Articles: intensive-care-units.
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Critical care nurse · Dec 2022
Trauma-Informed Care: Pediatric Intensive Care Nurses at the Root of Children's Safety and Trust.
Any experience that a child perceives as threatening or detrimental and has long-term consequences for the child's holistic health and welfare qualifies as trauma. Whether an experience is traumatic depends on the 3 E's of trauma: the event, the experience of the event, and the effects. Traumatic events can affect an infant's or child's development and have lifelong repercussions. ⋯ The nurse providing trauma-informed care understands the impact of trauma on the child, the family, and the staff and responds by integrating knowledge about trauma into care, both individually and systemwide, seeking to actively avoid retraumatization. This article presents the 6 principles of trauma-informed care and 3 case examples illustrating the application of these principles in the pediatric intensive care unit. Additional resources are provided to equip critical care nurses to fully implement this standard of care for critically ill children.
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Journal of critical care · Dec 2022
Risk factors for mortality in ICU patients in 10 middle eastern countries: The role of healthcare-associated infections.
The International Nosocomial Infection Control Consortium (INICC) found a high mortality rate in ICUs of the Middle East (ME). Our goal was to identify mortality risk factor (RF) in ICUs of the ME. ⋯ Some identified RF are unlikely to change, such as country income-level, facility ownership, hospitalization type, gender, and age. Some can be modified; LOS, CL-use, MV-use, CLABSI, VAP. So, to lower the mortality risk in ICUs, we recommend focusing on strategies to shorten the LOS, reduce CL and MV-utilization, and use evidence-based recommendations to prevent CLABSI and VAP.
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Background: Severe progression of coronavirus disease 2019 (COVID-19) causes respiratory failure and critical illness. Recently, COVID-19 has been associated with heparanase (HPSE)-induced endothelial barrier dysfunction and inflammation, so called endothelitis, and therapeutic treatment with heparin or low-molecular-weight heparin (LMWH) targeting HPSE has been postulated. Because, up to this date, clinicians are unable to measure the severity of endothelitis, which can lead to multiorgan failure and concomitant death, we investigated plasma levels of HPSE and heparin-binding protein (HBP) in COVID-19 intensive care patients to render a possible link between endothelitis and these plasma parameters. ⋯ Conclusion: Our results demonstrated that patients, who recover from COVID-19-induced vascular and pulmonary damage and were discharged from the intensive care unit, have significantly higher plasma HPSE level than patients who succumb to COVID-19. Therefore, HPSE is not suitable as marker for disease severity in COVID-19 but maybe as marker for patient's recovery. In addition, patients receiving therapeutic heparin treatment displayed significantly lower heparanse plasma level than upon therapeutic treatment with LMWH.
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Relatives of intensive care unit (ICU) survivors may suffer from various symptoms after ICU admittance of their relative, known as post-intensive care syndrome-family (PICS-F). Studies regarding PICS-F have been performed but its impact in primary care is unknown. ⋯ Relatives of ICU survivors present more morbidity in primary care than relatives of chronically ill patients up to five years after ICU discharge.