Articles: intensive-care-units.
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Randomized Controlled Trial Multicenter Study
Effect of an intensive care unit virtual reality intervention on relatives´ mental health distress: a multicenter, randomized controlled trial.
Relatives of intensive care unit (ICU) patients often endure symptoms of post-traumatic stress, anxiety, and depression during and after treatment of a family member's hospitalization. The aim of this study was to evaluate the effect of ICU-specific virtual reality (ICU-VR) on mental health among relatives, 6 months after patient's ICU discharge. ⋯ ICU-VR did not significantly improve mental health distress symptoms among relatives 6-months after a patient's discharge. Relatives highly endorsed ICU-VR and self-reported that it improved their understanding of ICU treatment.
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Patients in the neurological intensive care unit (ICU) are at an increased risk of venous thromboembolism (VTE). Anticoagulation is often indicated because deep venous thrombosis (DVT) can develop into pulmonary embolism (PE). However, anticoagulation also increases the risk of intracranial bleeding. Physicians must weigh the opposing risks carefully. It is commonly believed that upper extremity DVT (UEDVT) is less likely to develop into PE as compared to lower extremity DVT (LEDVT), but this lacks evidence, and our study investigates its validity. ⋯ In this sample of neurocritical care patients, the coexistence of DVT and PE did not differ in patients with upper versus lower extremity DVT. This should be considered in the neurocritical care unit when deciding whether to treat patients with DVT with anticoagulants.
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A single-center retrospective study was designed to investigate the risk factors associated with delayed discharge from the Anesthesia Intensive Care Unit (AICU). ⋯ The incidence of delayed discharge from the AICU in a single-center tertiary hospital is 1.54%. It is influenced by various risk factors, including age, ASA physical status classification, BMI, preoperative complications, type of surgery and intraoperative blood loss. The nomogram model exhibits excellent performance.
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Passive leg raising (PLR) is a well-recognized method for assessing volume responsiveness in the intensive care unit (ICU); however, it has some limitations. The physiology of the cardiac preload induced by the Trendelenburg position and PLR is similar. The Trendelenburg position can be initiated from the supine position and then tilted downward (TRENDSUPINE) or from the reverse Trendelenburg position and then tilted further downward (TRENDrTREND). Therefore, this study aimed to compare the predictive performance of the percentage change in stroke volume index (ΔSVI) induced by TRENDSUPINE, TRENDrTREND, and PLR for volume responsiveness in mechanically ventilated patients in the ICU. ⋯ The Trendelenburg position (TRENDSUPINE and TRENDrTREND)-induced and PLR-induced percentage changes in SVI were similar in their ability to predict volume responsiveness in mechanically ventilated patients in the ICU. Considering that TRENDrTREND induced greater percentage changes in SVI, it is preferentially recommended as a reasonable alternative to PLR for predicting volume responsiveness in certain clinical scenarios.