scholarly journals Nursing Interventions For Prevention of Corneal Injury: A Protocol For A Systematic Review

2021 ◽  
Author(s):  
Patrícia Rezende do Prado ◽  
Renata Cristina Campos Pereira Silveira ◽  
Mario Vianna Vettore ◽  
Mariann Fossum ◽  
Grete Lund Vabo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Intervention Studies ◽  
Nursing Interventions ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Corneal Injury ◽  
Study Selection ◽  
Ventilated Patients

Abstract Background: Critically ill patients are vulnerable to corneal injury and the incidence of this adverse event remains high in these patients. Randomized clinical trials have been assessing different types of interventions, hindering nurses' clinical practice for the prevention of corneal injury in critically ill patients. The aim of this systematic review is to identify the most effective nursing interventions to prevent corneal injury in critically ill sedated and mechanically ventilated patients.Methods: A systematic review of intervention studies will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses 2020, in the following electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Central, Embase, Latin American and Caribbean Literature in Health Sciences, Livivo, PubMed, Scopus and Web of Science. The search of the grey literature will be undertaken on Google Scholar. No language or year of publication restrictions will be applied for the selection of primary studies. Study selection and data extraction will be performed by two independent reviewers who will screen the titles and abstracts of the retrieved papers to assess the studies for inclusion. Disagreements between reviewers, during study selection, will be resolved by discussion with a third reviewer. The inclusion criteria will be epidemiologic intervention studies evaluating nursing interventions to prevent or decrease the occurrence of corneal injury in critically ill sedated and mechanically ventilated patients. Methodological quality of the studies will be assessed using the Risk of Bias and Robins-2 tools. Quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation system. Discussion: this study has a potencial to identify the most effective nursing interventions for prevention corneal injury in critically ill sedated and mechanically ventilated patients.Systematic review registration: The protocol of this research is approved in PROSPERO under protocol No. 253289.

CUIDADOS BUCAIS EM PACIENTES VENTILADOS MECANICAMENTE: CONHECIMENTO DE ENFERMEIROS DE UM HOSPITAL ESCOLA

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Gérsica Sampaio Silva ◽  
Fernanda Alves Ferreira Gonçalves ◽  
Bárbara Ribeiro Miquelin Bueno ◽  
Georlucya Kátia Da Silva Ferreira ◽  
Ludmila Pinheiro Da Silva ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Oral Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Complicating Factors ◽  
Materials Used ◽  
Ventilated Patients

Objetivo: Avaliar o conhecimento acerca dos cuidados bucais realizados por enfermeiros a pacientes ventilados mecanicamente. Método: Estudo transversal, realizado em um hospital escola de Goiânia/Goiás. A coleta de dados deu-se por meio de questionário estruturado. Resultados: Os enfermeiros conhecem as medidas recomendadas sobre higiene bucal. Os fatores dificultadores encontrados foram a falta de pessoal (21,7%), falta de tempo (16,7%) e trabalhos burocráticos (15%). Contudo ainda existem lacunas no que se refere a produtos e materiais utilizados na higiene bucal. Conclusão: As Lacunas e os fatores dificultadores sinalizados nesse estudo merecem reflexão, como forma de avaliar a qualidade do cuidado oferecido.Descritores: Biofilme; Higiene Bucal; Cuidados de enfermagem.ORAL CARE IN MECHANICALLY VENTILATED PATIENTS: KNOWLEDGE OF NURSES FROM A SCHOOL HOSPITALObjective: To evaluate the knowledge about oral care performed by nurses in mechanically ventilated patients. Methods: a cross-sectional study, conducted in a teaching hospital of Goiania/Goias. The data collection was performed by means of a structured questionnaire. Results: The nurses know the measures recommended on oral hygiene. The complicating factors found were the lack of personnel (21.7%), lack of time (16.7%) and work on tape (15%). However there are still gaps in relation to products and materials used in oral hygiene. Conclusion: The gaps and the factors complicating factors indicated in this study deserve consideration, as a means of evaluating the quality of care offered.Keywords: Biofilm; Oral hygiene; Nursing care.CUIDADO ORAL EN PACIENTES CON VENTILACIÓN MECÁNICA: EL CONOCIMIENTO DE LAS ENFERMERAS DEL HOSPITAL ESCUELAObjetivo: Evaluar el conocimiento sobre el cuidado bucal realizadas por enfermeras en pacientes ventilados mecánicamente. Métodos: Estudio transversal, realizado en un hospital de Goiania y Goias. La recolección de datos se realizó por medio de un cuestionario estructurado. Resultados: Las enfermeras saben las medidas recomendadas en la higiene bucal. Los factores encontrados fueron la falta de personal (21,7%), la falta de tiempo (16,7%) y trabajar en la cinta (15%). Sin embargo todavía hay lagunas en relación con los productos y los materiales utilizados en la higiene bucal. Conclusión: Las brechas y los factores factores indicados en este estudio merecen consideración, como medio de evaluar la calidad de la atención ofrecida.Palabras clave: Biofilme; Higiene Bucal; Atención de Enfermería.

scholarly journals Selection strategy for sedation depth in critically ill patients on mechanical ventilation

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
Longxiang Su ◽  
Chun Liu ◽  
Fengxiang Chang ◽  
Bo Tang ◽  
Lin Han ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Dimensionality Reduction ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Latent Profile Analysis ◽  
Profile Analysis ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Sedation And Analgesia ◽  
Ventilated Patients

Abstract Background Analgesia and sedation therapy are commonly used for critically ill patients, especially mechanically ventilated patients. From the initial nonsedation programs to deep sedation and then to on-demand sedation, the understanding of sedation therapy continues to deepen. However, according to different patient’s condition, understanding the individual patient’s depth of sedation needs remains unclear. Methods The public open source critical illness database Medical Information Mart for Intensive Care III was used in this study. Latent profile analysis was used as a clustering method to classify mechanically ventilated patients based on 36 variables. Principal component analysis dimensionality reduction was used to select the most influential variables. The ROC curve was used to evaluate the classification accuracy of the model. Results Based on 36 characteristic variables, we divided patients undergoing mechanical ventilation and sedation and analgesia into two categories with different mortality rates, then further reduced the dimensionality of the data and obtained the 9 variables that had the greatest impact on classification, most of which were ventilator parameters. According to the Richmond-ASS scores, the two phenotypes of patients had different degrees of sedation and analgesia, and the corresponding ventilator parameters were also significantly different. We divided the validation cohort into three different levels of sedation, revealing that patients with high ventilator conditions needed a deeper level of sedation, while patients with low ventilator conditions required reduction in the depth of sedation as soon as possible to promote recovery and avoid reinjury. Conclusion Through latent profile analysis and dimensionality reduction, we divided patients treated with mechanical ventilation and sedation and analgesia into two categories with different mortalities and obtained 9 variables that had the greatest impact on classification, which revealed that the depth of sedation was limited by the condition of the respiratory system.

SuPAR and PAI-1 in critically ill, mechanically ventilated patients

2012 ◽  
Vol 39 (3) ◽  
pp. 489-496 ◽  
Author(s):  
Ville Jalkanen ◽  
◽  
Runkuan Yang ◽  
Rita Linko ◽  
Heini Huhtala ◽  
...  
Keyword(s):  
Critically Ill ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Pai 1 ◽  
Ventilated Patients

scholarly journals The ethical concerns of seeking consent from critically ill, mechanically ventilated patients for research – A matter of possessing capacity or surrogate insight

2018 ◽  
Vol 13 (3) ◽  
pp. 107-111 ◽  
Author(s):  
Avelino C Verceles ◽  
Waqas Bhatti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Informed Consent ◽  
Critically Ill ◽  
Ethical Issues ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ethical Concerns ◽  
Multiple Factors ◽  
Ventilated Patients

Conducting clinical research on subjects admitted to intensive care units is challenging, as they frequently lack the capacity to provide informed consent due to multiple factors including intensive care unit acquired delirium, coma, the need for sedation, or underlying critical illness. However, the presence of one or more of these characteristics does not automatically designate a potential subject as lacking capacity to provide their own informed consent. We review the ethical issues involved in obtaining informed consent for medical research from mechanically ventilated, critically ill patients, in addition to the concerns that may arise when a legally authorized representative is asked to provide informed consent on behalf of these patients.

The Feasibility of Objective Sleep-Quality Assessment in an ICU Setting

2021 ◽  
Vol 104 (2) ◽  
pp. 304-309
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Sleep Quality ◽  
Acute Respiratory Failure ◽  
Critically Ill ◽  
Sleep Stages ◽  
Poor Sleep ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Background: Sleep disruptions frequently occur in hospitalized patients, especially with critically ill, mechanically ventilated patients. Severely altered sleep architectures result in unclassifiable sleep stages as listed by the conventional Rechtschaffen and Kales (R&K) criteria, and a new classification for sleep scoring including atypical sleep (AS) and pathological wakefulness (PW) has recently been proposed. Objective: To demonstrate the feasibility of performing objective sleep qualification in patients receiving mechanical ventilation due to acute respiratory failure. Materials and Methods: In the present prospective cohort study, polysomnography was performed in 38 patients requiring invasive mechanical ventilation due to acute respiratory failure at the respiratory care unit (RCU) of Siriraj Hospital between February and December 2017. Their sleep stages were analyzed by conventional rules and the new classifications of AS and PW. The associations between the presence of AS or PW and the patients’ characteristics were analyzed. Correlations between sleep quality and clinical parameters were also determined. Results: Most of the patients had poor sleep quality with median sleep efficiency (IQR) of 35.9% (18.5, 62.3) and significantly decreased slowwave sleep [median (IQR) 0.4% (0.00, 5.70)] and REM [median (IQR) 1.3% (0.00, 6.43)]. According to the new classifications, 14 out of 38 (prevalence of 36.8%) mechanically ventilated patients had AS. The prevalence of PW and either AS or PW were 36.8% and 52.6%, respectively. A higher baseline respiratory rate was observed among patients who had either AS or PW at 24 versus 20 breaths/minute (p=0.02), while a longer duration of mechanical ventilator support was found in patients with PW at nine versus five (p=0.003). Patient-ventilator asynchrony was also noted in all patients. Conclusion: Sleep quality among critically ill and mechanically ventilated patients was severely disturbed. A higher prevalence of AS and PW were noted. The technical feasibility of sleep recording in Thai intensive care unit (ICU) settings was established. Keywords: Polysomnography, Atypical sleep, ICU

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