Acute and Critical Care

Guideline

Pulmonary
Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines: Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park; Acute Crit Care. 2024;39(1):1-23. Published online February 28, 2024; DOI: https://doi.org/10.4266/acc.2024.00052

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Abstract PDF Supplementary Material: Background
Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. Results: Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusions: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

Review Article

Neurology
Prevention and management of delirium in critically ill adult patients in the intensive care unit: a review based on the 2018 PADIS guidelines: Seung Yong Park, Heung Bum Lee; Acute Crit Care. 2019;34(2):117-125. Published online April 17, 2019; DOI: https://doi.org/10.4266/acc.2019.00451

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40 Web of Science
41 Crossref

Delirium is an acute, confusional state characterized by altered consciousness and a reduced ability to focus, sustain, or shift attention. It is associated with a number of complex underlying medical conditions and can be difficult to recognize. Many critically ill patients (e.g., up to 80% of patients in the intensive care unit [ICU]) experience delirium due to underlying medical or surgical health problems, recent surgical or other invasive procedures, medications, or various noxious stimuli (e.g., underlying psychological stressors, mechanical ventilation, noise, light, patient care interactions, and drug-induced sleep disruption or deprivation). Delirium is associated with a longer duration of mechanical ventilation and ICU admittance as well as an increased risk of death, disability, and long-term cognitive dysfunction. Therefore, the early recognition of delirium is important and ICU medical staff should devote careful attention to both watching for the occurrence of delirium and its prevention and management. This review presents a brief overview of delirium and an update of the literature with reference to the 2018 Society of Critical Care Medicine Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU.

Citations

Citations to this article as recorded by

Precision Anesthesia in 2050
Frederick H. Kuo, Brant H. Tudor, Geoffrey M. Gray, Luis M. Ahumada, Mohamed A. Rehman, Scott C. Watkins
Anesthesia & Analgesia.2024; 138(2): 326. CrossRef
Incidence, characteristics and risk factors of delirium in the intensive care unit: An observational study
Öznur Erbay Dalli, Nermin Kelebek Girgin, Ferda Kahveci
Journal of Clinical Nursing.2023; 32(1-2): 96. CrossRef
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Marlies van Bochove-Waardenburg, Mathieu van der Jagt, Janneke de Man-van Ginkel, Erwin Ista
Intensive and Critical Care Nursing.2023; 76: 103398. CrossRef
Impact of critical care pharmacist‐led interventions on pain, agitation, and delirium in mechanically ventilated adults: A systematic review
Mitchell S. Buckley, Russel J. Roberts, Melanie J. Yerondopoulos, Audrey K. Bushway, Grace C. Korkames, Sandra L. Kane‐Gill
JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY.2023; 6(9): 1041. CrossRef
Delirium in the intensive care unit: a narrative review
Stefania Renzi, Nicola Gitti, Simone Piva
Journal of Gerontology and Geriatrics.2023; 71(1): 22. CrossRef
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Cynthia Daniela Bazán Acevedo, Edgar Fernández Muñoz, Netzahualcóyotl González Pérez, Lilia López Carrillo
Medicina Crítica.2023; 37(1): 35. CrossRef
Effect of using eye masks and earplugs in preventing delirium in intensive care patients: A single‐blinded, randomized, controlled trial
Gülşen Kiliç, Sultan Kav
Nursing in Critical Care.2023; 28(5): 698. CrossRef
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Uludağ Üniversitesi Tıp Fakültesi Dergisi.2023; 49(1): 55. CrossRef
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Efrat Gil, Anna Zisberg, Efrat Shadmi, Nurit Gur-Yaish, Ksenya Shulyaev, Yehudith Chayat, Maayan Agmon
Age and Ageing.2023;[Epub] CrossRef
Optimization of Care for the Elderly Surgical Emergency Patient
Rachel Lynne Warner, Nadia Iwanyshyn, Donald Johnson, David J. Skarupa
Surgical Clinics of North America.2023; 103(6): 1253. CrossRef
Identification and Best Practice Management of Comorbid Geri-Psych Conditions in Critical Care
Noel Koller-Ditto
Critical Care Nursing Clinics of North America.2023; 35(4): 481. CrossRef
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Rongrong Guo, Shan Zhang, Saiying Yu, Xiangyu Li, Xinju Liu, Yanling Shen, Jinling Wei, Ying Wu
International Journal of Nursing Studies.2023; 147: 104582. CrossRef
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Gülmisal Güder, Eva von Rein, Thomas Flohr, Dirk Weismann, Dominik Schmitt, Stefan Störk, Stefan Frantz, Vincent Kratzer, Christian Kendi
Applied Sciences.2023; 13(16): 9319. CrossRef
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Antonious Anis, Ravi Patel, Maged A Tanios
Journal of Intensive Care Medicine.2023;[Epub] CrossRef
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Jinhua He, Ran Duan, Peng Qiu, Huanhuan Zhang, Meng Zhang, Meinv Liu, Xiaoqian Wu, Jianli Li
Journal of Cardiothoracic Surgery.2023;[Epub] CrossRef
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José Miguel Marcos-Vidal, Rafael González, María Merino, Eva Higuera, Cristina García
Journal of Personalized Medicine.2023; 13(12): 1641. CrossRef
Le delirium, un syndrome mal connu
Jean-Pierre Bénézech
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Kristin Salottolo, Richard Meinig, Landon Fine, Michael Kelly, Robert Madayag, Francie Ekengren, Allen Tanner, David Bar-Or
JAAOS: Global Research and Reviews.2022;[Epub] CrossRef
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Cláudia Oliveira, Cátia Filipa Garnacho Martins Nobre, Rita Margarida Dourado Marques, Maria Manuela Madureira Lebre Mendes, Patrícia Cruz Pontífice Sousa
Revista Cuidarte.2022;[Epub] CrossRef
Predictors of sedation period for critical illness patients focusing on early rehabilitation on the bed
Yosuke Morimoto, Tsubasa Watanabe, Masato Oikawa, Masatoshi Hanada, Motohiro Sekino, Tetsuya Hara, Ryo Kozu
Scientific Reports.2022;[Epub] CrossRef
The Age-adjusted Charlson Comorbidity Index predicts post-operative delirium in the elderly following thoracic and abdominal surgery: A prospective observational cohort study
Jing Liu, Jianli Li, Jinhua He, Huanhuan Zhang, Meinv Liu, Junfang Rong
Frontiers in Aging Neuroscience.2022;[Epub] CrossRef
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Szu-Ying Lee, Chieh-Yu Liu, Te-Yu Wu
Healthcare.2022; 10(8): 1538. CrossRef
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Katarzyna Wojnar-Gruszka, Aurelia Sega, Lucyna Płaszewska-Żywko, Stanisław Wojtan, Marcelina Potocka, Maria Kózka
International Journal of Environmental Research and Public Health.2022; 19(17): 10894. CrossRef
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Journal of Korean Critical Care Nursing.2022; 15(3): 37. CrossRef
Complex Hallucinations in Hospitalized Rehabilitation Patients With COVID-19
Mari Tobita, Shan-Pin Fanchiang, Aida Saldivar, Sarah Taylor, Barry Jordan
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Journal of the Neurological Sciences.2021; 420: 117251. CrossRef
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AACN Advanced Critical Care.2021; 32(1): 64. CrossRef
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Yun Li, Lina Zhao, Chenyi Yang, Zhiqiang Yu, Jiannan Song, Qi Zhou, Xizhe Zhang, Jie Gao, Qiang Wang, Haiyun Wang
Frontiers in Neuroscience.2021;[Epub] CrossRef
Delirium and Associated Length of Stay and Costs in Critically Ill Patients
Claudia Dziegielewski, Charlenn Skead, Toros Canturk, Colleen Webber, Shannon M. Fernando, Laura H. Thompson, Madison Foster, Vanja Ristovic, Peter G. Lawlor, Dipayan Chaudhuri, Chintan Dave, Brent Herritt, Shirley H. Bush, Salmaan Kanji, Peter Tanuseputr
Critical Care Research and Practice.2021; 2021: 1. CrossRef
Effects of a simulation‐based education programme on delirium care for critical care nurses: A randomized controlled trial
Mu‐Hsing Ho, Lee‐Fen Yu, Pu‐Hung Lin, Hui‐Chen (Rita) Chang, Victoria Traynor, Wen‐Cheng Huang, Jed Montayre, Kee‐Hsin Chen
Journal of Advanced Nursing.2021; 77(8): 3483. CrossRef
A Note on Common Apathy versus Hypoactive Delirium in Critical Illness
Jan N. M. Schieveld, Jacqueline J. M. H. Strik
American Journal of Respiratory and Critical Care Medicine.2021; 203(7): 921. CrossRef
Effect of Sedatives on In-hospital and Long-term Mortality of Critically Ill Patients Requiring Extended Mechanical Ventilation for ≥ 48 Hours
Hannah Lee, Seongmi Choi, Eun Jin Jang, Juhee Lee, Dalho Kim, Seokha Yoo, Seung-Young Oh, Ho Geol Ryu
Journal of Korean Medical Science.2021;[Epub] CrossRef
Improving delirium detection in intensive care units: Multicomponent education and training program
Liron Sinvani, Cynthia Delle Site, Tara Laumenede, Vidhi Patel, Suzanne Ardito, Anum Ilyas, Craig Hertz, Gisele Wolf‐Klein, Renee Pekmezaris, Negin Hajizadeh, Lily Thomas
Journal of the American Geriatrics Society.2021; 69(11): 3249. CrossRef
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Sandra Lange, Wioletta Mędrzycka-Dąbrowska, Adriano Friganovic, Ber Oomen, Sabina Krupa
International Journal of Environmental Research and Public Health.2021; 18(16): 8809. CrossRef
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Dong Jung Kim, Bongyeon Sohn, Hakju Kim, Hyoung Woo Chang, Jae Hang Lee, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
The Korean Journal of Thoracic and Cardiovascular Surgery.2020; 53(1): 8. CrossRef
INCIDENCIA DE DELIRIO SEGÚN EL REGIMEN DE VISITAS EN UNA UNIDAD DE CUIDADOS INTENSIVOS
Juan Carlos Muñoz Camargo
Enfermería Intensiva.2020; 31(2): 94. CrossRef
Incidence of delirium according to the visiting regime in an intensive care unit
J.C. Muñoz Camargo
Enfermería Intensiva (English ed.).2020; 31(2): 94. CrossRef
The Diagnostic Accuracy of Critical Care Pain Observation Tool (CPOT) in ICU Patients: A Systematic Review and Meta-Analysis
Yue Zhai, Shining Cai, Yuxia Zhang
Journal of Pain and Symptom Management.2020; 60(4): 847. CrossRef
Neurologic Manifestations of Systemic Disease: Sleep Disorders
Eric M. Davis, Chintan Ramani, Mark Quigg
Current Treatment Options in Neurology.2020;[Epub] CrossRef
Delirium
Melissa L.P. Mattison
Annals of Internal Medicine.2020; 173(7): ITC49. CrossRef
Neurological Complications and Noninvasive Multimodal Neuromonitoring in Critically Ill Mechanically Ventilated COVID-19 Patients
Denise Battaglini, Gregorio Santori, Karthikka Chandraptham, Francesca Iannuzzi, Matilde Bastianello, Fabio Tarantino, Lorenzo Ball, Daniele Roberto Giacobbe, Antonio Vena, Matteo Bassetti, Matilde Inglese, Antonio Uccelli, Patricia Rieken Macedo Rocco, N
Frontiers in Neurology.2020;[Epub] CrossRef

Original Article

Medical Residents' Perception and Emotional Stress on Withdrawing Life-Sustaining Therapy: Jae Young Moon, Hee Young Lee, Chae Man Lim, Younsuck Koh; Korean J Crit Care Med. 2012;27(1):16-23.; DOI: https://doi.org/10.4266/kjccm.2012.27.1.16

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Abstract PDF

BACKGROUND
In order to promote the dignity of terminal patients, and improve end-of-life care (EOL care) in Korea, consensus guidelines to the withdrawal of life-sustaining therapies (LST) were published in October, 2009. The aim of this study was to assess the current perception of the guideline among internal medicine residents and to identify barriers to the application of the guidelines.
METHODS
The study was designed prospectively on the basis of data from e-mail survey. We surveyed 98 medical residents working in 19 medical centers.
RESULTS
75.5% of respondents agreed with withdrawing (WD) of LST and 33.3% (33/98) of respondents were unaware of the guideline. Although 58.1% of all respondents had taken an EOL care class in medical school, about 30% of residents did feel uncomfortable with communicating with patients and surrogates. The most important obstacle for decision of WD of LST was the resident's psychological stress. 39.8% of medical residents felt guilty or failure after a patient's death, and 41.8% became often or always depressed in a patient's dying.
CONCLUSIONS
In order to protect and enhance the dignity and autonomy of terminal patients, the improvement of the medical training program in the hospitals and the more concern of educational leaders are urgent.

Citations

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Moral Distress Regarding End-of-Life Care Among Healthcare Personnel in Korean University Hospitals: Features and Differences Between Physicians and Nurses
Eun Kyung Choi, Jiyeon Kang, Hye Youn Park, Yu Jung Kim, Jinui Hong, Shin Hye Yoo, Min Sun Kim, Bhumsuk Keam, Hye Yoon Park
Journal of Korean Medical Science.2023;[Epub] CrossRef
The Effects of South Korean Social Workers' Professional Resources on their Understanding of a Patient's Right to End‐of‐Life Care Decisions in Long‐term Care Facilities
Sooyoun Han
Asian Social Work and Policy Review.2016; 10(2): 200. CrossRef
A Study of Social Workers’ Understanding of Elderly Patients’ and Family Caregivers’ Rights to End-of-Life Care Decisions and of Their Own Roles in the Process
Sooyoun Han
The Korean Journal of Hospice and Palliative Care.2015; 18(1): 42. CrossRef
The Current Status of Medical Decision-Making for Dying Patients in a Medical Intensive Care Unit: A Single-Center Study
Kyunghwa Shin, Jeong Ha Mok, Sang Hee Lee, Eun Jung Kim, Na Ri Seok, Sun Suk Ryu, Myoung Nam Ha, Kwangha Lee
Korean Journal of Critical Care Medicine.2014; 29(3): 160. CrossRef
The End-of-Life Care in the Intensive Care Unit
Jae Young Moon, Yong Sup Shin
Korean Journal of Critical Care Medicine.2013; 28(3): 163. CrossRef

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