Heart & Lung最新文献_第10页

The effect of sitting baduanjin in patients with ST-segment elevation acute myocardial infarction after percutaneous coronary intervention: A quasi-experimental study 经皮冠状动脉介入术后 ST 段抬高型急性心肌梗死患者服用坐位 baduanjin 的效果：一项准实验研究

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-08 DOI: 10.1016/j.hrtlng.2024.04.003

Xiaocui Cao, Yanyan Dong, Hongjing Yu, Xuemei Liu, Yuqin Gu, Jian Song, Peng Ouyang, Zehang Hong

Background

Early cardiac rehabilitation plays a crucial role in the recovery of patients with ST-segment elevation acute myocardial infarction (STEMI) following percutaneous coronary intervention (PCI). This study sought to determine the effect of a program of sitting Baduanjin exercises on early cardiac rehabilitation.

Objective

The goal of this study was to investigate the effects of sitting Baduanjin exercises on cardiovascular and psychosocial functions in patients with STEMI following PCI.

Methods

This quasi-experimental study employed a randomized, non-equivalent group design. Patients in the intervention group received daily sitting Baduanjin training in addition to a series of seven-step rehabilitation exercises, whereas those in the control group received only the seven-step rehabilitation training, twice daily. Differences in heart rate variability (HRV) indicators, exercise capacity (Six-Minute Walking Distance; 6-MWD), anxiety (Generalized Anxiety Disorder-7; GAD-7), and depression (Patient Health Questionnaire-9; PHQ-9) between the two study groups during hospitalization were analyzed.

Results

Patients in the intervention group exhibited lower rates of abnormalities in the time domain and frequency domain parameters of HRV. The median scores of GAD-7 and PHQ-9 in both groups were lower than those at the time of admission, with the intervention group exhibiting lower scores than the control group (P < 0.001; P < 0.001, respectively). The 6-MWD after the intervention was greater in the intervention group compared to the control group (P = 0.014).

Conclusions

We found that sitting Baduanjin training has the potential to enhance HRV, cardiac function, and psychological well-being in patients with STEMI after PCI. This intervention can potentially improve the exercise capacity of a patient before discharge.

背景早期心脏康复在经皮冠状动脉介入治疗（PCI）后ST段抬高型急性心肌梗死（STEMI）患者的康复中起着至关重要的作用。本研究旨在确定坐姿八段锦锻炼计划对早期心脏康复的影响。本研究旨在探讨坐姿八段锦锻炼对 PCI 术后 STEMI 患者的心血管和社会心理功能的影响。干预组患者每天除了接受坐式八段锦训练外，还接受一系列七步康复训练，而对照组患者只接受七步康复训练，每天两次。结果干预组患者的心率变异性（HRV）指标、运动能力（六分钟步行距离；6-MWD）、焦虑（广泛性焦虑症-7；GAD-7）和抑郁（患者健康问卷-9；PHQ-9）在住院期间的差异得到了分析。两组患者的 GAD-7 和 PHQ-9 中位数评分均低于入院时的评分，其中干预组的评分低于对照组（分别为 P < 0.001 和 P < 0.001）。结论我们发现，坐姿八段锦训练有可能增强 PCI 后 STEMI 患者的心率变异、心脏功能和心理健康。这种干预措施有可能提高患者出院前的运动能力。

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引用次数: 0

Multiple coronary heart diseases are risk factors for mental health disorders: A mendelian randomization study 多种冠心病是精神疾病的危险因素：泯灭随机研究

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-08 DOI: 10.1016/j.hrtlng.2024.04.009

Tianwei Meng , Zhiping Liu , Jiawen Liu , Xiaobing Zhang , Chengjia Li , Jiarui Li , Boyu Wang , Yinxiong He , Zengguang Fan , Shilong Xin , Jia Chen , Rui Qie

Background

Previous observational studies have suggested associations between Coronary Heart Disease (CHD) and Mental Health Disorders (MHD). However, the causal nature of these relationships has remained elusive.

Objective

The purpose of this study is to elucidate the causal relationships between eight distinct types of CHD and six types of MHD using Mendelian randomization (MR) analysis.

Methods

The MR analysis employed a suite of methods including inverse variance-weighted (IVW), MR-Egger, weighted mode, weighted median, and simple mode techniques. To assess heterogeneity, IVW and MR-Egger tests were utilized. MR-Egger regression also served to investigate potential pleiotropy. The stability of IVW results was verified by leave-one-out sensitivity analysis.

Results

We analyzed data from over 2,473,005 CHD and 803,801 MHD patients, informed by instrumental variables from large-scale genomic studies on European populations. The analysis revealed a causal increase in the risk of Major Depressive Disorder and Mania associated with Coronary Artery Disease and Myocardial Infarction. Heart Failure was found to causally increase the risk for Bipolar Disorder and Schizophrenia. Atrial Fibrillation and Ischemic Heart Diseases were positively linked to Generalized Anxiety Disorder and Mania, respectively. There was no significant evidence of an association between Hypertensive Heart Disease, Hypertrophic Cardiomyopathy, Pulmonary Heart Disease, and MHD. Reverse MR analysis indicated that MHD do not serve as risk factors for CHD.

Conclusions

The findings suggest that specific types of CHD may act as risk factors for certain MHDs. Consequently, incorporating psychological assessments into the management of patients with CHD could be advantageous.

背景以往的观察性研究表明，冠心病（CHD）与心理健康障碍（MHD）之间存在关联。本研究旨在利用孟德尔随机分析法（MR）阐明八种不同类型的冠心病与六种精神疾病之间的因果关系。为了评估异质性，使用了 IVW 和 MR-Egger 检验。MR-Egger回归也可用于研究潜在的多重效应。结果我们分析了超过 2,473,005 名 CHD 患者和 803,801 名 MHD 患者的数据，这些数据来自欧洲人群大规模基因组研究的工具变量。分析结果显示，患重度抑郁症和躁狂症的风险与冠心病和心肌梗死有因果关系。研究还发现，心力衰竭会增加躁郁症和精神分裂症的患病风险。心房颤动和缺血性心脏病分别与广泛焦虑症和躁狂症呈正相关。没有明显证据表明高血压性心脏病、肥厚性心肌病、肺心病与多发性硬化症之间存在关联。反向 MR 分析表明，MHD 并非心脏病的危险因素。因此，将心理评估纳入心脏病患者的管理中可能是有益的。

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引用次数: 0

Intersection of social determinants of health with ventricular assist device therapy: An integrative review 健康的社会决定因素与心室辅助装置治疗的交叉点：综合综述

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-07 DOI: 10.1016/j.hrtlng.2024.04.002

Mireille Chehade, Komal Patel Murali, Victoria Vaughan Dickson , Margaret M. McCarthy

Background

Social determinants of health (SDOH) may influence the clinical management of patients with heart failure. Further research is warranted on the relationship between SDOH and Ventricular Assist Device (VAD) therapy for heart failure.

Objectives

The purpose of this integrative review was to synthesize the state of knowledge on the intersection of SDOH with VAD therapy.

Methods

Guided by Whittemore and Knafl's methodology, this literature search captured three concepts of interest including VAD therapy, SDOH, and their domains of intersection with patient selection, decision-making, treatment outcome, and resource allocation. CINAHL, Embase, PsycINFO, PubMed, and Web of Science were searched in March 2023. Articles were included if they were peer-reviewed publications in English, published between 2006 and 2023, conducted in the United States, and examined VAD therapy in the context of adult patients (age ≥ 18 years).

Results

22 quantitative studies meeting the inclusion criteria informed the conceptualization of SDOH using the Healthy People 2030 framework. Four themes captured how the identified SDOH intersected with different processes relating to VAD therapy: patient decision-making, healthcare access and resource allocation, patient selection, and treatment outcomes. Most studies addressed the intersection of SDOH with healthcare access and treatment outcomes.

Conclusion

This review highlights substantial gaps in understanding how SDOH intersect with patient and patient selection for VAD. More research using mixed methods designs is warranted. On an institutional level, addressing bias and discrimination may have mitigated health disparities with treatment outcomes, but further research is needed for implementing system-wide change. Standardized assessment of SDOH is recommended throughout clinical practice from patient selection to outpatient VAD care.

背景健康的社会决定因素（SDOH）可能会影响心力衰竭患者的临床治疗。方法以 Whittemore 和 Knafl 的方法论为指导，该文献检索捕捉了三个感兴趣的概念，包括 VAD 治疗、SDOH 以及它们与患者选择、决策、治疗结果和资源分配的交叉领域。在 2023 年 3 月对 CINAHL、Embase、PsycINFO、PubMed 和 Web of Science 进行了检索。结果22项符合纳入标准的定量研究利用 "健康2030 "框架为SDOH的概念化提供了依据。四个主题反映了已确定的 SDOH 如何与 VAD 治疗的不同过程相互交织：患者决策、医疗服务获取和资源分配、患者选择和治疗结果。大多数研究都探讨了 SDOH 与医疗服务获取和治疗结果之间的交集。有必要使用混合方法设计开展更多研究。在机构层面，解决偏见和歧视问题可能会减轻治疗结果的健康差异，但要实施全系统的变革，还需要进一步的研究。建议从患者选择到 VAD 门诊护理的整个临床实践过程中对 SDOH 进行标准化评估。

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引用次数: 0

The Heart Failure Patient Foundation Position Statement on Research and Patient Involvement 心力衰竭患者基金会关于研究和患者参与的立场声明。

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-06 DOI: 10.1016/j.hrtlng.2024.04.005

Marilyn A. Prasun PhD, RN, CCNS, CHFN, FAHA (Carle BroMenn Medical Center Endowed Professor) , Annette Hubbell PhD, RN (Assistant Professor) , Lisa Rathman MSN, CRNP, CHFN (Acute Care Heart Failure Nurse Practitioner) , Kelly D. Stamp PhD, NP-C, RN, CHFN, FAHA, FAAN (Associate Professor & Associate Dean of Academic Programs)

Background

Heart Failure (HF) is a growing global public health problem affecting approximately 64 million people worldwide.

Objectives

The Heart Failure Patient Foundation developed a position statement to advocate for adult patients with HF to be an active participant in research and for HF leaders to integrate patients throughout the research process.

Methods

A review of the literature and best practices was conducted. Based on the evidence, the HF Patient Foundation made recommendations regarding the inclusion of adult patients with HF throughout the research process.

Results

Healthcare clinicians, researchers and funding agencies have a role to ensure rigorous quality research is performed and implemented into practice. Inclusion of adult patients with HF throughout the research process can improve the lives of patients and families while advancing HF science.

Conclusions

The HF Patient Foundation strongly advocates that patients with HF be involved in research from inception of the project through dissemination of findings to improve patient outcomes.

背景心力衰竭（HF）是一个日益严重的全球性公共卫生问题，影响着全球约 6400 万人。目标心力衰竭患者基金会制定了一份立场声明，倡导成年心力衰竭患者积极参与研究，并倡导心力衰竭领导者将患者纳入整个研究过程。结果医疗保健临床医生、研究人员和资助机构有责任确保开展严格的高质量研究并将其应用于实践。将成年心房颤动患者纳入整个研究过程可以改善患者和家属的生活，同时推动心房颤动科学的发展。结论心房颤动患者基金会强烈主张心房颤动患者从项目开始到研究结果发布的整个过程中都参与研究，以改善患者的预后。

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引用次数: 0

Board of Directors 董事会

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-06 DOI: 10.1016/S0147-9563(24)00037-2

引用次数: 0

High-flow nasal cannula therapy versus conventional oxygen therapy for adult patients after cardiac surgery: A systemic review and meta-analysis 对心脏手术后的成年患者进行高流量鼻插管疗法与传统氧气疗法的比较：系统回顾和荟萃分析

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-06 DOI: 10.1016/j.hrtlng.2024.03.008

Chuantao Liu, Qihong Lin, Dongyu Li

Background

Oxygen therapy constitutes a crucial element of post-cardiac operative care. The study assessed the effectiveness of high-flow nasal cannula (HFNC) in comparison to conventional oxygen therapy (COT).

Objectives

The aim of the study was to assess the effectiveness of HFNC in comparison to COT for adult patients following cardiac surgery.

Methods

We conducted a comprehensive search of Embase, PubMed, Scopus, Cochrane Library, and Web of Science databases from inception until April 18, 2023, to identify randomized controlled trials (RCTs) and crossover studies that compared the efficacy of HFNC with COT in adult patients following cardiac surgery.

Results

The meta-analysis included nine studies, consisting of eight RCTs and one crossover study. Compared with COT, HFNC could reduce the need for escalation of respiratory support (RR 0.67, 95% CI: 0.48 to 0.93, P = 0.02), decrease arterial partial pressure of carbon dioxide (PaCO₂) levels (MD -3.14, 95% CI: -4.90 to -1.39, P<0.001), and increase forced expiratory volume in 1 second (FEV₁) levels (MD 0.08, 95% CI: 0.02 to 0.15, P = 0.02). There was no significant difference between the HFNC and COT groups in terms of mortality, intubation rate, respiratory rate, heart rate, intensive care unit and hospital length of stay, arterial partial pressure of oxygen (PaO₂), forced vital capacity, and complications of atrial fibrillation and delirium.

Conclusion

Compared with COT, HFNC could decrease the need for escalation of respiratory support, lower PaCO₂ levels, and elevate FEV₁ levels in patients following cardiac surgery.

背景氧疗是心脏手术后护理的重要组成部分。本研究评估了高流量鼻插管（HFNC）与传统氧疗（COT）相比的有效性。研究目的本研究旨在评估高流量鼻插管与传统氧疗相比对心脏手术后成年患者的有效性。方法我们对 Embase、PubMed、Scopus、Cochrane Library 和 Web of Science 等数据库进行了全面检索，以确定在心脏手术后的成人患者中比较 HFNC 与 COT 疗效的随机对照试验 (RCT) 和交叉研究。与 COT 相比，HFNC 可减少呼吸支持升级的需要（RR 0.67，95% CI：0.48 至 0.93，P = 0.02），降低动脉二氧化碳分压（PaCO2）水平（MD -3.14，95% CI：-4.90 至 -1.39，P<0.001），增加 1 秒用力呼气容积（FEV1）水平（MD 0.08，95% CI：0.02 至 0.15，P = 0.02）。在死亡率、插管率、呼吸频率、心率、重症监护室和住院时间、动脉血氧分压（PaO2）、用力肺活量以及心房颤动和谵妄等并发症方面，HFNC 组与 COT 组无明显差异。

{"title":"High-flow nasal cannula therapy versus conventional oxygen therapy for adult patients after cardiac surgery: A systemic review and meta-analysis","authors":"Chuantao Liu, Qihong Lin, Dongyu Li","doi":"10.1016/j.hrtlng.2024.03.008","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.03.008","url":null,"abstract":"<div><h3>Background</h3><p>Oxygen therapy constitutes a crucial element of post-cardiac operative care. The study assessed the effectiveness of high-flow nasal cannula (HFNC) in comparison to conventional oxygen therapy (COT).</p></div><div><h3>Objectives</h3><p>The aim of the study was to assess the effectiveness of HFNC in comparison to COT for adult patients following cardiac surgery.</p></div><div><h3>Methods</h3><p>We conducted a comprehensive search of Embase, PubMed, Scopus, Cochrane Library, and Web of Science databases from inception until April 18, 2023, to identify randomized controlled trials (RCTs) and crossover studies that compared the efficacy of HFNC with COT in adult patients following cardiac surgery.</p></div><div><h3>Results</h3><p>The meta-analysis included nine studies, consisting of eight RCTs and one crossover study. Compared with COT, HFNC could reduce the need for escalation of respiratory support (RR 0.67, 95% CI: 0.48 to 0.93, <em>P</em> = 0.02), decrease arterial partial pressure of carbon dioxide (PaCO<sub>2</sub>) levels (MD -3.14, 95% CI: -4.90 to -1.39, <em>P</em><0.001), and increase forced expiratory volume in 1 second (FEV<sub>1</sub>) levels (MD 0.08, 95% CI: 0.02 to 0.15, <em>P</em> = 0.02). There was no significant difference between the HFNC and COT groups in terms of mortality, intubation rate, respiratory rate, heart rate, intensive care unit and hospital length of stay, arterial partial pressure of oxygen (PaO<sub>2</sub>), forced vital capacity, and complications of atrial fibrillation and delirium.</p></div><div><h3>Conclusion</h3><p>Compared with COT, HFNC could decrease the need for escalation of respiratory support, lower PaCO<sub>2</sub> levels, and elevate FEV<sub>1</sub> levels in patients following cardiac surgery.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324000475/pdfft?md5=862ff95c5c48ace6aedf9c998057a17d&pid=1-s2.0-S0147956324000475-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to: “Nursing Care of the Patient Hospitalized with Heart Failure: Executive Summary: A Scientific Statement from the American Association of Heart Failure Nurses” [Heart Lung. 64(2024).A1-A5/doi:10.1016/j.hrtlng.2024.01.008. Epub 2024 Feb 7]. 更正："对心力衰竭住院患者的护理：执行摘要：美国心力衰竭护士协会的科学声明"[心肺。64(2024).A1-A5/doi:10.1016/j.hrtlng.2024.01.008.Epub 2024 Feb 7].

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-04 DOI: 10.1016/j.hrtlng.2024.03.009

Meg Fraser (Chair) DNP, ANP-C, CHFN, FHFSA , Stephanie G. Barnes MSN, AGPCNP-C, CHFN , Carol Barsness MS, RD, LD, CNSC , Craig Beavers PharmD , Cynthia J. Bither ACNP, ANP, AACC, CHFN , Samantha Boettger RN, BSN, CHFN , Christine Hallman DNP, APRN, ACHPN, A-GNP-C , Anne Keleman LICSW, APHSW-C , Lauren Leckliter RN, MSN , Colleen K. McIlvennan PhD, DNP, ANP-C, FHFSA , Cemal Ozemek PhD, ACSM-CEP , Amit Patel MD , Natalie W. Pierson MSN, RN, NC-BC, FHFSA , Courtney Shakowski PharmD, MS, FHFSA , S. Craig Thomas MSN, ACNP, ACNS, CHFN , Tara Whitmire DNP, APRN-NP, CHFN , Kelley M. Anderson PhD, RN, FNP, CHFN

引用次数: 0

Dietary isoflavone intake is inversely associated with remnant cholesterol in US adults: A cross-sectional study 美国成年人的膳食异黄酮摄入量与残余胆固醇成反比：一项横断面研究

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-03 DOI: 10.1016/j.hrtlng.2024.03.010

Jing Cao , Jinqi Zhu , Sue Zhao

Background

Several studies have shown that dietary isoflavones are negatively correlated with total cholesterol and low-density lipoprotein cholesterol. However, few studies have investigated the link between dietary isoflavones and remnant cholesterol (RC).

Objectives

We used the National Health and Nutrition Examination Survey (NHANES) database to explore the association between dietary isoflavone intake and RC.

Methods

A cross-sectional study was conducted with 4731 participants aged ≥ 20 years from the 2007–2008, 2009–2010, and 2017–2018 NHANES databases. We adopted univariate and multiple linear regression analysis and restricted cubic spline (RCS) to assess the relationship between dietary isoflavone intake and RC. Moreover, we conducted stratified and interaction analyses to ensure the stability of the results and identify specific populations.

Results

The weighted multifactor linear regression model showed a negative correlation between dietary isoflavone intake and remnant cholesterol (Model 2, β = -0.049, 95% CI: (-0.096, -0.002), P = 0.040). The RCS analysis indicated that there was an L-shaped negative correlation between dietary isoflavone intake and RC (P-value for non-linearity was 0.0464). Stratified analyses showed the inverse relationship between dietary isoflavone intake and RC persisted in most subgroups and there was no interaction except for the recreational activity group.

Conclusions

Our study found a non-linear and negative association between dietary isoflavone intake and RC in US adults, so we hypothesized that consuming an isoflavone-rich diet may help reduce blood RC and further reduce the risk of cardiovascular disease.

背景多项研究表明，膳食异黄酮与总胆固醇和低密度脂蛋白胆固醇呈负相关。然而，很少有研究调查了膳食异黄酮与残余胆固醇（RC）之间的联系。目的我们利用美国国家健康与营养调查（NHANES）数据库探讨了膳食异黄酮摄入量与残余胆固醇之间的联系。方法我们对来自 2007-2008、2009-2010 和 2017-2018 NHANES 数据库的 4731 名年龄≥20 岁的参与者进行了横断面研究。我们采用单变量和多元线性回归分析以及限制性立方样条曲线（RCS）来评估膳食异黄酮摄入量与RC之间的关系。结果加权多因素线性回归模型显示，膳食异黄酮摄入量与残余胆固醇之间呈负相关（模型 2，β = -0.049，95% CI：（-0.096，-0.002），P =0.040）。RCS 分析表明，膳食异黄酮摄入量与 RC 之间呈 L 型负相关（非线性 P 值为 0.0464）。结论我们的研究发现，在美国成年人中，膳食异黄酮摄入量与 RC 之间存在非线性负相关，因此我们假设，摄入富含异黄酮的膳食可能有助于降低血液中的 RC，并进一步降低罹患心血管疾病的风险。

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引用次数: 0

Reliability and validity of the training satisfaction questionnaire for family members (TSQ-FM) entering the ICU during an isolation disease outbreak 隔离病爆发期间进入重症监护室的家属培训满意度问卷（TSQ-FM）的可靠性和有效性

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-03 DOI: 10.1016/j.hrtlng.2024.03.004

Francesca Trotta MSN (PhD Student), Francesco Petrosino MSN (PhD Student), Gianluca Pucciarelli PhD, FAHA (Assistant Professor), Rosaria Alvaro MSN, FAAN, FESC (Professor), Ercole Vellone PhD, FAAN, FESC (Associate Professor), Davide Bartoli MSN (PhD Student)

Background

The presence of family members in an isolated ICU during an isolation disease outbreak is restricted by hospital policies because of the infectious risk. This can be overcome by conferring to family members the skill and the ability to safely don and doff the personal protective equipment (PPE) through a nurse-led training intervention and assess their satisfaction, to respond to the need to define a safe, effective and quality care pathway focused on Family-Centered Care (FCC) principles.

Objective

the study aimed to build a valid and reliable instrument for clinical practice to assess family members’ satisfaction to allow ICU nurses to restore family integrity in any case of infectious disease outbreak that requires isolation.

Methods

A cross-sectional study was conducted to test the psychometric properties. The questionnaire was constructed based on a literature review on the needs of family members in the ICU. 76 family members were admitted to a COVID-ICU. Cronbach's coefficient, Geomin rotated loading, and EFA were applied to assess the reliability and validity of the instrument.

Results

The Kaiser-Mayer-Olkin (KMO) measure was 0.662, the Bartlett sphericity test showed a significant p-value (χ²=448.33; df=45; p < 0.01), Cronbach's alpha coefficient was.896. A further CFA analysis confirmed that all fit indices were acceptable. The results showed satisfactory validity and reliability, which could be generalized and extended to any outbreak of isolation disease.

Conclusions

This study provides a valid and reliable instrument for clinical practice to maintain family integrity in the dyadic relationship between the patient and the family member, even during an emergency infectious disease outbreak that requires isolation.

背景在隔离病爆发期间，由于存在传染风险，家属在隔离重症监护病房的存在受到医院政策的限制。通过由护士主导的培训干预，让家属掌握安全穿脱个人防护设备（PPE）的技能和能力，并评估他们的满意度，就可以克服这一问题，从而满足以家庭为中心的护理（FCC）原则定义安全、有效和优质护理路径的需要。目的该研究旨在为临床实践建立一个有效可靠的工具来评估家庭成员的满意度，以便重症监护病房的护士在任何需要隔离的传染病暴发病例中恢复家庭的完整性。调查问卷是根据有关 ICU 家属需求的文献综述制作的。76名家属被送入COVID-ICU。结果 Kaiser-Mayer-Olkin（KMO）测量值为 0.662，Bartlett 球形度检验显示 p 值显著（χ²=448.33; df=45; p <0.01），Cronbach's alpha 系数为 0.896。进一步的 CFA 分析证实，所有拟合指数均可接受。结论：本研究为临床实践提供了一个有效、可靠的工具，即使在需要隔离的紧急传染病爆发期间，也能在患者与家庭成员的二元关系中保持家庭完整性。

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引用次数: 0

Infectious respiratory pathogens among patients with acute exacerbation of idiopathic pulmonary fibrosis during the coronavirus disease 2019 pandemic in Japan 日本 2019 年冠状病毒病大流行期间特发性肺纤维化急性加重患者中的传染性呼吸道病原体

IF 2.8 4区医学 Q2 Medicine

Heart & Lung

Pub Date : 2024-04-02 DOI: 10.1016/j.hrtlng.2024.03.007

Kentaro Akata , Kei Yamasaki , Takako Kawaguchi , Yosuke Chiba , Konomi Sennari , Saki Shigemi , Kazuki Nemoto , Midori Funada , Katsunori Suzuki , Kazuhiro Yatera

Background

Few studies have investigated the prevalence of pathogens in patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF), specifically, the interactions between respiratory pathogens and AE-IPF during the coronavirus disease 2019 (COVID-19) pandemic.

Objectives

We aimed to analyze pathogens in patients with AE-IPF between September 2020 and December 2022.

Methods

This retrospective observational study was conducted at our hospital between September 2020 and December 2022. In patients with AE-IPF, pre-hospitalization polymerase chain reaction (PCR) tests for respiratory pathogens, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), were performed using multiplex PCR or Smart Gene assay with nasopharyngeal swab specimens. Microbiological assays, including Gram staining, sputum cultures, blood cultures, and urinary antigen tests for Streptococcus pneumoniae and Legionella pneumophila, were also performed.

Results

Forty-nine patients with AE-IPF were included. The median age was 75 years old and 42 (86 %) were male. Only one of the 49 patients (2 %) was positive for SARS-CoV-2. Two of 28 patients (7 %) were positive for human rhinovirus/enterovirus. No bacteria were detected in sputum culture, blood culture, or urinary antigen tests.

Conclusions

The detection frequency of SARS-CoV-2 infection in patients with AE-IPF was lower than that of human rhinovirus/enterovirus. Continuous analysis for the presence of pathogens is necessary for appropriate infection control because respiratory viruses may increase as the coronavirus pandemic subsides.

背景很少有研究调查特发性肺纤维化急性加重期（AE-IPF）患者中病原体的流行情况，特别是在2019年冠状病毒病（COVID-19）大流行期间呼吸道病原体与AE-IPF之间的相互作用。在 AE-IPF 患者中，使用多重 PCR 或智能基因检测法对鼻咽拭子标本进行入院前聚合酶链反应（PCR）检测，以检测呼吸道病原体，包括严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）。此外，还进行了微生物学检测，包括革兰氏染色、痰培养、血液培养以及肺炎链球菌和嗜肺军团菌的尿抗原检测。中位年龄为 75 岁，男性 42 人（占 86%）。49 名患者中只有一人（2%）对 SARS-CoV-2 呈阳性反应。28 名患者中有 2 人（7%）对人类鼻病毒/肠病毒呈阳性反应。结论在 AE-IPF 患者中，SARS-CoV-2 感染的检出率低于人类鼻病毒/肠道病毒。由于随着冠状病毒大流行的消退，呼吸道病毒可能会增加，因此有必要对病原体的存在进行持续分析，以进行适当的感染控制。

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引用次数: 0