Articles: intensive-care-units.
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J Pain Symptom Manage · Mar 2025
Bereaved family quality of life varies with comorbid psychological distress and ICU-care quality.
Health-related quality of life (HRQOL) is highly endorsed, but HRQOL studies scarcely investigate the following: ICU family members; modifiable end-of-life (EOL) ICU-care factors; conjoint associations with prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), and depression; and long-term bereavement outcomes. ⋯ Bereaved family members' HRQOL was significantly associated with PGD-PTSD-depressive-symptom states and QODD classes-both modifiable through high-quality EOL ICU care.
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J Pain Symptom Manage · Mar 2025
Navigating Uncertainty during Family Meetings in the Pediatric Cardiac Intensive Care Unit: A Qualitative Investigation of Team Communication and Family Engagement.
Uncertainty is a known barrier to effective communication during family meetings in the pediatric cardiac intensive care unit (CICU), however, limited data has characterized patterns of communication during these meetings, limiting our ability to make best practice recommendations to clinicians. ⋯ Our results encourage clinicians to communicate uncertainty in an unburied and explicit manner, which may reduce the burden on families to engage in effective communication strategies, such as clarifying and summarizing opaquely stated information.
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Randomized Controlled Trial
Ultrasound guided transcutaneous phrenic nerve stimulation in critically ill patients: a new method to evaluate diaphragmatic function.
Diaphragm dysfunction is common in intensive care unit and associated with weaning failure and mortality. The diagnosis gold standard is the transdiaphragmatic or tracheal pressure induced by magnetic phrenic nerve stimulation. However, the equipment is not commonly available and requires specific technical skills. This study aimed to evaluate ultrasound-guided transcutaneous phrenic nerve stimulation for daily bedside assessment of diaphragm function by targeted electrical phrenic nerve stimulation. ⋯ The SONOTEPS method is a simple and accurate tool for bedside assessment of diaphragm function with ultrasound-guided transcutaneous phrenic nerve stimulation in sedated patients with no or minimal spontaneous respiratory activity.
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Paediatric anaesthesia · Mar 2025
Observational StudyThe Newborn Infant Parasympathetic Evaluation Index for Assessment of Procedural Pain and Discomfort in Mechanically Ventilated Pediatric Intensive Care Patients: A Prospective, Exploratory, Observational Study.
The heart rate variability-based Newborn Infant Parasympathetic Evaluation (NIPE) Index is a continuous noninvasive tool for the assessment of pain and discomfort in infants. Little is known about its performance in the pediatric intensive care unit (PICU) setting, where assessment of pain/discomfort is usually based on discontinuous observational scoring systems or personal experience of medical staff. ⋯ The NIPE detects procedural pain and discomfort in conscious mechanically ventilated infants with an accuracy comparable to established clinical scoring systems. However, because of significant interindividual variability of NIPE values and frequent data recording failure associated with patient movement, we believe it is premature to recommend its use in conscious infants.
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Acta Anaesthesiol Scand · Mar 2025
ReviewFluid accumulation in adult ICU patients - A protocol for a scoping review.
Fluid accumulation in critically ill patients is associated with adverse outcomes. However, there is a substantial variability in the terminology and definitions used to describe fluid accumulation. We aim to provide an overview of evidence describing fluid accumulation in critically ill adult patients admitted to the intensive care unit (ICU), including how it is defined, patient characteristics associated with fluid accumulation, ICU population, and outcomes assessed. ⋯ This scoping review will provide an overview of definitions used for fluid accumulation, and describe ICU patient populations, patient characteristics, and outcomes assessed in ICU research.