Articles: intensive-care-units.
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Minerva anestesiologica · Mar 2023
Burnout in Italian anesthesiologists and intensivists during the COVID-19 pandemic: a national survey.
COVID-19 pandemic added additional burden upon healthcare systems and anesthesiology and intensive care physicians (AI) who possessed crucial expertise for dealing with the pandemic. Aim of the study was to uncover specific burnout patterns among Italian AI, exploring the hypothesis that burnout has a multicluster structure. Differences in social and professional characteristics between burnout patterns were explored. ⋯ These findings highlight different burnout patterns in Italian AI: older age, more professional experience, and work in intensive care units and departments dedicated to COVID-19 seemed to be protective factors during the pandemic. This appears a first step to promote focused interventions.
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Anesthesia and analgesia · Mar 2023
Patient and Operative Factors Predict Risk of Discretionary Prolonged Postoperative Mechanical Ventilation in a Broad Surgical Cohort.
Patients undergoing surgery with general anesthesia and endotracheal intubation are ideally extubated upon case completion, as prolonged postoperative mechanical ventilation (PPMV) has been associated with poor outcomes. However, some patients require PPMV for surgical reasons, such as airway compromise, while others remain intubated at the discretion of the anesthesia provider. Incidence and risk factors for discretionary PPMV (DPPMV) have been described in individual surgical subspecialties and intensive care unit (ICU) populations, but are relatively understudied in a broad surgical cohort. The present study seeks to fill this gap and identify the perioperative risk factors that predict DPPMV. ⋯ DPPMV was uncommon in this broad surgical cohort but could be accurately predicted using readily available patient-specific and operative factors. These results may be useful for preoperative risk stratification, postoperative resource allocation, and clinical trial planning.
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The COVID-19 pandemic has substantially affected health care professionals. Health care professionals have noted increased distress, psychiatric symptoms, and feelings of burnout during this time. Implementation of brief, easy-to-access psychosocial interventions might help health care professionals process stressful events, thus bolstering mental health. One such approach is the narrative expressive writing program, a 5-session cognitive behavioral writing intervention. ⋯ Preliminary data show that narrative expressive writing is an easy-to-access intervention that has the potential to decrease stress and depressive symptoms. Additional research on tailoring or augmenting the narrative expressive writing program may facilitate health care professionals' engagement and address other mental health domains (eg, burnout).
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Intensive care medicine · Mar 2023
Multicenter StudyEpidemiology, clinical presentation, and outcomes of 620 patients with eosinophilia in the intensive care unit.
Although eosinophil-induced manifestations can be life-threatening, studies focusing on the epidemiology and clinical manifestations of eosinophilia in the intensive care unit (ICU) are lacking. ⋯ Eosinophilia ≥ 1 × 109/L is not uncommon in the ICU. According to the timing of eosinophilia, two subsets of patients requiring different etiological workups and management can be distinguished.
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Acta Anaesthesiol Scand · Mar 2023
Factors associated with treatment limitations in two Swedish ICUs - prevalence and patient involvement.
The aim was to study the prevalence, documentation, and patient involvement in treatment limitations (TLs) in two Swedish intensive care units (ICUs). All patients admitted to the ICUs of two Swedish regional hospitals in 2019 were screened for inclusion. Exclusion criteria included postanesthesia care <24 h. ⋯ When the intensivist documented why a TL was established, patient autonomy was four times more commonly stated as the motivation for the TL among women compared to men (15.5% vs. 3.8% p < .05). TLs were common in two Swedish ICUs but a substantial number of patients and next-of-kin were not involved in the decision-making process or informed of the decision. Women were more often than men engaged in the decision to establish a TL.