共查询到20条相似文献，搜索用时 46 毫秒
1.
JiYeon Choi Jennifer H. Lingler Michael P. Donahoe Mary Beth Happ Leslie A. Hoffman Judith A. Tate 《Heart & lung : the journal of critical care》2018,47(4):401-407
Background
Few studies have longitudinally explored the experience and needs of family caregivers of ICU survivors after patients' home discharge.Methods
Qualitative content analysis of interviews drawn from a parent study that followed family caregivers of adults ICU survivors for 4 months post-ICU discharge.Results
Family caregivers (n = 20, all white, 80% woman) viewed home discharge as positive progress, but reported having insufficient time to transition from family visitor to the active caregiver role. Caregivers expressed feelings of relief during the steady recovery of family members' physical and cognitive function. However, the slow pace of improvement conflicted with their expectations. Even after patients achieved independent physical function, emotional needs persisted and these issues contributed to caregivers' anxiety, worry, and view that recovery was incomplete.Conclusion
Family caregivers of ICU survivors need information and skills to help managing patients' care needs, pacing expectations with actual patients' progress, and caregivers' health needs. 相似文献2.
Glenna Schluck Wei Wu James Whyte Laurie Abbott 《Heart & lung : the journal of critical care》2018,47(5):458-464
Background
Emergency room utilization and hospital readmission rates are disproportionately high for heart failure patients (HF). Emergency department (ED) utilization is intimately intertwined with hospital readmissions.Objective
Describe the arrival time distribution of HF patients presenting to the ED.Method
The study analyzed heart failure discharge data from the Florida State Emergency Department Database and the Florida State Inpatient Database from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. Data were treated as a Poisson process and analyzed using functional data analysis tools.Results
HF arrivals are multi-modal with the largest peak arrival time in the middle of the day as well as a smaller peak in the early morning hours, especially in rural areas.Conclusions
The arrival pattern has minor differences in rural and urban areas. HF clinic appointments should be established in the early morning hours when these patients utilize the ED. 相似文献3.
Kyoungrim Kang Leila Gholizadeh Hae-Ra Han Sally C. Inglis 《Heart & lung : the journal of critical care》2018,47(2):142-148
Background
Experience of myocardial infarction (MI) negatively affects different aspects of health-related quality of life (HRQoL).Objectives
This study aimed to examine trends in HRQoL of MI patients and to identify demographic, clinical and psychosocial predictors of HRQoL at three months.Methods
A total of 150 patients in South Korea were completed the study questionnaires at baseline. After three months from discharge, 136 participants completed follow-up questionnaires, including the Korean version of the MacNew Quality of Life after Myocardial Infarction Questionnaire (MacNew).Results
HRQoL significantly improved over three months. Younger age, ST-elevation MI, and higher LVEF, lower level of depression, better understanding of the illness and higher perceived social support at baseline were associated with better HRQoL at three months.Conclusion
Providing adequate information about the illness and social support as well as reducing negative psychological experiences in early days after MI may improve HRQoL of MI patients. 相似文献4.
James M. Walter Chitaru Kurihara Thomas C. Corbridge Ankit Bharat 《Heart & lung : the journal of critical care》2018,47(4):398-400
Background
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications.Objectives
To provide an example of a common complication, circuit “chugging,” and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS.Methods
We use a clinical case to illustrate chugging and discuss potential management strategies.Results
Our patient received frequent boluses of albumin for intermittent circuit chugging contributing to a net positive fluid balance of roughly 6 liters 4 days after cannulation.Conclusions
Chugging is a common complication for patients on VV ECMO. A thoughtful approach to management may help limit potentially harmful fluid administration for patients with ARDS. 相似文献5.
Claire J. Tipping Anne E. Holland Meg Harrold Tom Crawford Nick Halliburton Carol L. Hodgson 《Heart & lung : the journal of critical care》2018,47(5):497-501
Background
The intensive care unit mobility scale (IMS) is reliable, valid and responsive. Establishing the minimal important difference (MID) of the IMS is important in order to detect clinically significant changes in mobilization.Objective
To calculate the MID of the IMS in intensive care unit patients.Methods
Prospective multi center observational study. The IMS was collected from admission and discharge physiotherapy assessments. To calculate the MID we used; anchor based methods (global rating of change) and two distribution-based methods (standard error of the mean and effect size).Results
We enrolled 184 adult patients; mean age 62.0 years, surgical, trauma, and medical. Anchor based methods gave a MID of 3 with area under the curve 0.94 (95% CI 0.89-0.97). The two distribution based methods gave a MID between 0.89 and 1.40.Conclusion
These data increase our understanding of the clinimetric properties of the IMS, improving its utility for clinical practice and research. 相似文献6.
Jemima Boyd Jenny Paratz Oystein Tronstad Lawrence Caruana Paul McCormack James Walsh 《Heart & lung : the journal of critical care》2018,47(2):81-86
Rationale
Consensus recommendations have been developed to guide exercise rehabilitation of mechanically ventilated patients in the intensive care unit.Objective
This study aimed to investigate the safety of exercise rehabilitation of mechanically ventilated patients and evaluate the consensus recommendations.Methods
This was a prospective, single-centre, cohort study conducted in a specialist cardiothoracic intensive care unit of a tertiary, university affiliated hospital in Australia.Results
91 mechanically ventilated participants; 54 (59.3%) male; mean age of 56.52 (16.3) years; were studied with 809 occasions of service recorded. Ten (0.0182%) minor adverse events were recorded, with only one adverse event occurring when a patient was receiving moderate level of vasoactive support.Conclusions
The consensus recommendations are a useful tool in guiding safe exercise rehabilitation of mechanically ventilated patients. Our findings suggest that there is further scope to safely commence exercise rehabilitation in patients receiving vasoactive support. 相似文献7.
Robyn Gallagher Sue Randall Stella H.M. Lin Janice Smith Alexander M. Clark Lis Neubeck 《Heart & lung : the journal of critical care》2018,47(5):471-476
Background
The mechanisms contributing to the success of cardiac rehabilitation (CR) are poorly understood and may include assessment, monitoring and review activities enabled by continuity of care and this is investigated in this study.Objectives
To identify active assessment components of CR.Methods
A qualitative study using focus groups and individual interviews. CR staff (n = 39) were recruited via professional association email and network contacts and organised into major themes.Results
CR staff assessment strategies and timely actions undertaken provided a sophisticated post-discharge safety net for patients. Continuity of care enabled detection of adverse health indicators, of which medication issues were prominent. Interventions were timely and personalised and therefore likely to impact outcomes, but seldom documented or reported and thus invisible to audit.Conclusion
CR staff assessment and intervention activities provide an unrecognised safety net of activities enabled by continuity of care, potentially contributing to the effectiveness of CR. 相似文献8.
Jungeun Lee Huong Q. Nguyen Monica E. Jarrett Pamela H. Mitchell Kenneth C. Pike Vincent S. Fan 《Heart & lung : the journal of critical care》2018,47(2):149-156
Background
Chronic obstructive pulmonary disease (COPD) patients experience multiple symptoms including dyspnea, anxiety, depression, and fatigue, which are highly correlated with each other. Together, those symptoms may contribute to impaired physical performance.Objectives
The purpose of this study was to examine interrelationships among dyspnea, anxiety, depressive symptoms, and fatigue as contributing factors to physical performance in COPD.Methods
This study used baseline data of 282 COPD patients from a longitudinal observational study to explore the relationship between depression, inflammation, and functional status. Data analyses included confirmatory factor analyses and structural equation modeling.Results
Dyspnea, anxiety and depression had direct effects on fatigue, and both dyspnea and anxiety had direct effects on physical performance. Higher levels of dyspnea were significantly associated with impaired physical performance whereas higher levels of anxiety were significantly associated with enhanced physical performance.Conclusion
Dyspnea was the strongest predictor of impaired physical performance in patients with COPD. 相似文献9.
Chunhua Ma 《Heart & lung : the journal of critical care》2018,47(2):136-141
Objectives
To explore whether five variables of the health belief model were factors influencing self-care behaviors in young and middle-aged adults with hypertension.Background
The self-care behaviors of young and middle-aged adults with hypertension are suboptimal in China, and the factors associated with self-care behaviors have rarely been studied in the population.Methods
A questionnaire survey was adopted in the study. 382 eligible participants were recruited from two tertiary teaching hospitals using the convenience sampling.Results
The predictors of self-care behaviors in young and middle-aged adults with hypertension included age, complications related to hypertension, perceived susceptibility, severity, benefits, barriers and self-efficacy. Five aspects of health beliefs model accounted for 47.0% of total variance.Conclusions
The perceived susceptibility, severity, benefits, barriers, and self-efficacy were key factors affecting self-care behaviors in young and middle-aged adults with hypertension. A health education program targeting improving health beliefs for the population should be developed. 相似文献10.
Bülent Özlek Eda Özlek Oğuzhan Çelik Cem Çil Volkan Doğan Murat Biteker 《Heart & lung : the journal of critical care》2018,47(4):360-362
Background
Allergic myocardial infarction is a rare clinical entity.Objectives
Although a few number of case reports with severe anaphylactic reactions to recombinant human insulin have been reported, allergic myocardial infarction, known as Kounis Syndrome, has not been reported before.Methods
Herein, we report a 57-year-old woman with myocardial infarction, referred for urticarial rash, chest pain, and palpitations developed after the first subcutaneous dose of recombinant human insulin.Results
The patient treated with antihistamines and steroids and discharged from hospital in a good condition.Conclusions
Physicians should be aware of allergic myocardial infarction. The diagnosis of Kounis Syndrome should be entertained when allergic symptoms, electrocardiographic changes, and high cardiac enzymes accompany acute-onset chest pain. All patients admitted to the emergency department with chest pain and ST elevation on electrocardiography should be asked about allergic insults. 相似文献11.
Connie Schumacher Leslie Hussey Vincent Hall 《Heart & lung : the journal of critical care》2018,47(4):297-303
Objective
To explore the decision making processes undertaken by community-dwelling individuals with heart failure as they experience symptom changes.Background
Heart failure patients are responsible for daily self-management that includes responding to symptom fluctuations between exacerbations. Despite education, some patients fail to seek timely medical intervention when symptoms change.Methods
Semi-structured interviews were conducted with homecare patients after receiving self-management education. Grounded theory methods and qualitative software were used to collect and analyze the data.Results
Five themes were identified: perceiving symptoms, alleviating actions and control, normalizing symptoms, absence of help seeking behaviors, and decreased functional capacity. Normalizing symptoms included actions taken by participants to mitigate symptom fluctuations. Daily fluctuations were assimilated into normal life resulting in desensitization of symptom recognition and decreased functional capacity.Conclusions
Findings support the need to educate on early symptom recognition, the benefits of safe physical activity, and building a system to support self-management patient-physician collaboration. 相似文献12.
Gbolahan O. Ogunbayo Le Dung Ha Qamar Ahmad Naoki Misumida Ayman Elbadawi Odunayo Olorunfemi Andrew Kolodziej Adrian W. Messerli Ahmed Abdel-Latif Claude S. Elayi Maya Guglin 《Heart & lung : the journal of critical care》2018,47(4):392-397
Introduction
This study compared inpatient outcomes related to the use of these two devices among patients who developed cardiogenic shock not due to acute myocardial infarction or coronary revascularization.Methods
We extracted admission-level records of patients with a diagnosis of cardiogenic shock who underwent either PVAD or IABP implantation from the National Inpatient Sample (NIS) database from 2010 to 2014. Our outcomes of interest were mortality and length of stay.Results
Inpatient mortality was significantly higher in the PVAD cohort. In multivariate analysis, PVAD use in these patients was associated with higher mortality. There was no difference in the length of stay between both groups among patients that survived to discharge.Conclusion
In our analysis of the NIS database, the use of PVADs in patients with cardiogenic shock of non-ischemic origin was associated with higher mortality when compared to IABP use. 相似文献13.
Sikandar H. Khan Michelle Kitsis Dmitriy Golovyan Sophia Wang Linda L. Chlan Malaz Boustani Babar A. Khan 《Heart & lung : the journal of critical care》2018,47(5):489-496
Background
Music listening has been shown to reduce anxiety, stress, and patient tolerance of procedures. Music may also have beneficial effects on inflammatory biomarkers in intensive care and post-operative patients, but the quality of evidence is not clear.Objectives
We conducted a systematic review to evaluate the effects of music on inflammatory biomarkers in intensive care, and post-operative patients.Methods
A comprehensive search of the literature was performed. After screening 1570 references, full text review of 26 studies was performed. Fourteen studies were selected for inclusion.Results
Seven studies showed a significant decrease in cortisol levels, but the level of evidence was low. Three studies had low risk of methodological bias, while 11 studies had high risk of bias.Conclusions
Music intervention may decrease cortisol levels, but other biomarkers remain unchanged. Given the low level of evidence, further research on music effects on inflammatory biomarkers is needed. 相似文献14.
Benjamin Marchandot François Levy Nicola Santelmo Paul-Michel Mertes Olivier Morel 《Heart & lung : the journal of critical care》2018,47(3):248-249
Background
Adequate strategies using either transthoracic (TTE) or transesophageal (TEE) echocardiography in patients receiving cardiopulmonary resuscitation (CPR) is an ongoing area of research.Objectives
As transthoracic point-of-care ultrasound (POCUS) during cardiac arrest resuscitation might result in an increased duration of interruptions in the delivery of chest compressions; the use of TEE has been proposed as an alternative.Methods
No technical complications of either TTE nor TEE are so far being reported in the literature.Results
We report the case of a left intramural atrial hematoma complicating TEE procedure during cardiac arrest. This highlights a unique and to our knowledge, first-in-man, described complicating TEE procedure during CPR.Conclusions
Further research on the safety of transesophageal echo during CRP is mandatory and the question about any potential harm of particular interest. 相似文献15.
Li Liu Xiuhua Wang Xi Cao Can Gu Chen Yang Yu OuYang 《Heart & lung : the journal of critical care》2018,47(3):216-221
Background
Existing theory and evidence suggest that self-care confidence may mediate the relationship between Type D personality and self-care adherence.Objectives
To assess the mediating role of self-care confidence between Type D personality and self-care adherence in Chinese HF patients.Methods
This is a secondary analysis of a cross-sectional study. Self-care confidence and self-care adherence (maintenance) were measured by the subscales of the Self-Care of Heart Failure Index (v6). The Type D Scale-14 was administered to assess negative affect (NA), social inhibition (SI), and Type D personality. Mediation analysis based on Baron and Kenny was performed.Results
A total of 127 HF patients were included. Self-care confidence partially mediated the relationship between Type D personality and self-care adherence but completely mediated the relationship between NA/SI and self-care adherence.Conclusions
Clinicians may effectively improve self-care adherence by enhancing self-care confidence in HF patients with Type D personality. 相似文献16.
Jengyuan Wu Chienming Liu Shangsen Lee Yuhung Kuo Tengfu Hsieh 《Heart & lung : the journal of critical care》2018,47(2):157-161
Background
Patients with thoracic empyema have an increased risk of mortality, but their absolute rate of mortality depends on age and comorbidities.Objective
This study seeks to assess the predictive value of the Charlson Comorbidity Index score (CCIS), CHADS2 and CHA2DS2-VASc scores for mortality risk in patients with empyema thoracis.Methods
From Taiwan's National Health Insurance Research Database we identified a total of 484 participants diagnosed with thoracic empyema. The CCIS, CHADS2 and CHA2DS2-VASc scores were used to stratify mortality risk.Results
The incidence rate of mortality in the present study was 20.39 per 1000 person-months. A strong correlation was found between thoracic empyema and CCIS score.Conclusions
Our results show that patients with thoracic empyema have a significantly high incidence rate of mortality and that CCIS can be used as an indicator of risk for mortality. 相似文献17.
Sim Leng Ooi Betsy Seah Vivien Xi Wu Karen Wei Ling Koh Nana Jiao Hong-Gu He Wenru Wang 《Heart & lung : the journal of critical care》2018,47(4):329-336
Background
Despite the increasing use of implantable cardioverter defibrillators (ICDs) as a preventive approach for high-risk patients with arrhythmias, little is known about the perceptions of ICD recipients regarding these devices and their impact on quality of life.Objectives
To explore perceptions towards quality of life, coping strategies, and learning needs of patients living with ICDs in Singapore.Methods
16 participants (age ranges 52 to 84 years old) were purposively recruited and interviewed individually for this exploratory qualitative study. Data collected was analyzed using thematic analysis.Results
Seven themes emerged: experiencing ICD shocks, ambivalent “love-hate” relationship with ICD, receiving support from healthcare professionals and social networks, attaining acceptance and returning to normalcy, physical coping, emotional coping, and readiness and need for enhanced patient education.Conclusions
With an insight to the perceptions of ICD recipients in Singapore, future practice can focus on addressing their concerns and improve post-implantation quality of life. 相似文献18.
Eamon P. Raith Joshua F. Ihle Jennifer Jamieson Anna Kalff Julian Bosco 《Heart & lung : the journal of critical care》2018,47(4):425-428
Background
Idiopathic capillary leak syndrome (Clarkson's Disease) is a rare angiopathy with a heterogenous phenotype that may present as distributive shock refractory to resuscitative management.Objective
We report a case of idiopathic systemic capillary leak syndrome presenting as septic shock.Methods
Structured case report and review of the literature.Results
A 27-year old man admitted to our institution with coryzal symptoms rapidly deteriorated with presumed sepsis, leading to intensive care unit admission. Following further deterioration, Idiopathic systemic capillary leak syndrome was considered and intravenous immunoglobulin administered, resulting in rapid improvement in the patient's clinical status.Conclusions
Idiopathic systemic capillary leak syndrome is a rare and potentially life-threatening angiopathy that may present as, and should be considered in, refractory distributive shock. Administration of intravenous immunglobulin resulted in rapid recovery in this patient, and has been associated with positive outcomes in previous cases. 相似文献19.
Chunhua Ma Wei Zhou Qiubo Tang Shuling Huang 《Heart & lung : the journal of critical care》2018,47(4):337-344
Objectives
To test the effects of group-based Tai chi on health-status outcomes among older adults with hypertension.Background
A high-quality study exploring the effects of Tai chi on physical and psychosocial health for older adults with hypertension is needed in China. The long-term effects of group-based Tai chi in Chinese older adults with hypertension remain unclear.Methods
A randomized controlled trial was conducted. The group-based Tai chi training and practice were implemented in older adults over six-month.Results
The Tai chi (TC) group showed significantly lower blood pressure and body mass index than the usual care (UC) group. The TC group participants showed greater improvements in social support, quality of life, and reduction in depressive symptoms over a six-month intervention than UC group. TC group showed significant group-by-time interactions in these variables.Conclusion
Group-based Tai chi is effective in the enhancement of health-status outcomes for older Chinese adults with hypertension. 相似文献20.
Jayne Rosenberger Susan McCrudden Carol McCullough Lu Wang Joni Kime Nancy M. Albert 《Heart & lung : the journal of critical care》2018,47(2):100-106