scholarly journals Actigraphy to Measure Physical Activity in the Intensive Care Unit: A Systematic Review

2019 ◽  
Vol 35 (11) ◽  
pp. 1323-1331 ◽  
Author(s):  
Kristin E. Schwab ◽  
An Q. To ◽  
Jennifer Chang ◽  
Bonnie Ronish ◽  
Dale M. Needham ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Data Extraction ◽  
Adverse Outcomes ◽  
Cochrane Library ◽  
Activity Levels ◽  
Activity Data ◽  
Icu Patients

Objective: In the intensive care unit (ICU), prolonged inactivity is common, increasing patients’ risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting. Data Sources: We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016. Study Selection: Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients. Data Extraction: Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts. Results: Of 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay. Conclusion: Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.

scholarly journals Effect of daily sedation interruption and the patient’s outcome who are under mechanical ventilation: A mini systematic review

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Konstantina Satolia ◽  
Dimitrios Alefragkis
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Length Of Stay ◽  
Total Duration ◽  
Cochrane Library ◽  
Continuous Administration ◽  
Meta Analyses ◽  
Daily Sedation Interruption

Continuous administration of sedatives to the intensive care unit may increase the duration of mechanical ventilation, extend the patient's stay in the intensive care unit, and, subsequently, to the hospital. The objective was to improve the outcome of intubated patients in terms of the total duration of mechanical ventilation, the stay of these patients in the intensive care unit (ICU), and their mortality. This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was conducted in October 2020. Articles were searched in the PubMed and Cochrane Library online databases. Data were extracted from all included research studies and analyzed thematically. The search duration was between 2008 and 2018. The studies do not document statistically significant differences with the parameters under study (total duration of mechanical ventilation, the total length of stay in the intensive care unit (ICU), and mortality), for a better outcome of intubated patients. The application of the daily sedation interruption (DSI) did not appear to affect the duration of Mechanical Ventilation, the length of stay in the ICU, and mortality in intubated patients. Keywords: Daily sedation interruption, intubated patients

scholarly journals Prolonged Central Venous Desaturation Measured by Continuous Oximetry Is Associated with Adverse Outcomes in Pediatric Cardiac Surgery

2011 ◽  
Vol 115 (5) ◽  
pp. 1033-1043 ◽  
Author(s):  
Ryan Crowley ◽  
Elizabeth Sanchez ◽  
Jonathan K. Ho ◽  
Kate J. Lee ◽  
Johanna Schwarzenberger ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Adverse Events ◽  
Clinical Outcomes ◽  
Pediatric Patients ◽  
Adverse Outcomes ◽  
Central Venous ◽  
Major Adverse Events

Background The role of continuous central venous oxygen saturation (ScvO₂) oximetry during pediatric cardiac surgery for predicting adverse outcomes is not known. Using a recently available continuous ScvO₂ oximetry catheter, we examined the association between venous oxygen desaturations and patient outcomes. We hypothesized that central venous oxygen desaturations are associated with adverse clinical outcomes. Methods Fifty-four pediatric patients undergoing cardiac surgery were prospectively enrolled in an unblinded observational study. ScvO₂ was measured continuously in the operating room and for up to 24 h post-Intensive Care Unit admission. The relationships between ScvO₂ desaturations, clinical outcomes, and major adverse events were determined. Results More than 18 min of venous saturations less than 40% were associated with major adverse events with 100% sensitivity and 97.6% specificity. Significant correlations resulted between the ScvO₂ area under the curve less than 40% and creatinine clearance at 12 h in the Intensive Care Unit (r = -0.58), Intensive Care Unit length of stay (r = 0.56), max inotrope use (r = 0.52), inotrope use at 24 h (r = 0.40), inotrope index score (r = 0.39), hospital length of stay (r = 0.36), and length of intubation (r = 0.32). Conclusions We demonstrate that ScvO₂ desaturations by continuous oximetry are associated with major adverse events in pediatric patients undergoing cardiac surgery. The most significant associations with major adverse events are seen in patients with greater than 18 min of central venous saturations less than 40%. Our results support the further investigation of ScvO₂ as a potential target parameter in high-risk pediatric patients to minimize the risk of major adverse events.

Effectiveness of Oral Rinse with Chlorhexidine in Preventing Nosocomial Respiratory Tract Infections among Intensive Care Unit Patients

2009 ◽  
Vol 30 (10) ◽  
pp. 952-958 ◽  
Author(s):  
Fernando Bellissimo-Rodrigues ◽  
Wanessa Teixeira Bellissimo-Rodrigues ◽  
Jaciara Machado Viana ◽  
Gil Cezar Alkmim Teixeira ◽  
Edson Nicolini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Respiratory Tract Infections ◽  
Icu Patients ◽  
Oral Application ◽  
Tract Infections

Objective.To evaluate the effectiveness of the oral application of a 0.12% solution of Chlorhexidine for prevention of respiratory tract infections among intensive care unit (ICU) patients.Design.The study design was a double-blind, randomized, placebo-controlled trial.Setting.The study was performed in an ICU in a tertiary care hospital at a public university.Patients.Study participants comprised 194 patients admitted to the ICU with a prospective length of stay greater than 48 hours, randomized into 2 groups: those who received Chlorhexidine (n = 98) and those who received a placebo (n = 96).Intervention.Oral rinses with Chlorhexidine or a placebo were performed 3 times a day throughout the duration of the patient's stay in the ICU. Clinical data were collected prospectively.Results.Both groups displayed similar baseline clinical features. The overall incidence of respiratory tract infections (RR, 1.0 [95% confidence interval [CI], 0.63-1.60]) and the rates of ventilator-associated pneumonia per 1,000 ventilator-days were similar in both experimental and control groups (22.6 vs 22.3; P = .95). Respiratory tract infection-free survival time (7.8 vs 6.9 days; P = .61), duration of mechanical ventilation (11.1 vs 11.0 days; P = .61), and length of stay (9.7 vs 10.4 days; P = .67) did not differ between the Chlorhexidine and placebo groups. However, patients in the Chlorhexidine group exhibited a larger interval between ICU admission and onset of the first respiratory tract infection (11.3 vs 7.6 days; P = .05). The chances of surviving the ICU stay were similar (RR, 1.08 [95% CI, 0.72-1.63]).Conclusion.Oral application of a 0.12% solution of Chlorhexidine does not prevent respiratory tract infections among ICU patients, although it may retard their onset.

scholarly journals Withdrawal of Life-Sustaining Therapy in Intensive Care Unit Patients Following Out-Of-Hospital Cardiac Arrest: An Australian Metropolitan ICU Experience

2022 ◽  
Author(s):  
Nilesh Anand Devanand ◽  
Mohammed Ishaq Ruknuddeen ◽  
Natalie Soar ◽  
Suzanne Edwards
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Length Of Stay ◽  
Motor Response ◽  
Temperature Management ◽  
Icu Patients ◽  
Icu Length Of Stay ◽  
Clinical Records ◽  
Hospital Cardiac Arrest

Abstract Objective: To determine factors associated with withdrawal of life-sustaining therapy (WLST) in intensive care unit (ICU) patients following out-of-hospital cardiac arrest (OHCA).Methods: A retrospective review of ICU data from patient clinical records following OHCA was conducted from January 2010 to December 2015. Demographic features, cardiac arrest characteristics, clinical attributes and targeted temperature management were compared between patients with and without WLST. We dichotomised WLST into early (ICU length of stay <72 hours) and late (ICU length of stay ≥72 hours). Factors independently associated with WLST were determined by multivariable binary logistic regression using a backward elimination method, and results were depicted as odds ratios (OR) with 95% confidence intervals (CI).Results: The study selection criteria resulted in a cohort of 260 ICU patients post-OHCA, with a mean age of 58 years and the majority were males (178, 68%); 151 patients (58%) died, of which 145 (96%) underwent WLST, with the majority undergoing early WLST (89, 61%). Status myoclonus was the strongest independent factor associated with early WLST (OR 38.90, 95% CI 4.55–332.57; p < 0.001). Glasgow Coma Scale (GCS) motor response of <4 on day 3 post-OHCA was the strongest factor associated with delayed WLST (OR 91.59, 95% CI 11.66–719.18; p < 0.0001).Conclusion: The majority of deaths in ICU patients post-OHCA occurred following early WLST. Status myoclonus and a GCS motor response of <4 on day 3 post-OHCA are independently associated with WLST.

Clinical and Economic Outcomes of Telemedicine Programs in the Intensive Care Unit: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 33 (7) ◽  
pp. 383-393 ◽  
Author(s):  
Jing Chen ◽  
Dalong Sun ◽  
Weiming Yang ◽  
Mingli Liu ◽  
Shufan Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Icu Length Of Stay ◽  
The Impact

Objective: To evaluate the impact of telemedicine programs in intensive care unit (Tele-ICU) on ICU or hospital mortality or ICU or hospital length of stay and to summarize available data on implementation cost of Tele-ICU. Methods: Controlled trails or observational studies assessing outcomes of interest were identified by searching 7 electronic databases from inception to July 2016 and related journals and conference literatures between 2000 and 2016. Two reviewers independently screened searched records, extracted data, and assessed the quality of included studies. Random-effect models were applied to meta-analyses and sensitivity analysis. Results: Nineteen of 1035 records fulfilled the inclusion criteria. The pooled effects demonstrated that Tele-ICU programs were associated with reductions in ICU mortality (15 studies; risk ratio [RR], 0.83; 95% confidence interval [CI], 0.72 to 0.96; P = .01), hospital mortality (13 studies; RR, 0.74; 95% CIs, 0.58 to 0.96; P = .02), and ICU length of stay (9 studies; mean difference [MD], −0.63; 95% CI, −0.28 to 0.17; P = .007). However, there is no significant association between the reduction in hospital length of stay and Tele-ICU programs. Summary data concerning costs suggested approximately US$50 000 to US$100 000 per Tele-ICU bed was required to implement Tele-ICU programs for the first year. Hospital costs of US$2600 reduction to US$5600 increase per patient were estimated using Tele-ICU programs. Conclusions: This systematic review and meta-analysis provided limited evidence that Tele-ICU approaches may reduce the ICU and hospital mortality, shorten the ICU length of stay, but have no significant effect in hospital length of stay. Implementation of Tele-ICU programs substantially costs and its long-term cost-effectiveness is still unclear.

scholarly journals Father's experiences during the stay of the premature baby in the Neonatal Intensive Care Unit (NICU): a systematic review protocol

2021 ◽  
Author(s):  
ZulyKatherine Garnica-Torres ◽  
Greicyani Brarymi Dias ◽  
Janari da Silva Pedroso
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Premature Baby ◽  
Cochrane Library ◽  
Kangaroo Care ◽  
Neonatal Icu ◽  
Father's Experience

Abstract Background: This systematic review aims to understand the father's experience in the neonatal ICU while accompanying his premature baby. Prematurity rates are increasing; every year, millions of parents faced having their premature baby hospitalized in neonatal ICU without being prepared to face this situation. It is relevant to talk about how fathers feel with the experience of being parents of premature babies. The father-baby attachment is affected by prematurity, thus performing the kangaroo care method with the active participation of the father is vital to promote the attachment between the dyad. Method: The authors will include original father-centered research articles, with measurements made in the Intensive Care Unit (ICU). Databases included articles from 2010 to 2020, are APA PsycNet, BVS, Web of Science, PubMed, Scopus, and The Cochrane Library (Cochrane Central Register of Controlled Trials. CENTRAL). Two researchers will extract the data and evaluate the quality of each study through the Newcastle-Ottawa Scale (NOS) and the Critical Appraisal Skills Programme (CASP) and references will be managed in the Mendeley software. This review will not perform a meta-analysis, results will be presented in a qualitative narrative synthesis that includes all the data found.Discussion: This review will contribute to the construction of evidence about the father's experience in the neonatal intensive care unit, as well as how attachment develops between the baby and the father in this field and how the kangaroo care method promotes attachment in this dyad. Ethics and dissemination: This is a protocol for a systematic review, therefore, no approval from an ethics committee is required. We will submit the article to a peer-reviewed health journal, and the results will be published in congresses focused on neonatal, child, and psychological health.PROSPERO registration number: CRD42019142086

scholarly journals Father's Experiences During the Stay of the Premature Baby in the Neonatal Intensive Care Unit (NICU): A Systematic Review Protocol

2020 ◽  
Author(s):  
ZulyKatherine Garnica-Torres ◽  
Greicyani Brarymi Dias ◽  
Janari da Silva Pedroso
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Premature Baby ◽  
Cochrane Library ◽  
Cochrane Central Register ◽  
Kangaroo Care ◽  
Father's Experience

Abstract Background: This systematic review aims to understand the father's experience in the neonatal Intensive Care Unit (NICU) while accompanying his premature baby. Prematurity rates are increasing; every year, millions of parents faced having their premature baby hospitalized in NICU without being prepared to face this situation. It is relevant to talk about how fathers feel with the experience of being parents of premature babies. The father-baby attachment is affected by prematurity, thus performing the kangaroo care method with the active participation of the father is vital to promote the attachment between the dyad. Method: The authors will include original father-centered research articles, with measurements made in the NICU. Databases included articles from 2010 to 2020, are APA PsycNet, BVS, Web of Science, PubMed, Scopus, and The Cochrane Library (Cochrane Central Register of Controlled Trials. CENTRAL). Two researchers will extract the data and evaluate the quality of each study through the Newcastle-Ottawa Scale (NOS) and the Critical Appraisal Skills Programme (CASP) and references will be managed in the Mendeley software. This review will not perform a meta-analysis, results will be presented in a qualitative narrative synthesis that includes all the data found.Discussion: This review will contribute to the construction of evidence about the father's experience in the neonatal intensive care unit, as well as how attachment develops between the baby and the father in this field and how the kangaroo care method promotes attachment in this dyad. Ethics and disseminationThis is a protocol for a systematic review, therefore, no approval from an ethics committee is required. We will submit the article to a peer-reviewed health journal, and the results will be published in congresses focused on neonatal, child, and psychological health.PROSPERO registration number: CRD42019142086

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