Heart & Lung最新文献

{"title":"Effects of breathing exercises performed with virtual reality on dyspnea, anxiety and quality of life in COPD patients: A randomized controlled trial","authors":"Derya Şimşekli ,&nbsp;Mehtap Tan","doi":"10.1016/j.hrtlng.2025.01.014","DOIUrl":"10.1016/j.hrtlng.2025.01.014","url":null,"abstract":"<div><h3>Background</h3><div>Breathing exercises can reduce dyspnea and anxiety in COPD patients and improve quality of life. To ensure these benefits are sustained, it is essential to incorporate engaging and innovative applications that capture patients' attention.</div></div><div><h3>Objectives</h3><div>This study aimed to determine the effects of breathing exercises performed with virtual reality on dyspnea, anxiety, and quality of life in COPD patients.</div></div><div><h3>Methods</h3><div>The research was conducted in randomized controlled experimental design with 48 COPD patients. In collecting research data, the COPD Patient Information Form, the Respiratory Function Test Evaluation Form, the COPD Assessment Test (CAT), the Modified Medical Research Council (mMRC) Dyspnea Scale, the Hospital Anxiety and Depression Scale (HAD-A), the St. George Respiratory Questionnaire (SGRQ) and the Virtual Reality Experience Evaluation Form were used. The Virtual Reality Breathing Exercise Group (VRBE-G) and control group (CG) were created by block randomization. VRBE-G performed breathing exercises with virtual reality 3 times a week for 8 weeks. The participants and the statistician were blinded. Repeated measures ANOVA test was performed to determine the group-time interaction, and independent samples <em>t</em>-test and Man Whitney U test were used for comparison between groups.</div></div><div><h3>Results</h3><div>In intra- and inter-group comparisons, it was determined that there was a statistically significant difference in VRBE-G compared to CG in terms of CAT score, mMRC dyspnea score, HAD-A and SGRQ total score (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>It was determined that breathing exercises applied to COPD patients with virtual reality reduced dyspnea and anxiety and increased the quality of life.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 7-13"},"PeriodicalIF":2.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond first-day biomarkers: The critical role of peak cardiac troponin I in sepsis prognosis","authors":"Dandan Zhao ,&nbsp;Huimin Li ,&nbsp;Yongdi Lin ,&nbsp;Lizhen Liu ,&nbsp;Lina Xu ,&nbsp;Dan Zhang ,&nbsp;Yu Fu ,&nbsp;Jiang Hong ,&nbsp;Congliang Miao","doi":"10.1016/j.hrtlng.2025.01.013","DOIUrl":"10.1016/j.hrtlng.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a global health challenge with high mortality rates. It demands timely risk identification and biomarker-based strategies to optimize ICU management and outcomes.</div></div><div><h3>Objectives</h3><div>To explore the prognostic value of cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP) in predicting 28-day mortality in septic patients.</div></div><div><h3>Methods</h3><div>We analyzed clinical data of septic ICU patients at Shanghai General Hospital. We used Cox models and ROC curves to assess the association between cTnI and BNP levels and 28-day mortality, and their prognostic accuracy.</div></div><div><h3>Results</h3><div>A total of 333 septic patients were included in this study (mean age [SD], 64.7 [15.2] years; 65.8 % male), of whom 63 (18.9 %) patients died during 28 days. Elevated peak cTnI levels, identified in 233 patients (70.0 %), were independently associated with higher 28-day mortality in septic patients, even after adjusting for SOFA scores, BNP, and other confounding variables. (adjusted HR 2.33, 95 % CI 1.08–5.04, <em>P</em> = 0.03). However, neither first-day cTnI nor BNP levels remained independent predictors of 28-day mortality. Sensitivity analyses for the magnitude of cTnI elevation as a predictive variable also yielded similar results. Compared to first-day cTnI, first-day BNP, and peak BNP, the peak cTnI had the most significant and modest area under the ROC curve (AUC: 0.64 [0.57–0.71]).</div></div><div><h3>Conclusion</h3><div>Elevated peak cTnI or the magnitude of cTnI, rather than first-day, could independently predict the risk of 28-day mortality in septic patients. This finding highlighted the importance of dynamic monitoring cTnI levels for risk stratification identification and management in septic patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 14-19"},"PeriodicalIF":2.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143314191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AAHFN Leadership Message","authors":"S․Craig Thomas MSN, ACNP-BC, ACNS-BC, CHFN","doi":"10.1016/j.hrtlng.2025.01.011","DOIUrl":"10.1016/j.hrtlng.2025.01.011","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Page A1"},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed methods study of backup behavior among interprofessional ICU teams","authors":"Deena Kelly Costa PhD, RN, FAAN ,&nbsp;Kathryn A. Lee PhD, RN ,&nbsp;Nathan C. Wright MA ,&nbsp;Emily M. Boltey PhD, RN ,&nbsp;Hannah C. Ratliff PhD, RN ,&nbsp;Deanna J. Marriott PhD ,&nbsp;Olga Yakusheva PhD","doi":"10.1016/j.hrtlng.2025.01.012","DOIUrl":"10.1016/j.hrtlng.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Backup behavior—when clinicians help each other via verbal assistance or task completion in their roles–is essential for effective teamwork in the intensive care unit (ICU) but is not well understood. Exploring how interprofessional team members provide backup may guide future interventions.</div></div><div><h3>Objective</h3><div>To examine who, how often, why, and under what circumstances ICU clinicians provide backup in mechanical ventilation care.</div></div><div><h3>Methods</h3><div>Using a convergence, triangulation mixed methods design in 2 medical ICUs (2017–2019), we collected qualitative data (observation, shadowing, interviews) to understand how ICU teams provide backup; and patient-shift level surveys of ICU nurses, physicians, and respiratory therapists, to identify whom clinicians contacted for help that shift. We analyzed and compared these data to gain insight into the frequency, and circumstances surrounding ICU clinicians’ requests for and receipt of backup when providing mechanical ventilation care.</div></div><div><h3>Results</h3><div>Backup behavior was common. Interprofessional backup (e.g. nurse to respiratory therapist) related to specific patient care tasks. Intraprofessional backup (e.g. nurse to nurse) involved team members ‘checking in’ to assist their colleague. Most (57%) survey respondents reported at least one interprofessional contact on day and night shifts, and approximately 25% reported at least one intraprofessional backup contact. We identified distinct backup behavior patterns on day and night shifts.</div></div><div><h3>Conclusions</h3><div>While backup behavior was common, interprofessional backup focused on care aligning with professional roles whereas intraprofessional backup entailed checking-in with team members. Examining how to enhance interprofessional backup through trainings or interventions may improve how teams work and patient care.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 1-6"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthesis of expert opinions on fluid management in severe sepsis: A contextual review of human albumin and crystalloids","authors":"Christian J. Wiedermann MD ,&nbsp;Arian Zaboli RN ,&nbsp;Gianni Turcato MD","doi":"10.1016/j.hrtlng.2025.01.010","DOIUrl":"10.1016/j.hrtlng.2025.01.010","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a critical condition associated with high mortality rates that necessitates effective fluid resuscitation. Crystalloids are widely utilized; however, human albumin solutions have been attributed potential oncotic and anti-inflammatory benefits. Given the ongoing debate and the absence of definitive empirical evidence, expert opinions provide valuable insights into the contextual and practical aspects of fluid management.</div></div><div><h3>Objectives</h3><div>This review synthesizes expert opinions on the utilization of albumin compared to crystalloids in critically ill sepsis patients, emphasizing the contextual and practical considerations rather than drawing conclusions about clinical efficacy.</div></div><div><h3>Methods</h3><div>Following the Joanna Briggs Institute (JBI) guidelines for systematic reviews of text and opinions, databases and registries were searched from 2015 to 2024. Two reviewers independently screened sources. Data extraction was conducted by one reviewer and verified by another reviewer. Of 1,917 sources, 38 met the inclusion criteria. Findings were synthesized narratively.</div></div><div><h3>Results</h3><div>Expert consensus emphasizes crystalloids as the preferred first-line fluid for sepsis due to their safety, cost-effectiveness, and availability. Albumin is conditionally recommended in specific scenarios such as severe hypoalbuminemia, high vasopressor requirements, or volume-sensitive conditions. While theoretical benefits of albumin, including enhanced volume expansion and reduced fluid overload, are recognized, evidence for consistent clinical outcomes remains limited. Experts underscore the importance of individualized management tailored to patient-specific factors and dynamic monitoring, aligning with guideline recommendations that advise against routine albumin use.</div></div><div><h3>Conclusions</h3><div>This review highlights the contextual and practical aspects of fluid management in sepsis, underscoring the predominance of crystalloids as the initial choice. Expert insights suggest that albumin may have a supplementary role in specific clinical scenarios. These findings provide a refined understanding of current practice and serve as a foundation for informed decision-making and future research.</div></div><div><h3>Trial Registry</h3><div>PROSPERO; Registration Number: CRD42024580521; URL: <span><span>https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=580521</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 339-359"},"PeriodicalIF":2.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The naples prognostic score as a new predictor for heart failure: A cross-sectional study","authors":"Ziyan Guo ,&nbsp;Futao Zhang ,&nbsp;Shuai Chai","doi":"10.1016/j.hrtlng.2025.01.009","DOIUrl":"10.1016/j.hrtlng.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>The Naples prognostic score (NPS), a novel nutritional and inflammatory index, holds great promise for predicting the prognosis of heart failure (HF), but research on its association with HF outcomes is limited.</div></div><div><h3>Objective</h3><div>To analyze the relationship between the NPS and the incidence rate and long-term prognosis of HF.</div></div><div><h3>Methods</h3><div>Participants from the National Health and Nutrition Examination Survey (NHANES) data were allocated into three groups (group 0 (the NPS=0), group 1–2 (the NPS=1–2), and group 3–4 (the NPS=3–4)) based on the NPS level. Regression analysis was conducted to examine the relationship between the NPS and HF prevalence, and ROC curve analysis was employed to determine the prediction accuracy. The Cox proportional hazards model and Kaplan-Meier survival curves analyzed mortality risk, with subgroup and sensitivity analyses for model stability.</div></div><div><h3>Results</h3><div>The study included 47,300 individuals (mean age 47.18 years; 51.07% female; 68.86% non-Hispanic white). The HF prevalence was 2.30% (95% CI: 1.66, 3.17). Among 1,581 HF patients, 851 all-cause deaths occurred during a median follow-up of 6.84 years. In groups 3–4, the risk of all-cause, cardiovascular, and cancer mortality was significantly higher (4.18, 4.89, and 16.93, respectively, all <em>p</em> &lt; 0.05) compared to group 0. Furthermore, a significant difference was observed in the association between the NPS and cancer mortality across age subgroups (<em>p</em> &lt; 0.05). In contrast, there was no significant interaction between the NPS and all-cause mortality or cardiovascular mortality in subgroup analyses.</div></div><div><h3>Conclusions</h3><div>The NPS is a low-cost and easy-to-calculate prognostic score that helps predict the clinical course of patients with HF.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 360-367"},"PeriodicalIF":2.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residing in areas with high residential greenspace is associated with increased COPD risk and decreased lung function of adults in eastern China","authors":"Le-Yun Tan ,&nbsp;Yao Wang ,&nbsp;Li Yang ,&nbsp;Cheng-Shui Chen ,&nbsp;Fan Zhang ,&nbsp;Ming-Tao Yu ,&nbsp;Pi Guo ,&nbsp;Qing-Ying Zhang","doi":"10.1016/j.hrtlng.2025.01.008","DOIUrl":"10.1016/j.hrtlng.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Evidence for a relation between residential greenspace and respiratory health is scarce and controversial.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to explore the association between residential greenspace and its interaction with particulate matter (PM_2.5) and risk of chronic obstructive pulmonary disease (COPD) and lung function.</div></div><div><h3>Methods</h3><div>A total of 3,759 adults were recruited from Wenzhou in this study. Lung function measurements included forced expiratory volume in 1 s (FEV1); forced vital capacity (FVC); FEV1/FVC ratio; peak expiratory flow (PEF); forced expiratory flow (FEF) at 25 %, 50 %, and 75 %; and maximal mid-expiratory flow (MMEF). The Normalized Difference Vegetation Index (NDVI) was used to characterize the greenspace.</div></div><div><h3>Results</h3><div>The mean (SD) age of study participants was 62.8(10.2) years, with 51.8 % female. NDVI was positively associated with risk of COPD (odds ratio [OR]: 1.26, 95 % CI: 1.04–1.54) and inversely with lung function: the βs (95 % CIs) for FEV1; FVC; FEV1/FVC ratio; PEF; FEF25 %, 50 %, and 75 %; and MMEF were -0.09 (-0.12, -0.06); -0.07 (-0.10, -0.04); -1.39 (-2.06, -0.72); -0.66 ( -0.74, -0.57); -0.52 (-0.61, -0.43), -0.22 (-0.28, -0.15), and -0.05 (-0.09, -0.01); and -0.17 (-0.22, -0.12), respectively. In high PM_2.5 areas, NDVI was positively associated with COPD risk (OR: 5.40, 95 % CI: 3.45–8.58) and inversely with FEV1/FVC ratio (β:8.29, 95 % CI:9.82, -6.76) and FVC (β:0.13, 95 %CI:0.21, 0.06), and in low PM_2.5 areas, was positively associated with risk of COPD (OR: 1.75, 95 % CI: 1.12–2.80) and inversely with FEV1/FVC ratio (β:3.45, 95 % CI:4.80, 2.11).</div></div><div><h3>Conclusions</h3><div>High residential greenspace may be associated with increased risk of COPD and decreased lung function in adults, particularly in areas with high PM_2.5.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 329-338"},"PeriodicalIF":2.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rapid shallow breathing index (RSBI) as a predictor for extubation success in medical and surgical ICU patients: A retrospective cohort study","authors":"Shaykhah M. Albashir ,&nbsp;Rebecca C. Robert ,&nbsp;Nalini N. Jairath ,&nbsp;Christopher B. Raub ,&nbsp;Omar A. Alzumai ,&nbsp;Samah Saad Salem","doi":"10.1016/j.hrtlng.2025.01.007","DOIUrl":"10.1016/j.hrtlng.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Endotracheal intubation and mechanical ventilation comprise common life support interventions for patients in intensive care units (ICUs). Premature or delayed extubation increases the risk of morbidity and mortality. Despite following weaning protocols, 10–20 % of patients fail extubation within 48 h. To improve extubation success, predictors such as the rapid shallow breathing index (RSBI–the ratio of respiratory rate to tidal volume) are needed. The current RSBI value (&lt;105 breaths/min/L) comes from clinically outdated methods and small samples.</div></div><div><h3>Objective</h3><div>To identify the highest-performing RSBI threshold value associated with extubation success using current weaning protocols in a large sample of medical and surgical ICU patients.</div></div><div><h3>Methods</h3><div>Using secondary data from hospital records, receiver operating characteristic (ROC) analysis of the RSBI, measured immediately after a spontaneous breathing trial, was conducted for 1313 mechanically ventilated (≥ 48 h and ≤ 21 days) patients at one hospital in Saudi Arabia.</div></div><div><h3>Results</h3><div>The sample of 61.5 % medical and 38.5 % surgical patients included 65 % males with a mean age of 53 years and an extubation failure rate of 12 %. Ideal RSBI threshold values differed by medical and surgical samples. For each sample, the area under the ROC curve approximated 0.5 for the RSBI, and multivariable logistic regression identified a unique set of physiologic parameters to predict successful extubation.</div></div><div><h3>Conclusion</h3><div>The RSBI alone demonstrated low diagnostic performance for predicting successful extubation using current weaning protocols. However, results suggest needed updates for RSBI threshold values in current weaning protocols to optimize RSBI use with other predictors for extubation success.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 321-328"},"PeriodicalIF":2.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing heart failure events via individualized patient education program in patients with reduced ejection fraction","authors":"Anu Philip Pharm.D ,&nbsp;Chakrakodi Shasidhara Shastry M.Pharm, PhD ,&nbsp;Basavaraj Utagi MD, DM ,&nbsp;Anjusha Alex M.Sc","doi":"10.1016/j.hrtlng.2025.01.001","DOIUrl":"10.1016/j.hrtlng.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Disease management programs for heart failure (HF) often include various strategies such as medication management and lifestyle modifications, and are known to improve clinical outcomes.</div></div><div><h3>Objectives</h3><div>To evaluate the effectiveness of an individualized patient education program (IPEP) specifically designed for patients with reduced ejection fraction (HFrEF) on clinical outcomes.</div></div><div><h3>Methods</h3><div>In our prospective interventional study involving 164 patients, participants were divided into control (CG) and intervention (IG) groups. The IG received the IPEP facilitated by the academic pharmacist, while both the IG and the CG continued to receive standard care from the healthcare team without any differences in the care provided. Self-care practices, medication adherence, quality of life, and clinical outcomes were assessed at both the 6th and 12th months. Statistical analysis included Chi-square tests, Kaplan-Meier survival plots, and Multivariable Cox proportional regression analysis. Data analysis was conducted using JAMOVI and R software.</div></div><div><h3>Results</h3><div>The demographic and clinical characteristics of sample population were largely homogeneous in both the groups. The unadjusted 1-year rehospitalization (RH) rate was significantly lower in the IG at 33 % compared to 48 % in the CG, with a hazard ratio of 0.55 (95 % CI: 0.34–0.90, <em>p</em> = 0.018). Kaplan-Meier survival analysis depicts a higher RH rate for HFrEF participants over time, with a significant difference observed between CG and IG (log-rank <em>P</em> = 0.017). Notable disparities in self-care practices emerged &amp; at the 6th and 12th-month assessments medication adherence &amp; QoL were significantly improved in the IG (<em>p</em> ≤ 0.001).</div></div><div><h3>Conclusion</h3><div>IPEP led by an academic pharmacist resulted in improved self-care practices, enhanced quality of life, and reduced one-year rehospitalization rates.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 313-320"},"PeriodicalIF":2.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a nurse training intervention in the emergency department to improve the diagnosis and treatment of stemi patients: EDUCAMI study","authors":"Gemma Berga Congost MsC, RN ,&nbsp;Salvatore Brugaletta PhD, MD ,&nbsp;Paloma Garcimartin Cerezo PhD, MsC, RN ,&nbsp;Jonatan Valverde Bernal MsC, RN ,&nbsp;Mariona Berrocal Comalat RN ,&nbsp;Sonia Mena Mejías RN ,&nbsp;Lorena Muñoz Millán RN ,&nbsp;Selma Rodriguez Evangelista RN ,&nbsp;Judit Ruiz Gabalda RN ,&nbsp;Jordi Torralbas Ortega PhD, RN, MsC ,&nbsp;Joan Garcia-Picart MD ,&nbsp;Marcelo Jimenez-Kockar MD ,&nbsp;Dabit Arzamendi Aizpurua PhD, MD ,&nbsp;Mireia Puig Campmany PhD, MD ,&nbsp;María Antonia Martinez Momblan PhD, MsC, RN","doi":"10.1016/j.hrtlng.2025.01.006","DOIUrl":"10.1016/j.hrtlng.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Clinical practice guidelines for acute coronary syndrome recommend an interval between electrocardiogram (ECG) and balloon of &lt;60 min in patients attending the emergency department (ED) of a hospital with primary angioplasty capacity. Compliance with this can be complex, especially in atypical presentations.</div></div><div><h3>Objective</h3><div>To assess the effectiveness of specific training for ED triage nurses in reducing ECG-balloon time in STEMI.</div></div><div><h3>Methods</h3><div>Quasi-experimental study with a pre-test-post-test design. In June 2021, a training intervention was implemented in the diagnosis of STEMI in the ED. The EDUCAMI program included complex presentations, emphasising disparities in women and elderly people. A historical sample was compared with a post-intervention sample.</div><div>All patients consecutively activated as code STEMI in the ED were included, excluding those activated out-of-hospital. The main variable was ECG-balloon time, which was compared according to sex and age.</div></div><div><h3>Results</h3><div>The final sample consisted of 447 patients distributed into historical sample (<em>n</em> = 327) and post-test groups (<em>n</em> = 120). A reduction from 88 (65–133) to 60 (50–116) minutes in ECG-balloon time was observed in the post-test group together with a shorter hospital stay of 5 (3-8) vs 4 (3–5.5) days (<em>p</em> <em>=</em> 0.013).</div><div>When comparing according to sex and age, a decrease in ECG-balloon time (<em>p</em> &lt; 0.001) was observed in men and patients under 65 years of age (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The training intervention proved effective, reducing the ECG-balloon time by 32 %. EDUCAMI reduces the time in men and young people, however, the bias persists in women and those over 65 years of age.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"70 ","pages":"Pages 305-312"},"PeriodicalIF":2.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}