Extracorporeal membrane oxygenation（ECMO） is used to rescue patients with severe cardiopulmonary failure,and nurses are important members of the ECMO team. This paper introduces the qualification requirements,training content,training methods and qualification accreditation of nurses participating in ECMO monitoring training at home and abroad,and puts forward relevant suggestions based on the current situation in China,in order to provide references for carrying out ECMO monitoring training in China and provide the guidance for managers to formulate relevant policies.
Objective To explore the potential trajectory categories of fatigue degree in patients with post-intensive care syndrome（PICS）,and to analyze the influence of patient demographic data and disease-related data on the potential categories of fatigue trajectory. Methods A convenient sampling method was used to select patients hospitalized in general ICU ward of a tertiary hospital in Guizhou Province from January 2020 to September,and the demographic and disease-related data of patients was collected. The fatigue degree of the patients was evaluated at 1 week（T1）,1 month（T2） and 3 months（T3） after ICU discharge. The growth mixture model was used to identify the potential trajectory category. Logistic regression analysis was used to analyze the prediction factors of trajectory category. Results 556 research subjects were initially enrolled,and 300 of them developed PICS. 4 types of fatigue trajectories were identified in these patients,and they were sustained fatigue group（19.00%）,increased fatigue group（6.00%）,fatigue remission group（27.67%）and non-fatigue group（47.33%）. Logistic regression analysis showed that high APACHE Ⅱ score,advanced age and history of respiratory diseases were independent predictors of fatigue trajectory categories. Conclusion The degree of fatigue in patients with PICS shows different trajectories. Medical staff should pay attention to the evaluation and intervention of fatigue in patients with high APACHE Ⅱ scores,advanced age,and history of respiratory diseases.
ICU acquired weakness affects the recovery of critically ill patients and the quality of life after discharge. Early functional exercise can reduce the incidence of ICU acquired weakness and promote the recovery of patients. In this article,the necessity of early functional exercise for ICU patients is described firstly. Secondly,the assessment of early functional exercise is also summarized,including the specific contents of the initial and continuous assessment of early functional exercise. Besides,the current status and problems of the research on the implementation of early functional exercise,including progressive functional exercise and goal-oriented functional exercise,are reviewed. Lastly,the impediments to the implementation of early functional exercise are analyzed,and the corresponding countermeasures are proposed. The purpose of this study is to provide a reference for clinical and nursing staff to implement early functional exercise effectively and safely.
Objective To explore the latent classes of symptom characteristics of post-intensive care syndrome（PICS）patients and to analyze the differences in demographic and disease characteristics of patients among different classes. Methods According to the inclusion and exclusion criteria,patients in the general ICU of a tertiary hospital in Guizhou were selected as the research subjects from August 16,2019 to January 16,2020,and from June 8,2020 to October 30,2020 by using convenient sampling method. Patients were followed up by telephone after being transferred out of ICU for 1 month to assess their PICS-related symptoms. Latent class analysis（LCA）was used to explore the latent classes of the symptom characteristics of PICS patients. Single factor analysis and multiple logistic regression were used to identify the influencing factors of the latent classes of PICS. Results A total of 299 samples were obtained and PICS occurred in 165 patients（55.18%）. The symptom characteristics of PICS could be divided into 3 latent classes,which were named as “fatigue-sleep disorder group”（44.24%）,“anxiety group”（16.97%）,and “high symptom group”（38.79%）. Compared “high symptom group” with “fatigue-sleep disorder group”,the higher acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）score was,the less likely it was to be classified as “fatigue-sleep disorder group”（OR=0.882,P=0.001）,and the more likely it was to be classified as “fatigue-sleep disorder group” without respiratory disease history or tracheotomy（OR=5.443,P=0.048;OR=4.015,P=0.006）. Compared “high symptom group” with “anxiety group”,the higher APACHE Ⅱ score was Less likely to be classified to be “anxiety group”（OR=0.903,P=0.027）,and patients younger than 50 years old were more likely to be classified as “anxiety group”（OR=3.392,P=0.025）. Compared with “fatigue-sleep disorder group”,patients with age younger than 50 years were more likely to be classified as “anxiety group”（OR=4.422,P=0.005）. Conclusion The symptomatic characteristics of PICS are heterogeneous and can be divided into 3 latent classes. Patients with a high APACHE II score,a history of respiratory disease,and a tracheotomy were more likely to be classified as “high symptom group”,while those younger than 50 were more likely to be classified as “anxiety group”. It is suggested that the clinical staff should pay attention to the heterogeneity of PICS individual symptom characteristics and give targeted intervention measures to different classes of patients.
