-
Journal of Nursing Scholarship : An... 2000To report an integrative review about sleep patterns, factors that influence sleep, and sleep interventions in acutely ill hospitalized adults; discuss methodological... (Review)
Review
PURPOSE
To report an integrative review about sleep patterns, factors that influence sleep, and sleep interventions in acutely ill hospitalized adults; discuss methodological challenges associated with studying sleep in this population; and propose future research.
ORGANIZING FRAMEWORK
Research literature on sleep patterns of acutely ill hospitalized adults, obtained using computerized searches of Medline and CINAHL, was reviewed. Studies of patients on intensive care and medical-surgical units conducted in a range of health disciplines over a span of almost 30 years were included. Studies were organized into the following categories: descriptive studies of sleep using objective and subjective measures; correlational studies of personal, health status, and environmental variables and sleep; and intervention studies.
FINDINGS
Sleep disturbance is a common but highly variable experience during acute care hospitalization. Multiple personal, health status, and environmental factors are related to sleep disturbance. Behavioral interventions show promise as a means to modify factors related to sleep. Few studies have shown the outcomes of sleep disturbance in acute care settings.
CONCLUSIONS
More systematic research is needed to determine correlates of sleep disturbance in acutely ill hospitalized adults. Such studies can help investigators to identify patients who are most at risk for sleep disturbance and to provide the theoretical and conceptual bases for sleep-promoting interventions. Methodological challenges include characteristics of acute care patients and hospital environments, as well as the complexity of measuring sleep.
Topics: Acute Disease; Hospital Units; Hospitalization; Humans; Nursing; Nursing Research; Sleep
PubMed: 10819736
DOI: 10.1111/j.1547-5069.2000.00031.x -
Frontiers in Psychiatry 2021Agitation is a common symptom encountered among patients treated in psychiatric emergency settings. While there are many guidelines available for initial management of... (Review)
Review
Agitation is a common symptom encountered among patients treated in psychiatric emergency settings. While there are many guidelines available for initial management of the acutely agitated patient, there is a notable dearth of guidelines that delineate recommended approaches to the acutely agitated patient in whom an initial medication intervention has failed. This manuscript aims to fill this gap by examining evidence available in the literature and providing clinical algorithms suggested by the authors for sequential medication administration in patients with persistent acute agitation in psychiatric emergency settings. We discuss risk factors for medication-related adverse events and provide options for patients who are able to take oral medications and for patients who require parenteral intervention. We conclude with a discussion of the current need for well-designed studies that examine sequential medication options in patients with persistent acute agitation.
PubMed: 34950067
DOI: 10.3389/fpsyt.2021.750686 -
Pain Research & Management 2016Background. Cardiovascular indices of pain are pervasive in the hospital setting. However, no prospective research has examined the development of cardiac responses to... (Review)
Review
Background. Cardiovascular indices of pain are pervasive in the hospital setting. However, no prospective research has examined the development of cardiac responses to acutely painful procedures in the first year of life. Objectives. Our main goal was to synthesize existing evidence regarding the development of cardiovascular responses to acutely painful medical procedures over the first year of life in preterm and term born infants. Methods. A systematic search retrieved 6994 articles to review against inclusion criteria. A total of 41 studies were included in the review. Results. In response to acutely painful procedures, most infants had an increase in mean heart rate (HR) that varied in magnitude both across and within gestational and postnatal ages. Research in the area of HR variability has been inconsistent, limiting conclusions. Conclusions. Longitudinal research is needed to further understand the inherent variability of cardiovascular pain responses across and within gestational and postnatal ages and the causes for the variability.
Topics: Acute Pain; Cardiovascular Physiological Phenomena; Heart Rate; Humans; Infant; Infant, Newborn; Longitudinal Studies; Pain Measurement
PubMed: 27445630
DOI: 10.1155/2016/8458696 -
British Journal of Hospital Medicine... Feb 2021In 2007, the acute care common stem pathway changed the delivery of acute specialty training. Acute care common stem is the core training programme for all emergency...
In 2007, the acute care common stem pathway changed the delivery of acute specialty training. Acute care common stem is the core training programme for all emergency medicine trainees, 46% of anaesthetic trainees and a cohort of acute medicine trainees with more than 630 places nationally, the third highest of any core training programme. In their first 2 years of core training (CT1-2), trainees rotate through 6-month rotations in emergency medicine, acute medicine, anaesthetics and intensive care to gain core competencies in the assessment and management of acutely unwell patients, before completing 1 year (CT3) in their parent specialty. Acute care common stem trainees benefit from undertaking rotations in allied acute specialties, which is invaluable when treating complex and comorbid patients in an ageing population. Acute care common stem gives trainees core skills in management of acutely unwell patients, which can be built upon in higher specialty training.
Topics: Anesthesiology; Clinical Competence; Critical Care; Education, Medical, Graduate; Emergency Medicine; Humans
PubMed: 33646034
DOI: 10.12968/hmed.2020.0634 -
The Journal of Nursing Administration Jan 2021Acute care nurse practitioners (NPs) are educated, clinically trained, and board certified to care for acutely and critically ill patients, largely in hospital settings....
Acute care nurse practitioners (NPs) are educated, clinically trained, and board certified to care for acutely and critically ill patients, largely in hospital settings. Acute care NPs can positively impact patient care outcomes and are often added to acute care teams to drive optimal, reliable, efficient, and safe care, often referred to as "high value" care.
Topics: Humans; Nurse Practitioners; Workforce
PubMed: 33278193
DOI: 10.1097/NNA.0000000000000957 -
International Journal of Cardiology May 2008During the progression of heart failure (HF), phases of chronic compensation and acute decompensation alternate and the clinical status worsens during the acute phase.... (Review)
Review
During the progression of heart failure (HF), phases of chronic compensation and acute decompensation alternate and the clinical status worsens during the acute phase. At the present time, few studies have focused their attention on the cycles of compensated and decompensated phases from the perspective of myocyte injury. We hypothesize that persistently increased serum cTn concentrations during chronic compensated HF identify patients likely to need multiple admissions to the hospital for management of acute cardiac decompensation, worsening their long-term prognosis by causing further myocyte injury during the acute phase. In patients with acute cardiac decompensation, myocyte injury observed within hours or days has a long-term predictive value, and the acute surge of myocyte injury occurring in the acutely decompensated phase might be an important therapeutic target from the perspective of myocyte preservation. Clinical trials that limit myocyte injury during acutely decompensated as well as during chronic compensated HF are warranted.
Topics: Acute Disease; Biomarkers; Chronic Disease; Heart Failure; Humans; Patient Admission; Recurrence; Troponin T
PubMed: 18063145
DOI: 10.1016/j.ijcard.2007.08.053 -
Frontiers in Physiology 2021Aortic compliance is an important determinant of cardiac afterload and a contributor to cardiovascular morbidity. In the present study, we sought to provide insights...
Aortic compliance is an important determinant of cardiac afterload and a contributor to cardiovascular morbidity. In the present study, we sought to provide insights into the acute as well as long-term effects of aortic compliance decrease on central hemodynamics. To that aim, we used a mathematical model of the cardiovascular system to simulate the hemodynamics (a) of a healthy young adult (baseline), (b) acutely after banding of the proximal aorta, (c) after the heart remodeled itself to match the increased afterload. The simulated pressure and flow waves were used for subsequent wave separation analysis. Aortic banding induced hypertension (SBP 106 mmHg at baseline versus 152 mmHg after banding), which was sustained after left ventricular (LV) remodeling. The main mechanism that drove hypertension was the enhancement of the forward wave, which became even more significant after LV remodeling (forward amplitude 30 mmHg at baseline versus 60 mmHg acutely after banding versus 64 mmHg after remodeling). Accordingly, the forward wave's contribution to the total pulse pressure increased throughout this process, while the reflection coefficient acutely decreased and then remained roughly constant. Finally, LV remodeling was accompanied by a decrease in augmentation index (AIx 13% acutely after banding versus -3% after remodeling) and a change of the central pressure wave phenotype from the characteristic ("old") to ("young") phenotype. These findings provide valuable insights into the mechanisms of hypertension and provoke us to reconsider our understanding of AIx as a solely arterial parameter.
PubMed: 34381376
DOI: 10.3389/fphys.2021.701154 -
Regenerative Medicine Oct 2016To evaluate the safety and efficacy of cell therapies administered acutely/sub-acutely after stroke. (Meta-Analysis)
Meta-Analysis Review
AIMS
To evaluate the safety and efficacy of cell therapies administered acutely/sub-acutely after stroke.
METHODS
Five databases were searched for studies examining the safety/efficacy of cell therapies administered ≤90 days post-stroke. Reporting quality and adherence to research guidelines were evaluated. Safety and efficacy were assessed using risk ratios/pooled incidence rates and Hedge's g, respectively.
RESULTS
11 therapies (Nstudies= 28) were trialed: reporting quality was high, but adherence to guidelines low. Serious adverse events were observed following five treatments; six improved outcomes. There was a trend toward larger treatment effects in non-blinded studies, younger participants, and higher dosages.
CONCLUSION
Although a number of therapies appear effective, many studies did not control for normal recovery (standard-care). Long-term safety also needs to be established.
Topics: Acute Disease; Cell- and Tissue-Based Therapy; Humans; Safety; Stroke
PubMed: 27580670
DOI: 10.2217/rme-2016-0063 -
Frontiers in Neurology 2023
PubMed: 37645605
DOI: 10.3389/fneur.2023.1258677