Acute and Critical Care

Original Articles

Nursing
Quality of life among patients with supraventricular tachycardia post radiofrequency cardiac ablation in Jordan: Mohammad Tayseer Al- Betar, Rami Masa'deh, Shaher H. Hamaideh, Fatma Refaat Ahmed, Hajar Bakkali, Mohannad Eid AbuRuz; Acute Crit Care. 2023;38(3):333-342. Published online August 30, 2023; DOI: https://doi.org/10.4266/acc.2023.00052

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Abstract PDF: Background
Supraventricular tachycardia (SVT) is a common arrhythmia with associated symptoms such as palpitation, dizziness, and fatigue. It significantly affects patients’ quality of life (QoL). Radiofrequency cardiac ablation (RFCA) is a highly effective treatment to eliminate arrhythmia and improve patients’ QoL. The purpose of this study was to assess the level of QoL among patients with SVT and examine the difference in QoL before and after RFCA.
Methods
One group pre-posttest design with a convenience sample of 112 patients was used. QoL was assessed by 36-Item Short Form (SF-36). Data were collected at admission through face-to-face interviews and 1-month post-discharge through phone interviews.
Results
There was a significant difference between QoL before (33.7±17.0) and 1 month after (62.5±18.5) the RFCA. Post-RFCA patients diagnosed with atrioventricular nodal reentrant tachycardia had higher QoL than other types of SVT. Moreover, there were significant negative relationships between QoL and the number and duration of episodes pre- and post-RFCA. There were no significant differences in QoL based on: age, sex, working status, marital status, smoking, coronary artery disease, diabetes mellitus, and hypertension.
Conclusions
After RFCA, the QoL of patients with ST improved for both physical and mental component subscales.

Neurology
Muscle Growth and Anabolism in Intensive Care Survivors (GAINS) trial: a pilot randomised controlled trial: Matthew H Anstey, Rashmi Rauniyar, Ethan Fitzclarence, Natalie Tran, Emma Osnain, Bianca Mammana, Angela Jacques, Robert N Palmer, Andrew Chapman, Bradley Wibrow; Acute Crit Care. 2022;37(3):295-302. Published online June 27, 2022; DOI: https://doi.org/10.4266/acc.2021.01767

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Abstract PDF Supplementary Material: Background
To explore the feasibility, safety, and potential benefits of administration of the anabolic steroid nandrolone to patients in the recovery phase from critical illness weakness.
Methods
In this phase II, double blind, randomized, controlled trial, adult critically ill patients admitted to one of two tertiary Intensive Care Units in Western Australia for longer than 7 days with significant weakness were enrolled. Patients received nandrolone (200 mg males, 100 mg females) intramuscularly or placebo weekly for up to 3 weeks in addition to standard care. The primary outcome measures were improvement in grip strength, Medical Research Council muscle strength sum score, and functional activity level (Chelsea critical care assessment tool [CPAx]).
Results
A total of 22 patients was enrolled between September 2017 and May 2019. No significant adverse events were detected. Median grip strength change was non-significantly greater in the nandrolone group (8.5 vs. 13.0, P=0.185), while hospital length of stay (36 vs. 26 days, P=0.023) and duration of mechanical ventilation (377 vs. 168, P=0.032) were lower. The discharge CPAx and intensive care unit mobility scores were higher in the nandrolone group, although there was no difference in the change in CPAx score (17.0 vs. 17.7, P=0.865). There were no changes in ultrasound-detected muscle thickness between the two groups.
Conclusions
In patients with prolonged critical illness, nandrolone appears to be safe. However, a larger study, potentially combined with resistance exercise, is needed to definitively address the potential benefits of nandrolone.

Ethics
The quality of dying and death for patients in intensive care units: a single center pilot study: Yanghwan Choi, Myoungrin Park, Da Hyun Kang, Jooseon Lee, Jae Young Moon, Heejoon Ahn; Acute Crit Care. 2019;34(3):192-201. Published online April 8, 2019; DOI: https://doi.org/10.4266/acc.2018.00374

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10 Web of Science
9 Crossref

Abstract PDF Supplementary Material

Background
To identify the necessary care for dying patients in intensive care units (ICUs), we designed a retrospective study to evaluate the quality of dying and death (QODD) experienced by the surrogates of patients with medical illness who died in the ICU of a tertiary referral hospital.
Methods
To achieve our objective, the authors compared the QODD scores as appraised by the relatives of patients who died of cancer under hospice care with those who died in the ICU. For this study, a Korean version of the QODD questionnaire was developed, and individual interviews were also conducted.
Results
Sixteen people from the intensive care group and 23 people from the hospice care group participated in the survey and completed the questionnaire. The family members of patients who died in the ICU declined participation at a high rate (50%), with the primary reason being to avoid bringing back painful memories (14 people, 87.5%). The relatives of the intensive care group obtained an average total score on the 17-item QODD questionnaire, which was significantly lower than that of the relatives of the hospice group (48.7±15.5 vs. 60.3±14.8, P=0.03).
Conclusions
This work implies that there are unmet needs for the care of dying patients and for the QODD in tertiary hospital ICUs. This result suggests that shared decision making for advance care planning should be encouraged and that education on caring for dying patients should be provided to healthcare professionals to improve the QODD in Korean ICUs.

Citations

Citations to this article as recorded by

Recent Trends in the Withdrawal of Life-Sustaining Treatment in Patients with Acute Cerebrovascular Disease : 2017–2021
Seung Hwan Kim, Ji Hwan Jang, Young Zoon Kim, Kyu Hong Kim, Taek Min Nam
Journal of Korean Neurosurgical Society.2024; 67(1): 73. CrossRef
Family Members’ Feedback on the “Quality of Death” of Adult Patients Who Died in Intensive Care Units and the Factors Affecting the Death Quality: A Systematic Review and Meta-Analysis
Kazuaki Naya, Hideaki Sakuramoto, Gen Aikawa, Akira Ouchi, Shun Yoshihara, Yuma Ota, Saiko Okamoto, Ayako Fukushima, Haruyoshi Hirashima
Cureus.2024;[Epub] CrossRef
Factors associated with the quality of dying and death and missed nursing care
Shahin Gahramani, Mokhtar Mahmoudi, Nouri, Sina Valiee
International Journal of Palliative Nursing.2024; 30(4): 190. CrossRef
Quality of dying and death in intensive care units: family satisfaction
Fur-Hsing Wen, Ming Chu Chiang, Chung-Chi Huang, Tsung-Hui Hu, Wen-Chi Chou, Li-Pang Chuang, Siew Tzuh Tang
BMJ Supportive & Palliative Care.2023; 13(e3): e1217. CrossRef
Development of an End-of-Life Nursing Care Protocol for Intensive Care Units
Jungeun Kim, Hye Young Yun, Euni Ji Kim, Hyunsook Kim, Geon Ah Kim, Sung Ha Kim, Jayoung Koo, Ju Youn Park, Aisoon Park, Eugene Han, So Yeon Kim, Jihye Jeong, Sanghee Kim
Journal of Hospice & Palliative Nursing.2022; 24(4): E159. CrossRef
Nurses’ perceptions of barriers and supportive behaviors in end-of-life care in the intensive care unit: a cross-sectional study
Dan-dan Xu, Dan Luo, Jie Chen, Ji-li Zeng, Xiao-lin Cheng, Jin Li, Juan-juan Pei, Fen Hu
BMC Palliative Care.2022;[Epub] CrossRef
The Quality of Dying and Death of Advanced Cancer Patients in Palliative Care and Its Association With Place of Death and Quality of Care
Daniel Gutiérrez-Sánchez, Rafael Gómez-García, María Luisa Martín Roselló, Antonio I. Cuesta-Vargas
Journal of Hospice & Palliative Nursing.2021; 23(3): 264. CrossRef
The Role of Anesthesiologists in Perioperative Limitation of Potentially Life-Sustaining Medical Treatments: A Narrative Review and Perspective
Tera Cushman, David B. Waisel, Miriam M. Treggiari
Anesthesia & Analgesia.2021; 133(3): 663. CrossRef
Decision-Making Processes in Surrogates of Cancer Patients in a Taiwan Intensive Care Unit
Wan-Na Sun, Hsin-Tien Hsu, Nai-Ying Ko, Yu-Tung Huang
International Journal of Environmental Research and Public Health.2020; 17(12): 4443. CrossRef

A Study on the Health-related Quality of Life after ICU Care: Min Young Kim, Yong Kyung Lee, Seo Rim Park, In Soon Hwang, Sook Ja Lee, Cheung Soo Shin; Korean J Crit Care Med. 2005;20(2):144-151.

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Abstract PDF: BACKGROUND
This study was designed to analyze the influences of ICU patients' experiences in the ICU setting and the effect of ICU patient families' stress derived from their needs and daily life stress on the patients' quality of life. METHODS: ICU patients' quality of life was evaluated with KQOLS surveying 144 patients alive. The data was classified into 2 groups according to severity of illness and analyzed with an ANOVA. With a t-test, comparative analysis was made to examine deficiency of responses on patient families' needs and patients' quality of life. RESULTS: The patients in the group of higher severity of illness showed lower quality of life. The APACHEII score had a negative correlation with all domains except health status change domain, health status perception domain, and spiritual domain. There was a negative correlation between patients' age and three domains of physical function, role limitation, and social function and a positive correlation between patients' hospital LOS and health status change domain. The families in the group of lower severity of illness showed higher level of deficiency of responses on their needs for medical treatment and nursing information, and emotional support. Also, patients' quality of life in lower daily life stress group was higher than that in higher stress group especially in psychological health domain. CONCLUSIONS: The findings show that ICU patients `quality of life was influenced by not only medical factors but also psychosocial factors and suggest that multidimensional intervention plans are required for improving patients' quality of life and recovering their health.

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