American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Point-of-Care Potassium Measurement vs Artificial Intelligence-Enabled Electrocardiography for Hyperkalemia Detection.
Hyperkalemia can be detected by point-of-care (POC) blood testing and by artificial intelligence- enabled electrocardiography (ECG). These 2 methods of detecting hyperkalemia have not been compared. ⋯ The ECG potassium measurement, with its high sensitivity and coverage rate, may be used initially and followed by POC potassium measurement for rapid detection of life-threatening hyperkalemia.
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Therapeutic activity after stroke is a component of early recovery strategies. Interactive video games have been shown to be safe as an adjunct rehabilitation therapy in the medical intensive care setting, but patients with neurologic disease were often excluded from those protocols. ⋯ In this pilot study, prescriptive interactive video game therapy in early rehabilitation was feasible and safe in the neurosciences critical care setting. Video game therapy may be a valuable complement to existing rehabilitation for critically ill neurologic patients and warrants validation in a larger patient sample.
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Moral distress affects the well-being of health care professionals and can lead to burnout and attrition. Assessing moral distress and taking action based on this assessment are important. A new moral conflict assessment (MCA) designed to prompt action was developed and tested. ⋯ The evaluation revealed positive and negative features of the MCA. Prevention and amelioration of moral distress require attention to cultural, structural, and leadership issues through education and communication.
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Enteral feeding intolerance, a common type of gastrointestinal dysfunction leading to underfeeding, is associated with increased mortality. Tracheal pepsin A, an indicator of microaspiration, was found in 39% of patients within 24 hours of enteral feeding. Tracheal pepsin A is a potential biomarker of enteral feeding intolerance. ⋯ Four predictor variables for tracheal pepsin A (microaspiration) are also reported predictors of enteral feeding intolerance, supporting the exploration of tracheal pepsin A as a potential biomarker of enteral feeding intolerance. Identification of predictor variables using machine learning models may facilitate treatment of patients at risk for enteral feeding intolerance.