both Hospitals) when glycaemic levels were below the established threshold of 10mmol/L. Additionally, a new glycaemic range has been discovered, where 88.3% (n = 113) of patients (across both Hospitals) receiving GCT were not controlled in hypoglycaemia, normoglycaemia or hyperglycaemia. They had mean blood glycaemic levels maintained between 5.6 - 9.9 mmol/L, now being described as medioglycaemia. Conclusions: The majority of patients receiving GCT were controlled in medioglycaemia and therefore a new comprehensive guideline needs to be developed incorporating this new range. Recommendations also need to be established to adapt the titration regimen to individual patients, to improve the effectiveness and safety of glycaemic control. 展开更多
关键词 Glycaemic CONTROL intensive care (icu) unitS Medioglycaemia TIGHT Glycaemic CONTROL
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Intensive care unit readmission in adult Egyptian patients undergoing living donor liver transplant:A single-centre retrospective cohort study
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作者 Manar Salah Iman Fawzy Montasser +9 位作者 Hanaa A El Gendy Alaa A Korraa Gamal M Elewa Hany Dabbous Hossam R Mahfouz Mostafa Abdelrahman Mohammed Hisham Goda Mohamed Mohamed Bahaa El-Din Mahmoud El-Meteini Heba A Labib 《World Journal of Hepatology》 2022年第6期1150-1161,共12页
BACKGROUND Patients who undergo living donor liver transplantation(LDLT)may suffer complications that require intensive care unit(ICU)readmission.AIM To identify the incidence,causes,and outcomes of ICU readmission af... BACKGROUND Patients who undergo living donor liver transplantation(LDLT)may suffer complications that require intensive care unit(ICU)readmission.AIM To identify the incidence,causes,and outcomes of ICU readmission after LDLT.METHODS A retrospective cohort study was conducted on patients who underwent LDLT.The collected data included patient demographics,preoperative characteristics,intraoperative details;postoperative stay,complications,causes of ICU readmission,and outcomes.Patients were divided into two groups according to ICU readmission after hospital discharge.Risk factors for ICU readmission were identified in univariate and multivariate analyses.RESULTS The present study included 299 patients.Thirty-one(10.4%)patients were readmitted to the ICU after discharge.Patients who were readmitted to the ICU were older in age(53.0±5.1 vs 49.4±8.8,P=0.001)and had a significantly higher percentage of women(29%vs 13.4%,P=0.032),diabetics(41.9%vs 24.6%,P=0.039),hypertensives(22.6%vs 6.3%,P=0.006),and renal(6.5%vs 0%,P=0.010)patients as well as a significantly longer initial ICU stay(6 vs 4 d,respectively,P<0.001).Logistic regression analysis revealed that significant independent risk factors for ICU readmission included recipient age(OR=1.048,95%CI=1.005-1.094,P=0.030)and length of initial hospital stay(OR=0.836,95%CI=0.789-0.885,P<0.001).CONCLUSION The identification of high-risk patients(older age and shorter initial hospital stay)before ICU discharge may help provide optimal care and tailor follow-up to reduce the rate of ICU readmission. 展开更多
关键词 intensive care units Liver transplantation Patient readmission Risk factors
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Effect of the Early Introduction of Mild Mobilization Performed by Nurses on the Recovery of Patients in the Intensive Care Unit
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作者 Yuta Mitobe Yu Koyama +11 位作者 Hagiko Aoki Utako Shimizu Yoshiyuki Muramatsu Chikayo Koyama Sayuri Sakai Yuka Iwasa Jun Kikunaga Megumi Taguchi Masakazu Nitta Hiroshi Endoh Masaki Kitajima Shinichiro Morishita 《Open Journal of Nursing》 2016年第12期969-976,共9页
Rationale: Recent studies have reported the effectiveness of the early introduction of rehabilitation for preventing muscle weakness in patients in the intensive care unit (ICU). The early introduction of full-scale r... Rationale: Recent studies have reported the effectiveness of the early introduction of rehabilitation for preventing muscle weakness in patients in the intensive care unit (ICU). The early introduction of full-scale rehabilitation by a physical therapist is difficult in some cases because of disease severity and/or patient conditions. However, mild mobilization by a nurse (MMN), as a part of standard care performed, may have a positive effect on patient recovery. We examined the effect of the early introduction of MMN on the recovery of patients in the ICU. Methods: We retrospectively examined patients admitted to Niigata University Hospital’s ICU during between April 2014 and March 2015 who were receiving mechanical ventilation for 7 days or more. Patients were divided into two groups according to the date of initiation of MMN: group L comprised patients for whom MMN was started after 72 hours and group E comprised patients for whom MMN was started within 72 hours after ICU admission. The data were analyzed using the Fisher test, Mann-Whitney U test, and Wilcoxon test. Statistical significance was defined as P Results: Sixty-three patients were included: 42 patients in group L and 21 in group E. There was no significant difference between the two groups in patients’ background, including the type of illness, steroid use, presence of sepsis or diabetes, and sequential organ failure assessment (SOFA) score on ICU admission;however, the SOFA score at ICU discharge was significantly decreased in group E compared to that in group L (6.21 versus 4.30;P = 0.034). Conclusion: Our results indicate that MMN may reduce disease severity if started within 72 hours after ICU admission. 展开更多
关键词 intensive care unit (icu) NURSE MOBILIZATION Sequential Organ Failure Assessment (SOFA) Score
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Prediction of hospital mortality in intensive care unit patients from clinical and laboratory data: A machine learning approach
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作者 Elena Caires Silveira Soraya Mattos Pretti +3 位作者 Bruna Almeida Santos Caio Fellipe Santos Correa Leonardo Madureira Silva Fabricio Freire de Melo 《World Journal of Critical Care Medicine》 2022年第5期317-329,共13页
BACKGROUND Intensive care unit(ICU)patients demand continuous monitoring of several clinical and laboratory parameters that directly influence their medical progress and the staff’s decision-making.Those data are vit... BACKGROUND Intensive care unit(ICU)patients demand continuous monitoring of several clinical and laboratory parameters that directly influence their medical progress and the staff’s decision-making.Those data are vital in the assistance of these patients,being already used by several scoring systems.In this context,machine learning approaches have been used for medical predictions based on clinical data,which includes patient outcomes.AIM To develop a binary classifier for the outcome of death in ICU patients based on clinical and laboratory parameters,a set formed by 1087 instances and 50 variables from ICU patients admitted to the emergency department was obtained in the“WiDS(Women in Data Science)Datathon 2020:ICU Mortality Prediction”dataset.METHODS For categorical variables,frequencies and risk ratios were calculated.Numerical variables were computed as means and standard deviations and Mann-Whitney U tests were performed.We then divided the data into a training(80%)and test(20%)set.The training set was used to train a predictive model based on the Random Forest algorithm and the test set was used to evaluate the predictive effectiveness of the model.RESULTS A statistically significant association was identified between need for intubation,as well predominant systemic cardiovascular involvement,and hospital death.A number of the numerical variables analyzed(for instance Glasgow Coma Score punctuations,mean arterial pressure,temperature,pH,and lactate,creatinine,albumin and bilirubin values)were also significantly associated with death outcome.The proposed binary Random Forest classifier obtained on the test set(n=218)had an accuracy of 80.28%,sensitivity of 81.82%,specificity of 79.43%,positive predictive value of 73.26%,negative predictive value of 84.85%,F1 score of 0.74,and area under the curve score of 0.85.The predictive variables of the greatest importance were the maximum and minimum lactate values,adding up to a predictive importance of 15.54%.CONCLUSION We demonstrated the efficacy of a Random Forest machine learning algorithm for handling clinical and laboratory data from patients under intensive monitoring.Therefore,we endorse the emerging notion that machine learning has great potential to provide us support to critically question existing methodologies,allowing improvements that reduce mortality. 展开更多
关键词 Hospital mortality Machine learning Patient outcome assessment Routinely collected health data intensive care units Critical care outcomes
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Predictive risk factors for prolonged stay in intensive care unit in patients undergoing coronary artery bypass grafting surgery
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作者 袁忠祥 《外科研究与新技术》 2011年第3期183-184,共2页
Objective To describe the preoperative factors of prolonged intensive care unit length of stay after coronary artery bypass grafting. Methods From 1997 to 2009, 1318 patients underwent isolated CABG in our hospital. R... Objective To describe the preoperative factors of prolonged intensive care unit length of stay after coronary artery bypass grafting. Methods From 1997 to 2009, 1318 patients underwent isolated CABG in our hospital. Retrospective analysis was performed on these cases. Univariate and multivariate analyses 展开更多
关键词 length CABG Predictive risk factors for prolonged stay in intensive care unit in patients undergoing coronary artery bypass grafting surgery LVEF
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Predictive risk factors associated with prolonged stay in the intensive care unit for patients undergoing coronary artery bypass grafting surgery
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作者 杨毅 《外科研究与新技术》 2011年第3期178-178,共1页
Objective The rate of post-operative complications has been increased with the changes in patients’age,prolonged duration,more severe and diffused lesions,and more patients with complications in recent years. We try ... Objective The rate of post-operative complications has been increased with the changes in patients’age,prolonged duration,more severe and diffused lesions,and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit (ICU) after coronary artery bypass graft surgery (CABG) . Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital 展开更多
关键词 CABG Predictive risk factors associated with prolonged stay in the intensive care unit for patients undergoing coronary artery bypass grafting surgery
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广西壮族自治区三级医院ICU有创机械通气病人口腔健康现状及其影响因素
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作者 唐龙 张源慧 +6 位作者 陆翠谊 韦春淞 许勇 梁美娟 周春峰 郑柏芳 韦艳春 《护理研究》 北大核心 2024年第14期2490-2495,共6页
目的:调查广西壮族自治区三级医院重症监护室(ICU)有创机械通气病人口腔健康现状,并分析其影响因素。方法:采用便利抽样法,于2023年7月抽取广西壮族自治区5所三级医院的204例ICU有创机械通气病人为研究对象。采用一般资料问卷、Beck口... 目的:调查广西壮族自治区三级医院重症监护室(ICU)有创机械通气病人口腔健康现状,并分析其影响因素。方法:采用便利抽样法,于2023年7月抽取广西壮族自治区5所三级医院的204例ICU有创机械通气病人为研究对象。采用一般资料问卷、Beck口腔评估量表(BOAS)进行调查。结果:204例ICU有创机械通气病人BOAS评分为(7.79±2.86)分,口腔健康无受损者62例(30.39%)。随机森林模型结果显示,重要性评分较高的前5位变量为机械通气时长、是否使用专用漱口水、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、是否使用牙刷、是否口唇保湿。逐步回归分析结果显示,APACHEⅡ评分、是否使用牙刷、是否使用专用漱口水、是否口唇保湿是ICU有创机械通气病人口腔健康的主要影响因素(P<0.05)。结论:口腔健康受损的ICU有创机械通气病人比例较大,其受多种因素影响,建议采用综合干预措施以促进病人口腔健康。 展开更多
关键词 重症监护室(icu) 有创机械通气 气管插管 口腔健康 影响因素 护理
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ICU护士导尿管相关尿路感染预防知信行现况及影响因素
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作者 张欢 张琦 吕汇颖 《护理研究》 北大核心 2024年第6期1076-1080,共5页
目的:调查重症监护室(ICU)护士导尿管相关尿路感染(CAUTI)预防知信行现况,并分析其影响因素。方法:选取2022年1月在上海交通大学医学院附属第一人民医院ICU工作的临床护士195人作为研究对象,采用一般资料调查表、CAUTI预防培训调查表、C... 目的:调查重症监护室(ICU)护士导尿管相关尿路感染(CAUTI)预防知信行现况,并分析其影响因素。方法:选取2022年1月在上海交通大学医学院附属第一人民医院ICU工作的临床护士195人作为研究对象,采用一般资料调查表、CAUTI预防培训调查表、CAUTI预防知信行量表进行调查。结果:ICU护士在CAUTI知识中留置导尿适应证维度得分为(28.50±3.23)分,知识中CAUTI预防策略维度得分为(58.84±5.34)分,信念维度得分为(24.85±3.52)分,行为维度得分为(21.45±2.59)分;是否参加过培训的情况不同,我院ICU护士的CAUTI预防知识、行为得分不同(P<0.05);科室、工作年限、近3年参加培训的次数不同,我院ICU护士的CAUTI预防知信行得分不同(P<0.05)。结论:我院ICU护士整体的CAUTI预防知信行水平较高,但仍存在不足,医疗机构应扩大培训范围,改变ICU护士的经验性认知,提高ICU护士对于CAUTI的知信行水平。 展开更多
关键词 导尿管相关尿路感染(CAUTI) 知识 信念 行为 重症监护室(icu) 影响因素 护理
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