Intensive Care Unit Staff Research Articles

The Value of Nursing Competence and Staffing for Patients in Critical Care: A Scoping Review

Background: Nurse competence and staffing in critical care are of interest to hospital managers and politicians, especially if a relationship exists between educated nurses and patient outcomes. Observational data can describe and measure the impact of critical care nursing practices in intensive care units and may be linked to outcomes. Objective: The aim of this study was to provide an understanding of how levels of nursing competence and staffing in intensive care units are described and associated with nurse-sensitive outcomes. Methods: A scoping review was conducted. Electronic databases, including CINAHL, Medline, Embase, the British Nursing Index, and SweMed+, were searched for English language studies from 2006 to 2023. The inclusion criteria were nurses working in critical care, nurse staffing ratio or assessment, and nurse-sensitive outcomes for intensive care patients. Results: Twenty-one studies were included. As only few studies mentioned the educational level of nurses and the studies used several job titles, it was difficult to interpret nursing competence. Studies that used valid tools for workloads often reported significant results of nursing staffing related to nurse-sensitive outcomes. Adverse events increased with higher levels of nurse workload, and some events were also affected by the level of competence. Lower mortality rate was linked to more nursing hours per patient. Conclusion: We found associations between education, nurse staffing, and nurse-sensitive outcomes in intensive and critical care units. To highlight its effects, advanced nursing competence in critical care and research must be better described. Patients’ need for nursing competence must be assessed using validated tools.

Literature Review of Burnout Syndrome in Intensive Care Unit (ICU) Staffs During The COVID-19 Pandemic

Introductions: Burnout syndrome becomes a special concern for health workers during COVID-19 pandemic that has been exposed to increased workload and intense working hours with COVID-19 patients, stating having a high risk of getting infected with COVID-19 as well. Methods: This literature review paper reviewed scientific journals with prevalence and burnout syndrome profile data. The journals were obtained through the search engines GoogleScholar, the MEDLINE (PubMed) database and PsychINFO. From the search, there are 13 articles in total that meet the required data criteria. Results: Prevalence of burnout syndrome were found severely high in ICU settings, it reached more than 50% from most of the survey. Burnout syndrome rate can be influenced by working conditions, age and gender, time of work and working experience. Burnout syndrome can manifest as higher fatigue level and decrease of cognitive function that can increase the risk of medical mistake. Conclusions: High prevalence and severity of burnout syndrome oblige us to pay attention to symptoms that can affect professional intensive care unit staff and its service to patients. Further research should review prevention therapy and how to apply to health workers and also the prevalence of prevention that has been done in other studies.

Grieving Children' Death in an Intensive Care Unit: Implementation of a Standardized Process.

Background: The grief that accompanies witnessing the death of a child puts health care professionals at risk of secondary trauma, burnout, and turnover when left unaddressed. Objective: Support staff well-being and promote resiliency. Methods: Descriptive implementation of a structured, peer-to-peer bereavement support program for intensive care unit (ICU) staff at a tertiary children's hospital. Results: Thirty-five virtual sessions were held over the period of one year.Through these sessions, participants shared perspectives and normalized reactions, and explored potential coping strategies. Post-session feedback surveys demonstrated the negative impact of a death on the personal or work life of ICU staff. Additionally, nearly all reported some level of burnout. Conclusions: The sessions were feasible and positively impacted staff coping and well-being. Barriers and facilitators to session attendance, as well as suggestions for improvement, were also explored. Implications for practice and future research are discussed. No clinical trial registration is applicable.

ANALISA JARAK AMAN PAPARAN RADIASI BAGI PETUGAS RUMAH SAKIT ICU CENTRAL DI RSUD ARIFIN ACHMAD PROVINSI RIAU

The Intensive Care Unit (ICU) is a room in a hospital with specialized staff and equipment. The patient in the ICU is unstable, so he needs the help of intensive equipment. The ICU patients' limitations require that X-ray examinations be carried out using an X-ray mobile. When an X-ray examination occurs, hospital staff, such as doctors, nurses, and staff, must maintain a certain distance from the radiation source (mobile X-ray aircraft). This study aimed to determine which distances and areas are safe from radiation exposure for hospital medical staff in the Central ICU room at Arifin Achmad Hospital, Riau Province. This research is quantitative with experimental methods. Retrieval of data in research by measuring exposure to radiation doses from 4 different points. The study was conducted from March to July 2023. The data obtained will be analyzed by comparing the results of measurements with NBD based on BAPETEN Regulation No. 15 of 2015 to explore safe areas for hospital staff in the ICU room. Measures at 4-point places show that all-point measurements are safe. Point 1 is the distance from the radiation source to the main door at 11m with a scatter radiation value of 0.9 mSv/y. Point 2 is the distance from the radiation source to the shielding at a distance of 12 m with a scatter radiation value of 0 mSv/y. The most recommended point for the safest medical staff at point 2 (behind the shielding) is the ICU staff room. Keywords: intensive care unit (ICU), safety distance, radiation exposure, X-ray mobile.

Info-NAS: A Computer Program for the Calculation of Intensive Care Unit Nurse Workload.

The purpose of this study was to design an algorithm that allows automatic calculation of nursing workload in intensive care units, based on the Nursing Activities Score scale, through a computer program. Three methodological steps were used: (1) Delphi method (group of experts); (2) identification of the correspondence: Nursing Activities Score items-variables in the EHR, namely, standardized terminology, laboratory values, and prescriptions; and (3) weighting of variables independently by a group of experts. Finally, the algorithm of the computer program was tested. The results showed an algorithm that calculates the nursing workload in an ICU. The calculation is objective and automatic through the EHRs. This study shows the feasibility of the algorithm as a rapid and objective strategy to quantify adequate nurse staffing in intensive care units. Moreover, it provides nurses with a practical resource for the correct completion of records and is thus an incentive to maintain or improve their quality.

Plasma Aβ level alterations after sleep deprivation correspond to brain structural remodeling in medical night shift workers

The relationship between brain structure alteration and metabolic product clearance after night shift work with total sleep deprivation (SD) remains unclear. Twenty-two intensive care unit staff on regularly rotating shift work were implemented with structural and diffusion MRI under both rest wakefulness (RW) and SD conditions. Peripheral blood samples were collected for the measurement of cerebral metabolites. Voxel-based morphometry and diffusion tensor imaging analysis were used to investigate the alterations in the gray matter density (GMD) and mean diffusivity (MD) within the participants. Furthermore, correlation analysis was performed to investigate the relationship between the neuroimaging metrics and hematological parameters. A significant increase in the GMD values was observed in the anterior and peripheral areas of the brain under SD. In contrast, a decrease in the values was observed in the posterior regions, such as the bilateral cerebellum and thalamus. In addition, a significant reduction in the total cerebrospinal fluid volume was observed under SD. The Aβ42/Aβ40 levels in participants under SD were significantly lower than those under RW. The mean MD increment values extracted from the region of interest (ROI) of the anterior brain were negatively correlated with the increment of plasma Aβ42/Aβ40 levels (r = −0.658, P = 0.008). The mean GMD decrement values extracted from the posterior ROI were positively correlated with the increment of plasma Aβ-40 levels (r = 0.601, P = 0.023). The findings of this study suggest that one night of shift work under SD induces extensive and direction-specific structural alterations of the brain, which are associated with aberrant brain metabolic waste clearance.

Recurrent Harlequin Ichthyosis in a Family: A Case Report

Introduction: Harlequin ichthyosis is a severe form of erythrodermic ichthyosis that manifests in a distinctive and distressing appearance at birth. The newborn baby is covered in thick, plate-like scales with distorted surface features, resulting in limited mobility. Fortunately, this condition is rare, with an estimated incidence of approximately 1 in 300,000 births. It is inherited in an autosomal recessive manner and is caused by a mutation in the adenosine triphosphate binding cassette subfamily A member 12 (ABCA12) gene. This mutation affects lipid transport, and the activity of ABCA12 is crucial to produce long-chain ceramides, which are essential for the development of a normal skin barrier. Methods: We present a case report of a newborn who presented with thick, firmly adherent dense plaques covering the entire body, accompanied by deep fissures that extended into the dermis. The facial features included severe ectropion, conjunctival chemosis, eclabium, tethered ears, and a rudimentary nose. In addition, there was flexion contracture of the arms, legs, and digits, along with hypoplastic nails. Results: The baby experienced respiratory difficulty, poor sucking, and a severe cutaneous infection. Unfortunately, the baby’s condition deteriorated and passed away on the 20th day after delivery. Conclusion: Previously considered universally fatal, harlequin ichthyosis now has reported cases of survivors, although it remains a challenging condition. It is crucial to provide parents and family with comprehensive information about the implications of the condition. They should be encouraged to explore all available options and receive psychological support throughout the process. It is essential for the neonatal intensive care unit staff to be trained in providing specialized care for these babies. In addition, parents should be offered the option of antenatal counseling, particularly in cases where there is a previously affected sibling or a history of consanguinity.

Intensive Care Managers’ Experiences of the COVID-19 Pandemic: A Dramatic Change of the Intensive Care Landscape

Aim. To describe intensive care managers’ experiences of premises and resources of care in intensive care units during the COVID-19 pandemic. Background. Intensive care units (ICUs) were enormously pressured during the COVID-19 pandemic from many ill patients, requiring advanced care. Hospital and community volunteers increased staff strength. Obligatorily, recruitments were also conducted using transfer of staff from different hospital departments. However, there is little knowledge about intensive care managers’ (ICMs) experiences of leadership during the COVID-19 pandemic. Methods. A qualitative descriptive study was conducted from March to April 2022. Semistructured interviews were held with 12 ICMs who were purposively sampled from the ICU in ten Swedish hospitals. Data were analysed using qualitative content analysis. Results. Two themes emerged: a dramatic change of the intensive care landscape and we could handle more than we thought, but at a steep price. Participants described that the ICUs had to perform extraordinary changes at a very fast pace, which initially created a sense of cohesion. Training and introduction to war-like conditions associated with uncertainty meant that ICMs had to support ICU staff in prioritising interventions. Participants described how ICUs stood strong against a pandemic, but stress, worries, and anxiety took a heavy toll on ICU staff and ICMs. The pandemic eroded the resilience in ICUs. Participants described a deterioration in health and said that sick leaves and resignations occurred. Conclusion. Our findings show ICMs’ experiences as a field of tension between resources and demands, whereby the changes created a heavy burden that left intensive care weakened. Implications for Nursing Management. Findings emphasised the importance of creating working conditions using human resources and materials in order to rebuild resilience in intensive care with the ability to conduct safe patient care.

Resilience index and mental stress of nursing staff working in intensive care units during the SARS-CoV-2 coronavirus pandemic

Background. Resilience, or mental toughness, is the ability to effectively cope in challenging circumstances. High resilience levels allow for faster adaptation in extreme situations. Aim of the study. An assessment of resilience, mental stress, and self-reported work environment among nursing staff in intensive care units (ICUs) during the SARS-CoV-2 pandemic. Material and methods. The study involved 102 nursing staff working in ICUs. Data collection used the Resilience Coping Scale (RCS-25), Meister’s psychological strain scale, and an original work environment self-assessment scale. Results. The overall mean score of the respondents on the resilience scale was 74.11 points out of a possible 100, while they scored an average of 24.36 points out of 50 on the mental stress scale. Staff working in hospitals converted into infectious disease sites (p = 0.000) or in infectious hospitals with a third level of referral (p = 0.012) assessed their working environment significantly better in the context of the coronavirus disease 19 (COVID-19) pandemic. Medical staff who worked longer at their current workplace, those with longer seniority in the profession, and those who were older scored higher in the resilience areas. The younger the respondent, the more mentally stressed they were in general (rho= -0.200), in non-specific areas (rho= -0.217), and in monotony (rho= -0.211). Those who did not feel well equipped with personal protective equipment showed lower resilience. Conclusions. Respondents were characterized by average resilience and second-level mental stress, while those with higher resilience suffered lower mental stress. We recommend organizing training to strengthen mental toughness, the identification of resilience factors, and the assessment of mental stress in the work environment in the context of the ongoing pandemic. The data obtained could be used to adjust working conditions during the next pandemic. Keywords: nurse, intensive care unit, resilience, mental stress, mental strain, COVID-19.

The Prevalence and Contributing Factors of Burnout Among Anesthesiologists and Intensive Care Unit Staff in Morocco: A Cross-Sectional Analysis.

Introduction Burnout is a common issue in the medical field, particularly in specialties like anaesthesiology and intensive care. It carries significant personal and professional consequences for healthcare providers and can impact the relationship between caregivers and patients. Despite its seriousness, there's been limited research on its causes in North Africa. In this study, our aim was straightforward: we wanted to find out how prevalent burnout is among Moroccan healthcare workers in anaesthesiology and intensive care and identify the main factors contributing to it. Methods To achieve this, we conducted a comprehensive multicenter cross-sectional study that included hospitals from different regions of Morocco. We focused on anesthesiologists and nurse anesthetists currently practicing in these settings. We measured burnout using the French version of the Maslach Burnout Inventory. Results We distributed 500 questionnaires and received and analyzed 396 of them, accounting for an 84% response rate. The results were striking: 48% of participants experienced high emotional exhaustion, 43.2% had a significant level of depersonalization, and 21% exhibited a low sense of personal accomplishment. When we looked at various factors, such as age, income, on-call duties, years of experience, and work location, our analysis showed statistically significant differences in all three dimensions of burnout. In our more complex multivariate analysis, we found that the risk factors for all three dimensions of burnout were practicing for 5 to 15 years and participating in on-call rotations. Surprisingly, practicing for over 25 years seemed to be a protective factor against all dimensions of burnout. Conclusion Our study clearly indicates that burnout is a shared issue among healthcare professionals in anaesthesiology and intensive care units in Morocco. Importantly, we've pinpointed specific risk factors that should be the foundation for a national strategy to prevent burnout in these critical healthcare sectors.

Student nurses’ experiences of their first clinical placement in intensive care unit: A descriptive phenomenology study

ABSTRACT Background: Technical complexity of patient care and the critical environment at the intensive care unit (ICU) provides a favorable setting for acquiring complicated and comprehensive skills among nursing students. Aims: The current research aims to explore the nursing students’ experiences of their first clinical placement in the ICU and identify the factors that facilitate or hinder their learning. Settings and Design: A study using a qualitative descriptive phenomenological approach was conducted in one of the Oman College of Health Sciences branches. Materials and Methods: A purposive sampling technique was used to recruit 12 Year II students enrolled in the Adult Health Nursing practicum course for in-depth face-to-face interviews. The data were collected in July 2020 following approval of the Ethical Review Board. Statistical Analysis Used: All the interviews were transcribed verbatim and analyzed using Colaizzi’s descriptive phenomenological method. Results: The study results revealed three themes with several subthemes under each. The “experience,” “challenges,” and “the facilitating and hindering factors for learning” were the themes that emerged from the data analysis. Conclusions: Overall, students showed unfavorable responses toward the ICU experience. In addition, the unsupportive interaction with ICU staff contributed significantly to the overall impression. Therefore, strategies to enhance communication and interaction with the ICU staff are essential for a positive ICU learning experience, as students rely on the ICU staff for patient-specific information beyond their academic needs. Therefore, curriculum designers must consider these experiences to facilitate a positive experience in future clinical placements.

Modifications in family centered developmental care and in neonatal intensive care during the COVID-19 pandemic in a hospital in Spain: A qualitative study

IntroductionFamily centered developmental care (FCDC) are a philosophy of care in the neonatal care units (NICU), based on the control of sensory stimulation the adequate position and of newborn and the family involvement of cares. Nursing staff are the main providers of this care. Sanitary measure to control of the COVID-19, such as the use of masks, isolation of positive cases and capacity limit, conditioned the implementation of FCDC. ObjectivesTo understand the meaning of the experience of the nursing staff of a neonatal intensive care unit (NICU) on the implementation of the FCDC, under the sanitary measures imposed for the containment of COVID-19. MethodsA qualitative study was conducted from the descriptive phenomenological paradigm in which NICU nurses were recruited. The qualitative data collection was carried out through open-ended and semi-structured interviews. These were analyzed respectively through a preliminary narrative analysis and a thematic analysis of the informant nurses’ narratives and discourses. ResultsThree open-ended and 7 semi-structured interviews were conducted from which three main topics emerged: 1) changes in the FCDC derived from the sanitary restrictions implemented for the containment of COVID-19; 2) changes in interpersonal relationships in the context of a pandemic, and 3) transition to normality. ConclusionsThe nurses of NICU perceived changes in the implementation of the FCDC due to the containment of COVID-19, that modified the relationship with the parents of NB, accelerating their training as caregivers, and involved the implementation of new measures such as video calls.

Reducing intrusive memories after trauma via an imagery-competing task intervention in COVID-19 intensive care staff: a randomised controlled trial

Intrusive memories (IMs) after traumatic events can be distressing and disrupt mental health and functioning. We evaluated the impact of a brief remotely-delivered digital imagery-competing task intervention on the number of IMs for intensive care unit (ICU) staff who faced repeated trauma exposure during the COVID-19 pandemic using a two-arm, parallel-group, single-blind randomised controlled trial, with the comparator arm receiving delayed access to active treatment (crossover). Eligible participants worked clinically in a UK NHS ICU during the pandemic and had at least 3 IMs of work-related traumatic events in the week before recruitment. Participants were randomly assigned (1:1) to immediate (weeks 1–4) or delayed (weeks 5–8) intervention access. Sequential Bayesian analyses to optimise the intervention and increase trial efficiency are reported elsewhere [1]. The primary endpoint for the pre-specified frequentist analysis of the final study population compared the number of IMs experienced in week 4 between the immediate and delayed access arms. Secondary outcomes included clinical symptoms, work functioning and wellbeing. Safety was assessed throughout the trial by scheduled questions and free report. All analyses were undertaken on an intention-to-treat basis (86 randomised participants). There were significantly fewer intrusive memories during week 4 in the immediate (median = 1, IQR = 0–3, n = 43), compared to the comparator delayed arm (median = 10, IQR = 6–17, n = 43), IRR 0.31, 95% CI: 0.20–0.48, p < 0.001. After crossover, the delayed arm also showed a significant reduction in IMs at week 8 compared to week 4. There were convergent findings for symptoms of PTSD, insomnia and anxiety, work engagement and burnout, general functioning and quality of life. The intervention was found safe and acceptable to participants. All adverse events were unrelated to the study. Our study provides the first evidence of a benefit on reducing IMs, improving other clinical symptoms, work functioning and wellbeing, as well as safety of a brief remotely-delivered digital imagery-competing task intervention. An efficacy trial with an active control and longer follow-up is warranted. The trial is registered at ClinicalTrials.gov (NCT04992390).

Modificaciones de los cuidados centrados en el desarrollo y la familia en cuidados intensivos neonatales durante la pandemia por COVID-19 en un hospital de España: un estudio cualitativo

IntroductionFamily centered developmental care (FCDC) are a philosophy of care in the neonatal care units (NICU), based on the control of sensory stimulation the adequate position and of newborn and the family involvement of cares. Nursing staff are the main providers of this care. Sanitary measure to control of the COVID-19, such as the use of masks, isolation of positive cases and capacity limit, conditioned the implementation of FCDC. ObjectivesTo understand the meaning of the experience of the nursing staff of a neonatal intensive care unit (NICU) on the implementation of the FCDC, under the sanitary measures imposed for the containment of COVID-19. MethodsA qualitative study was conducted from the descriptive phenomenological paradigm in which NICU nurses were recruited. The qualitative data collection was carried out through open-ended and semi-structured interviews. These were analyzed respectively through a preliminary narrative analysis and a thematic analysis of the informant nurses’ narratives and discourses. ResultsThree open-ended and 7 semi-structured interviews were conducted from which three main topics emerged: 1)changes in the FCDC derived from the sanitary restrictions implemented for the containment of COVID-19; 2)changes in interpersonal relationships in the context of a pandemic, and 3)transition to normality. ConclusionsThe nurses of NICU perceived changes in the implementation of the FCDC due to the containment of COVID-19, that modified the relationship with the parents of NB, accelerating their training as caregivers, and involved the implementation of new measures such as video calls.

A brief questionnaire for measuring alarm fatigue in nurses and physicians in intensive care units

When exposed to hundreds of medical device alarms per day, intensive care unit (ICU) staff can develop “alarm fatigue” (i.e., desensitisation to alarms). However, no standardised way of quantifying alarm fatigue exists. We aimed to develop a brief questionnaire for measuring alarm fatigue in nurses and physicians. After developing a list of initial items based on a literature review, we conducted 15 cognitive interviews with the target group (13 nurses and two physicians) to ensure that the items are face valid and comprehensible. We then asked 32 experts on alarm fatigue to judge whether the items are suited for measuring alarm fatigue. The resulting 27 items were sent to nurses and physicians from 15 ICUs of a large German hospital. We used exploratory factor analysis to further reduce the number of items and to identify scales. A total of 585 submissions from 707 participants could be analysed (of which 14% were physicians and 64% were nurses). The simple structure of a two-factor model was achieved within three rounds. The final questionnaire (called Charité Alarm Fatigue Questionnaire; CAFQa) consists of nine items along two scales (i.e., the “alarm stress scale” and the “alarm coping scale”). The CAFQa is a brief questionnaire that allows clinical alarm researchers to quantify the alarm fatigue of nurses and physicians. It should not take more than five minutes to administer.

The Initial Experiences of intensive care unit staff during the COVID-19 pandemic in Turkey: A qualitative study

Objective: This study aimed to explore the initial experiences of intensive care unit (ICU) staff during the COVID-19 pandemic.

Association of CPR simulation program characteristics with simulated and actual performance during paediatric in-hospital cardiac arrest

AimTo evaluate associations between characteristics of simulated point-of-care cardiopulmonary resuscitation (CPR) training with simulated and actual intensive care unit (ICU) CPR performance, and with outcomes of children after in-hospital cardiac arrest. MethodsThis is a pre-specified secondary analysis of the ICU-RESUScitation Project; a prospective, multicentre cluster randomized interventional trial conducted in 18 ICUs from October 2016–March 2021. Point-of-care bedside simulations with real-time feedback to allow multidisciplinary ICU staff to practice CPR on a portable manikin were performed and quality metrics (rate, depth, release velocity, chest compression fraction) were recorded. Actual CPR performance was recorded for children 37 weeks post-conceptual age to 18 years who received chest compressions of any duration, and included intra-arrest haemodynamics and CPR mechanics. Outcomes included survival to hospital discharge with favourable neurologic status. ResultsOverall, 18,912 point-of-care simulations were included. Simulation characteristics associated with both simulation and actual performance included site, participant discipline, and timing of simulation training. Simulation characteristics were not associated with survival with favourable neurologic outcome. However, participants in the top 3 sites for improvement in survival with favourable neurologic outcome were more likely to have participated in a simulation in the past month, on a weekday day, to be nurses, and to achieve targeted depth of compression and chest compression fraction goals during simulations than the bottom 3 sites. ConclusionsPoint-of-care simulation characteristics were associated with both simulated and actual CPR performance. More recent simulation, increased nursing participation, and simulation training during daytime hours may improve CPR performance.

Use of Sequential Organ Failure Assessment Among Intensive Care Unit Patients with Septic Shock

Purpose: Sepsis is a significant cause of mortality in modern intensive care units (ICUs). At Sharp Grossmont Hospital (SGH), sepsis cases increased the patient mortality rate in comparison to other Sharp facilities. Currently, no tools are utilized to identify septic patients at SGH. The study aimed to find out the impact of early consultation of advanced illness management (AIM) and goals of care conversations (GOCC) on reducing the length of stay (LOS) among septic shock patients.&#x0D; Methodology: Descriptive data were attained based on Electronic Medical Records (EMR) of 39 septic shock patients form which ICU nurses utilize to calculate Sequential Organ Failure Assessment (SOFA) on admission and daily for 2 days. &#x0D; Findings: The education increased the ICU staff’s awareness of the high occurrence of septic shock among ICU patients. After the deployment of SOFA scores among 39 patients of septic shock, the average LOS was 3 days, compared to more than 5 days before implementing SOFA scores. Post-implementation, 33 % of patients received early AIM or GOCC intervention, with 84% of them receiving intervention from the first day of admission. These percentages are compared to pre-implementation, when early AIM or GOCC intervention was provided to 36.4 % of patients, with 41.3 % of them receiving AIM or GOCC from the first day of admission.&#x0D; Recommendations: In this study, the leader of change must be aware of standardized Arterial Blood Gas (ABG) orders for SOFA scores and measure the compliance of ICU nurses in documenting SOFA scores. Moreover, raise awareness among healthcare professionals about the high occurrence of septic shock mortality among ICU patients.

ASSESSMENT OF OUTCOMES OF MALIGNANCY PATIENTS ADMITTED IN INTENSIVE CARE UNITS

Background: The decision to admit advanced cancer patients to the intensive care unit (ICU) is multifaceted, considering factors such as prognosis and quality of life. This study aimed to identify mortality risk factors in critically ill advanced cancer patients admitted to the ICU. Objectives: The objective of this study was to identify mortality risk factors in critically ill advanced cancer patients admitted to the ICU. Study Design: This was an observational study. Setting: The study was conducted at Bahria International Hospital, Lahore. Duration of Study: The study was conducted between March 2022 and March 2023. Material and Methods: A total of 65 adult cancer patients admitted non-electively to the ICU were enrolled in the study. Data on demographics, clinical conditions, and outcomes were collected. Independent medical decisions were made by ICU staff. Results: The ICU mortality rate was 34.6%, rising to 59.4% within thirty days post-discharge. Patients spent an average of 15.2 days in the ICU. Common admission reasons included respiratory failure (36.2%) and sepsis/septic shock (59.2%). Cox regression analysis revealed six significant indicators of poor outcomes: acute kidney injury (AKI), sepsis with multiple organ failure (MOF), acute respiratory distress syndrome (ARDS), uncontrolled malignancy, mechanical ventilation, and vasopressor use. Conclusion: Our findings highlight AKI, sepsis, MOF, ARDS, and uncontrolled malignancy as prognostic predictors of early death in critically ill cancer patients admitted to the ICU. Additionally, mechanical ventilation and vasopressor use are associated with increased mortality risk. These insights can aid clinicians in optimizing care strategies for this vulnerable patient population.

ASSESSMENT OF OUTCOMES OF MALIGNANCY PATIENTS ADMITTED IN INTENSIVE CARE UNITS

Background: The decision to admit advanced cancer patients to the intensive care unit (ICU) is multifaceted, considering factors such as prognosis and quality of life. Objectives: The objective of this study was to identify mortality risk factors in critically ill advanced cancer patients admitted to the ICU. Study Design: This was an observational study. Setting: The study was conducted at Bahria International Hospital, Lahore. Duration of Study: The study was conducted between March 2022 and March 2023.Material and Methods: A total of 65 adult cancer patients admitted non-electively to the ICU were enrolled in the study. Data on demographics, clinical conditions, and outcomes were collected. Independent medical decisions were collected by ICU staff. Results: The ICU mortality rate was 34.6%, increased to 59.4% within thirty days post-discharge. Patients spent an average of 15.2 days in the ICU. Common admission reasons included respiratory failure (36.2%) and sepsis/septic shock (59.2%). Cox regression analysis revealed six significant indicators of poor outcomes: acute kidney injury (AKI), sepsis with multiple organ failure (MOF), acute respiratory distress syndrome (ARDS), uncontrolled malignancy, mechanical ventilation, and vasopressor use. Conclusion: Our findings highlight AKI, sepsis, MOF, ARDS, and uncontrolled malignancy as prognostic predictors of early death in critically ill cancer patients admitted to the ICU. Additionally, mechanical ventilation and vasopressor use are associated with increased mortality risk. These insights can aid clinicians in optimizing care strategies for cancer patients