Acute and Critical Care

Original Articles

Neurology
The effects of restricted visitation on delirium incidence in the intensive care units of a tertiary hospital in South Korea: Leerang Lim, Christine Kang, Minseob Kim, Jinwoo Lee, Hong Yeul Lee, Seung-Young Oh, Ho Geol Ryu, Hannah Lee; Acute Crit Care. 2025;40(3):452-461. Published online August 21, 2025; DOI: https://doi.org/10.4266/acc.000500

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Abstract PDF Supplementary Material: Background
Delirium is a common but serious complication in critically ill patients. Family visitation has been shown to reduce delirium; however, during the coronavirus disease 2019 (COVID-19) pandemic, intensive care units (ICUs) restricted regular visitation to prevent the spread of infection. This study aimed to evaluate the association between visitation policies and incidence of delirium in the ICUs. Methods: This was a retrospective before-and-after study conducted in medical and surgical ICUs at a tertiary hospital. Adult patients admitted to an ICU during one of two periods were included: before the COVID-19 pandemic (June 2017 to May 2019) with regular visitation and during the pandemic (June 2020 to May 2022) with prohibited visitation. Delirium was assessed using the Confusion Assessment Method for the ICU. The primary outcome was association between delirium incidence and visitation policy. Results: Totals of 1,566 patients from the pre-COVID-19 period and 1,404 patients from the COVID-19 period were analyzed. The incidence of delirium was higher during the COVID-19 period (48.1% vs. 38.4%, P<0.001). After adjusting for relevant variables, the restricted visitation policy during COVID-19 remained a risk factor for delirium (odds ratio, 1.37; 95% CI, 1.13–1.65; P=0.001). Conclusions: Complete restriction of ICU visitations during the COVID-19 pandemic was associated with a significant increase in delirium incidence. These findings suggest the importance of visitation policies on patient outcomes and suggest the need for alternative strategies, such as video visitation, to mitigate the adverse effects of visitation restrictions during pandemics.

Nutrition
The impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea: Hyun-Jun Park, Yoon Hae Ahn, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee; Acute Crit Care. 2025;40(2):304-312. Published online May 30, 2025; DOI: https://doi.org/10.4266/acc.000700

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Abstract PDF: Background
While enteral feeding intolerance (EFI) is associated with worse clinical outcomes in critically ill patients, the relationship between the number of days of EFI and mortality outcomes remains unclear.
Methods
We retrospectively analyzed adult patients admitted to the medical intensive care unit (ICU) with septic shock at a tertiary referral center. EFI was defined as the presence of vomiting, abdominal distension, pain, diarrhea, or radiographic evidence of ileus. EFI status was assessed daily, and we evaluated the prognostic impact of total number of EFI days during the first 3 days of enteral feeding on clinical outcomes.
Results
A total of 94 patients were included in the analysis, with 77 (81.9%) experiencing EFI. During the first 3 days of enteral feeding, 25 patients (26.6%) experienced EFI for 1 day, 22 patients (23.4%) experienced EFI for 2 days, and 30 patients (31.9%) experienced EFI for all 3 days. The total number of EFI days was identified as an independent risk factor of 90-day mortality (adjusted hazard ratio, 1.400; 95% CI 1.021–1.919). Higher total EFI days was significantly associated with increased ICU mortality (P for trend=0.036), in-hospital mortality (P for trend=0.007), 30-day mortality (P for trend=0.004), and 90-day mortality (P for trend=0.006).
Conclusions
An increase in the total number of EFI days was significantly associated with mortality outcomes in patients with septic shock, suggesting that EFI may serve as a useful indicator for predicting outcomes in this population.

Thoracic surgery
Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea: Tae Jung Kim, Hyun Joo Lee, Samina Park, Sang-Bae Ko, Soo-Hyun Park, Seung Hwan Yoon, Kwon Joong Na, In Kyu Park, Chang Hyun Kang, Young Tae Kim, Sun Mi Choi, Jimyung Park, Joong-Yub Kim, Hong Yeul Lee; Acute Crit Care. 2025;40(1):79-86. Published online January 7, 2025; DOI: https://doi.org/10.4266/acc.003384

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Abstract PDF Supplementary Material: Background
Posterior reversible encephalopathy syndrome (PRES) is a rare complication of lung transplantation with poorly understood risk factors and clinical characteristics. This study aimed to examine the occurrence, risk factors, and clinical data of patients who developed PRES following lung transplantation.
Methods
A retrospective analysis was conducted on 147 patients who underwent lung transplantation between February 2013 and December 2023. The patients were diagnosed with PRES based on the clinical symptoms and radiological findings. We compared the baseline characteristics and clinical information, including primary lung diseases and immunosuppressive therapy related to lung transplantation operations, between the PRES and non-PRES groups.
Results
PRES manifested in 7.5% (n=11) of the patients who underwent lung transplantation, with a median onset of 15 days after operation. Seizures were identified as the predominant clinical manifestation (81.8%, n=9) in the group diagnosed with PRES. All patients diagnosed with PRES recovered fully. Patients with PRES were significantly associated with connective tissue disease-associated interstitial lung disease (45.5% vs. 18.4%, P=0.019, odds ratio=9.808; 95% CI, 1.064–90.386; P=0.044). Nonetheless, no significant variance was observed in the type of immunotherapy, such as the use of calcineurin inhibitors, blood pressure, or acute renal failure subsequent to lung transplantation.
Conclusions
PRES typically manifests shortly after lung transplantation, with seizures being the predominant initial symptom. The presence of preexisting connective tissue disease as the primary lung disease represents a significant risk factor for PRES following lung transplantation.

Pulmonary
Factors influencing sleep quality in the intensive care unit: a descriptive pilot study in Korea: Yoon Hae Ahn, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee; Acute Crit Care. 2023;38(3):278-285. Published online August 11, 2023; DOI: https://doi.org/10.4266/acc.2023.00514

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Abstract PDF Supplementary Material

Background
As sleep disturbances are common in the intensive care unit (ICU), this study assessed the sleep quality in the ICU and identified barriers to sleep.
Methods
Patients admitted to the ICUs of a tertiary hospital between June 2022 and December 2022 who were not mechanically ventilated at enrollment were included. The quality of sleep (QoS) at home was assessed on a visual analog scale as part of an eight-item survey, while the QoS in the ICU was evaluated using the Korean version of the Richards-Campbell Sleep Questionnaire (K-RCSQ). Good QoS was defined by a score of ≥50.
Results
Of the 30 patients in the study, 19 reported a QoS score <50. The Spearman correlation coefficient showed no meaningful relationship between the QoS at home and the overall K-RCSQ QoS score in the ICU (r=0.16, P=0.40). The most common barriers to sleep were physical discomfort (43%), being awoken for procedures (43%), and feeling unwell (37%); environmental factors including noise (30%) and light (13%) were also identified sources of sleep disruption. Physical discomfort (median [interquartile range]: 32 [28.0–38.0] vs. 69 [42.0–80.0], P=0.004), being awoken for procedures (36 [20.0–48.0] vs. 54 [36.0–80.0], P=0.04), and feeling unwell (31 [18.0–42.0] vs. 54 [40.0–76.0], P=0.01) were associated with lower K-RCSQ scores.
Conclusions
In the ICU, physical discomfort, patient care interactions, and feeling unwell were identified as barriers to sleep.

Citations

Citations to this article as recorded by

Effects of nursing interventions applied at night on sleep quality and sleep effort of patients in the intensive care unit
Aynur Bahar, Mina Güner Muşluoğlu, Hilal Uygur
Psychology, Health & Medicine.2025; 30(9): 1947. CrossRef
Impact of Noninvasive Ventilation on Quality of Sleep among Patients Admitted to the Critical Care Unit
Margiben T Bhatt, Aiswarya Kunjappan, Madhura M Reddy, Samruddha S Prabhu, Vani Lakshmi R
Indian Journal of Critical Care Medicine.2025; 29(5): 424. CrossRef
Sleep Quality and Its Associated Factors among Adult Patients Admitted in the Intensive Care Units of Public Hospitals in Addis Ababa, Ethiopia
Taye Mezgebu Ashine, Birehanu Melaku Kassaye, Asefu Woldestadik, Kasie Gebeyehu Tiruneh, Tadesse Sahle Adeba, Edmialem Getahun Mesfin, Tamrat Alate Woldeyohannis, Asaminew Habtamu Sane
Sage Open Nursing.2025;[Epub] CrossRef
Factors Predicting Sleep Quality in Sepsis Survivors: A Cross-Sectional Study
Kewalin Pongsuwun, Wimolrat Puwarawuttipanit, Ruttanaporn Kongkar, Yong Rongrungruang
Pacific Rim International Journal of Nursing Research.2025; 29(3): 619. CrossRef
Quieting the ICU: Pathway to Recovery, by Enhancing Sleep through Non Pharmacological Intervention: A Comparative Analysis
Shivakumar Shivanna, Swapna Mandala Babu, Deepak CP
Indian Journal of Critical Care Medicine.2025; 29(S1): S198. CrossRef
Comparing single-patient and multi-patient room intensive care units: a multicenter cohort study on architectural differences and clinical significance in South Korea
Daun Jeong, Donghyoun Lee, Kyoung Won Yoon, Hyo Jin Kim, Sun Young Choi, Chi-Min Park
Acute and Critical Care.2025; 40(2): 160. CrossRef
Translation and Validation of the Richards–Campbell Sleep Questionnaire for Intensive Care Unit Patients in Morocco: Reliability and Validity Assessment
Abdelmajid Lkoul, Keltouma Oum’barek, Mohamed Amine Baba, Asmaa Jniene, Tarek Dendane
Clocks & Sleep.2025; 7(3): 31. CrossRef
Sleep Quality and Disruptive Factors in Intensive Care Units: A Comparison Between Mechanically Ventilated and Spontaneously Breathing Patients
Öznur Erbay Dalli, Nermin Kelebek Girgin
Nursing in Critical Care.2025;[Epub] CrossRef
Electroencephalography-based evaluation of the impact of night-time nursing care on sleep during intensive care unit administration after cardiac surgery
Yutaka Matsuura, Yuko Ohno, Hiroki Natori, Akemi Ichikawa, Mariko Nakamura, Ryo Akiyama, Takayoshi Ueno
Scientific Reports.2025;[Epub] CrossRef
Nurses’ Perspectives on Sleep Promotion Practices in Indonesian ICUs: A Multicenter Cross-Sectional Study
Sri Setiyarini, Desy Listyaningrum, Hersinta Retno Martani, Purwadi Sujalmo, Happy Indah Kusumawati
Journal of Applied Nursing and Health.2025; 7(2): 34. CrossRef
Could fever dreams influence sleep in intensive care units?
Jeng Swen Ng, Sheryn Tan, Sanjana Santhosh, Brandon Stretton, Joshua Kovoor, Aashray Gupta, Stephen Bacchi
Acute and Critical Care.2024; 39(2): 327. CrossRef
Effects of ICU diaries on psychological disorders and sleep quality in critically ill patients and their family members: A systematic review and meta-analysis
Wenjie Huang, Yang Gao, Lingjun Zhou, Xiaojuan Xiao, Hong Xu, Lizhou Lu, Jinhao Deng, Juan Wu
Sleep Medicine.2024; 122: 84. CrossRef
Nursing‐Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review
Issa M. Hweidi, Omar H. Jebreel, Hossam N. Alhawatmeh, Mohamad I. Jarrah, Awwad A. Abu‐Awwad, Mohammed I. Hweidi
Journal of Clinical Nursing.2024; 33(12): 4528. CrossRef
Nursing Sleep Promotion in Intensive Care Unit
Orlando Fernandes, Válter Gonçalves, Leonardo Ribeiro, Elsa Sousa, Michelle Viríssimo, Abel Viveiros, Ana Alves
European Journal of Theoretical and Applied Sciences.2024; 2(6): 238. CrossRef
Different nursing interventions on sleep quality among critically ill patients: A systematic review and network meta-analysis
Daijin Huang, Yumei Li, Jing Ye, Chang Liu, Dongyan Shen, Yunhui Lv
Medicine.2023; 102(52): e36298. CrossRef

Letter to the Editor

Rapid response system
Current status of the rapid response system and early warning score: a survey-based analysis: Sang-Hyeon Park, Jeehoon Kang, Tae Jung Kim, Hong Yeul Lee, Hyun-Jai Cho, Sang-Min Lee; Acute Crit Care. 2022;37(4):687-689. Published online November 21, 2022; DOI: https://doi.org/10.4266/acc.2022.01144

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PDF Supplementary Material

Original Articles

Pulmonary
Association between timing of intubation and mortality in patients with idiopathic pulmonary fibrosis: Eunhye Bae, Jimyung Park, Sun Mi Choi, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee; Acute Crit Care. 2022;37(4):561-570. Published online October 28, 2022; DOI: https://doi.org/10.4266/acc.2022.00444

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Abstract PDF Supplementary Material: Background
Delayed intubation is associated with poor prognosis in patients with respiratory failure. However, the effect of delayed intubation in patients with idiopathic pulmonary fibrosis (IPF) remains unknown. This study aimed to analyze whether timing of intubation after high-concentration oxygen therapy was associated with worse clinical outcomes in IPF patients.
Methods
This retrospective propensity score-matched study enrolled adult patients with IPF who underwent mechanical ventilation between January 2011 and July 2021. Patients were divided into early and delayed intubation groups. Delayed intubation was defined as use of high-concentration oxygen therapy for at least 48 hours before tracheal intubation. The primary outcome was intensive care unit (ICU) mortality, and a conditional logistic regression model was used to evaluate the association between timing of intubation and clinical outcomes.
Results
The median duration of high-concentration oxygen therapy before intubation was 0.5 days in the early intubation group (n=60) and 5.1 days in the delayed intubation group (n=36). The ICU mortality rate was 56.7% and 75% in the early and delayed intubation groups, respectively, before propensity matching (P=0.075). After matching for demographic and clinical covariates, 33 matched pairs were selected. In the propensity-matched cohort, delayed intubation significantly increased the risk of ICU mortality (adjusted odds ratio, 3.99; 95% confidence interval, 1.02–15.63; P=0.046). However, in-hospital mortality did not differ significantly between the groups.
Conclusions
In patients with IPF, delayed intubation after initiation of high-concentration oxygen therapy was significantly associated with increased risk of ICU mortality compared to early intubation.

Meta-analysis
Comparison of mNUTRIC-S2 and mNUTRIC scores to assess nutritional risk and predict intensive care unit mortality: So Jeong Kim, Hong Yeul Lee, Sun Mi Choi, Sang-Min Lee, Jinwoo Lee; Acute Crit Care. 2022;37(4):618-626. Published online October 18, 2022; DOI: https://doi.org/10.4266/acc.2022.00612

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Abstract PDF Supplementary Material

Background
Nutritional status is associated with mortality. The modified Nutrition Risk in the Critically Ill (mNUTRIC) score is one of the most commonly used nutritional risk assessment tools in intensive care units (ICUs). The purpose of this study was to compare the mortality predictive ability of the mNUTRIC score to that of the mNUTRIC-S2 score, which uses the Simplified Acute Physiology Score (SAPS) II instead of the Acute Physiology and Chronic Health Evaluation (APACHE) II.
Methods
This retrospective cohort analysis included patients admitted to the ICU between January and September 2020. Each patient’s electronic medical records were reviewed. The model discrimination for predicting ICU mortality was assessed by the area under the receiver operating characteristic (ROC) curve, and a Cox regression model was performed to confirm the relationship between the groups and mortality.
Results
In total, 220 patients were enrolled. The ROC curve for predicting ICU mortality was 0.64 for the mNUTRIC score versus 0.67 for the mNUTRIC-S2 score. The difference between the areas was 0.03 (95% confidence interval [CI], –0.01 to 0.06; P=0.09). Patients with mNUTRIC-S2 score ≥5 had a greater risk of ICU mortality (hazard ratio [HR], 3.64; 95% CI, 1.85–7.14; P<0.001); however, no such relationship was observed with mNUTRIC score (HR, 1.69; 95% CI, 0.62–4.62; P=0.31).
Conclusions
The mNUTRIC-S2 score was significantly associated with ICU mortality. A cutoff score of 5 was selected as most appropriate.

Citations

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Bayesian Analysis of Modified Nutrition Risk in Critically Ill (mNUTRIC) Score for Mortality Prediction in Critically Ill Patients
Raj Kumar, Archana Kumari, Vivek Verma, Jay Prakash, Pradip K Bhattacharya, Shio Priye, Khushboo Saran, Kunal Raj, Bram Rochwerg
Indian Journal of Critical Care Medicine.2025; 29(5): 449. CrossRef
Comparison of mNUTRIC Score and mnutric Score with Albumin in Predicting Outcome in CKD Patients
Venkatesh Dhat, Jainab Bhori, Manish Mali, Mahesh R Jarkad, Aishwarya Chavan, Tushar Warke
Indian Journal of Critical Care Medicine.2025; 29(S1): S259. CrossRef
Predictive value of the mNUTRIC score and survival analysis in critically-ill patients hospitalized in the intensive care unit: A prospective observational study
Harun Tolga Duran, Osman Özgür Kilinç
Medicine.2025; 104(44): e45645. CrossRef
Association between nutritional risk scores and timing of endotracheal intubation in COVID-19-associated acute respiratory distress syndrome: a single-center cohort study in South Korea
Hyojin Jang, Wanho Yoo, Kwangha Lee
Acute and Critical Care.2025; 40(4): 538. CrossRef
Association of malnutrition status with 30-day mortality in patients with sepsis using objective nutritional indices: a multicenter retrospective study
Moon Seong Baek, Young Suk Kwon, Sang Soo Kang, Daechul Shim, Youngsang Yoon, Jong Ho Kim
Acute and Critical Care.2024; 39(1): 127. CrossRef
Modified NUTRIC Score as a Predictor of All-cause Mortality in Critically Ill Patients: A Systematic Review and Meta-analysis
Amit Kumar, Archana Kumari, Jay Prakash, Pradip K Bhattacharya, Saket Verma, Priyanka Shrivastava, Khushboo Saran, Kunal Raj, Hemant N Ray
Indian Journal of Critical Care Medicine.2024; 28(5): 495. CrossRef

Pulmonary
Effect of prone positioning on gas exchange according to lung morphology in patients with acute respiratory distress syndrome: Na Young Kim, Si Mong Yoon, Jimyung Park, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee; Acute Crit Care. 2022;37(3):322-331. Published online July 29, 2022; DOI: https://doi.org/10.4266/acc.2022.00367

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Background
There are limited data on the clinical effects of prone positioning according to lung morphology. We aimed to determine whether the gas exchange response to prone positioning differs according to lung morphology.
Methods
This retrospective study included adult patients with moderate-to-severe acute respiratory distress syndrome (ARDS). The lung morphology of ARDS was assessed by chest computed tomography scan and classified as “diffuse” or “focal.” The primary outcome was change in partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio after the first prone positioning session: first, using the entire cohort, and second, using subgroups of patients with diffuse ARDS matched 2 to 1 with patients with focal ARDS at baseline.
Results
Ninety-five patients were included (focal ARDS group, 23; diffuse ARDS group, 72). Before prone positioning, the focal ARDS group showed worse oxygenation than the diffuse ARDS group (median PaO2/FiO2 ratio, 79.9 mm Hg [interquartile range (IQR)], 67.7–112.6 vs. 104.0 mm Hg [IQR, 77.6–135.7]; P=0.042). During prone positioning, the focal ARDS group showed a greater improvement in the PaO2/FiO2 ratio than the diffuse ARDS group (median, 55.8 mm Hg [IQR, 11.1–109.2] vs. 42.8 mm Hg [IQR, 11.6–83.2]); however, the difference was not significant (P=0.705). Among the PaO2/FiO2-matched cohort, there was no significant difference in change in PaO2/FiO2 ratio after prone positioning between the groups (P=0.904).
Conclusions
In patients with moderate-to-severe ARDS, changes in PaO2/FiO2 ratio after prone positioning did not differ according to lung morphology. Therefore, prone positioning can be considered as soon as indicated, regardless of ARDS lung morphology.

Citations

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Imaging and pulmonary function techniques in ARDS diagnosis and management: current insights and challenges
Denise Battaglini, Marcus J. Schultz, Gustavo A. Cortes Puentes, John J. Marini, Patricia R. M. Rocco
Critical Care.2025;[Epub] CrossRef
Predicting early prone position ventilation responsiveness in patients with acute respiratory distress syndrome based on electrical impedance tomography: a prospective study
Yongran Wu, Azhen Wang, Chengchao Peng, Yaqi Ouyang, Jiali Su, Xiaobo Yang, Huaqing Shu, Hong Qi, Haiyan Huang, Le Yang, Xiaojing Zou, You Shang
Critical Care.2025;[Epub] CrossRef
Subphenotypes of Acute Respiratory Distress Syndrome: Advancing Towards Precision Medicine
Andrea R. Levine, Carolyn S. Calfee
Tuberculosis and Respiratory Diseases.2024; 87(1): 1. CrossRef

Neurology
The effects of hypomagnesemia on delirium in middle-aged and older adult patients admitted to medical intensive care units: Joong-Yub Kim, Hyo Jin Lee, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee, Tae Yun Park; Acute Crit Care. 2022;37(3):407-414. Published online July 5, 2022; DOI: https://doi.org/10.4266/acc.2022.00164

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Background
In critically ill patients, the most common manifestation of brain dysfunction is delirium, which is independently associated with higher morbidity and mortality. While electrolyte imbalance is one of the precipitating factors, the impact of hypomagnesemia on the incidence of delirium remains unknown.
Methods
We retrospectively analyzed patients admitted to the medical intensive care unit (ICU) of a tertiary referral center between January and June 2020. Patients with ICU stay ≥48 hours and aged 40–85 years were included. The primary outcome was cumulative incidence of delirium in the ICU. Patients were divided into two groups based on serum magnesium level at ICU admission. Multivariable Cox proportional hazards regression analysis was performed, and covariates were selected using the least absolute shrinkage and selection operator (LASSO) method.
Results
A total of 109 patients included 43 (39.4%) women and had a median age of 69.0 years (interquartile range [IQR], 60.0–76.0 years). The median magnesium level was 1.7 mg/dl (IQR, 1.5–1.9 mg/dl), and the cumulative incidence of delirium was 32.1% (35 patients). Hypomagnesemia was independently associated with delirium (adjusted hazard ratio [aHR], 2.12; 95% confidence interval [CI], 1.03–4.38), along with prior use of immunosuppressants (aHR, 3.08; 95% CI, 1.46–6.48) or benzodiazepines (aHR, 4.02; 95% CI, 1.54–10.50), body mass index (aHR, 0.93; 95% CI, 0.84–1.02), and alcohol history (aHR, 1.68; 95% CI, 0.74–3.80).
Conclusions
In critically ill adults, hypomagnesemia increases the risk of delirium by more than two-fold compared to patients with normal magnesium level.

Citations

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Hypomagnesemia and Acute Cognitive Decline in Older Adults: An Evaluation of Clinical Practice and Cognitive Outcomes at a National Health Service (NHS) Trust in England
Xuan Ning Lai, Vasvi Sadhwani, Wen Min Ng, Akif Gani
Cureus.2025;[Epub] CrossRef
Validation of the Anticipatory Grief Scale through Confirmatory Factor Analysis and Latent Profile Analysis
Yali Jiang, Chunyi Wang, Peici Zheng, Xixi Wang, Simin Hu, Li Ma, Ying Chen, Juanjuan Zhao
Nursing in Critical Care.2025;[Epub] CrossRef
Association between albumin-corrected anion gap and delirium in acute pancreatitis: insights from the MIMIC-IV database
Yuanshuo Ge, Youran Ma, Peng Lv, Junhao Ren, Zhe Wang, Cheng Zhang
BMC Gastroenterology.2025;[Epub] CrossRef
Incidence and predictors of delirium in patients admitted to intensive care unit at comprehensive specialised hospitals in Amhara region, northwest Ethiopia: a multicentre prospective observational study
Temesgen Brilie Asmare, Habtie Bantider Wubet, Negesse Zurbachew Gobezie, Getachew Mekete Deress, Kumlachew Geta Belete, Molla Amsalu Tadesse, Abere Gebru Abuhay, Biruk Demissie, Amanu Addis Melesew, Walelign Asmie Afework, Yewlsew Fentie Alle, Daniel Get
BMJ Open.2025; 15(9): e103581. CrossRef
Role of serum magnesium in post-aneurysmal subarachnoid hemorrhagic hydrocephalus
Moinay Kim, Hyunchul Jung, Seung Bin Kim, Jun Ha Hwang, Hanwool Jeon, Yeongu Chung, Youngbo Shim, Jae Hyun Kim, Joonho Byun, Aiden Cousins, Wonhyoung Park, Jung Cheol Park, Jae Sung Ahn, Seungjoo Lee
Acute and Critical Care.2025; 40(4): 582. CrossRef
Hypomagnesemia may be related to frailty, gait and balance problems, and basic activities of daily living in older adults
Suleyman Emre Kocyigit, Bilal Katipoglu
Acta Clinica Belgica.2024; 79(3): 160. CrossRef
Postoperative Delirium Following Posterior Lumbar Spinal Fusion: Epidemiology, Risk Factors, and Associated Complications
Ashley Knebel, Manjot Singh, Rhea Rasquinha, Mohammad Daher, Joseph E. Nassar, John Hanna, Bassel G. Diebo, Alan H. Daniels
World Neurosurgery.2024; 191: e753. CrossRef
Hypomagnesemia and incident delirium in hospitalized older persons
Virginia Boccardi, Sara Ercolani, Rocco Serra, Valentina Bubba, Alessandro Piccolo, Michela Scamosci, Alfredo Villa, Carmelinda Ruggiero, Patrizia Mecocci
Aging Clinical and Experimental Research.2023; 35(4): 847. CrossRef

Neurology
Association of natural light exposure and delirium according to the presence or absence of windows in the intensive care unit: Hyo Jin Lee, Eunhye Bae, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee; Acute Crit Care. 2021;36(4):332-341. Published online November 26, 2021; DOI: https://doi.org/10.4266/acc.2021.00556

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Background
Patients in the intensive care unit (ICU) have increased risks of delirium, which is associated with worse outcomes. As pharmacologic treatments for delirium are ineffective, prevention is important. Nonpharmacologic preventive strategies include exposure to natural light and restoring circadian rhythm. We investigated the effect of exposure to natural light through windows on delirium in the ICU.
Methods
This retrospective cohort study assessed all patients admitted to the medical ICU of a university-affiliated hospital between January and June 2020 for eligibility. The ICU included 12 isolation rooms, six with and six without windows. Patients with ICU stays of >48 hours were included and were divided into groups based on their admission to a single room with (window group) or without windows (windowless group). The primary outcome was the cumulative incidence of delirium. The secondary outcomes were the numbers of delirium- and mechanical ventilation-free days, ICU and hospital length of stay, and in-ICU and 28-day mortalities.
Results
Of the 150 included patients (window group: 83 [55.3%]; windowless group: 67 [44.7%]), the cumulative incidence of delirium was significantly lower in the window group than in the windowless group (21.7% vs. 43.3%; relative risk, 1.996; 95% confidence interval [CI], 1.220–3.265). Other secondary outcomes did not differ between groups. Admission to a room with a window was independently associated with a decreased risk of delirium (adjusted odds ratio, 0.318; 95% CI, 0.125–0.805).
Conclusions
Exposure to natural light through windows was associated with a lower incidence of delirium in the ICU.

Citations

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Alexa P. Bosco, Margaret L. Sullivan, Daniel Gabriel, Shanika De Silva, Daniel Hedequist, Michael T. Hresko, Craig Munro Birch, Grant D. Hogue
North American Spine Society Journal (NASSJ).2026; : 100848. CrossRef
Innovate and renovate: Environmental intensive care unit design
Minnette Markus‐Rodden, Kristen Bell, Maryann Brookes, Georgia Harrison, Jeffrey O'Neill
Nursing in Critical Care.2025; 30(1): 75. CrossRef
Windows in the ICU and Postoperative Delirium: A Retrospective Cohort Study
Diana C. Anderson, Paige E. Warner, Matthew R. Smith, Marissa L. Albanese, Ariel L. Mueller, John Messervy, B. Christian Renne, Samuel J. Smith
Critical Care Medicine.2025; 53(3): e590. CrossRef
Daylighting and Patients’ Access to View Assessment in the Palestinian Hospitals’ ICUs
Deema Amleh, Abdelrahman Halawani, Muhannad Haj Hussein, Laith Alamlih
HERD: Health Environments Research & Design Journal.2025; 18(2): 221. CrossRef
Light levels in a modern intensive care unit: Impact of time of year, window directionality, and outdoor light levels
Nikhil Chilakapati, Liz Timple, Sophia Pizzi, Janelle M. Fine, Hirsh Makhija, Lauryn K. Bruce, Robert L. Owens, Douglas Alden, Atul Malhotra, Jennifer L. Martin, Biren B. Kamdar
Chronobiology International.2025; 42(3): 351. CrossRef
Delirium in the ICU: Steps forward and the road ahead
Leona Bannon, Bronagh Blackwood
Intensive and Critical Care Nursing.2025; 89: 104068. CrossRef
Development of a Nomogram Model to Predict the Risk of Postoperative Delirium in Cardiac Surgery Patients
Zikomo Gaudence Kipanga, Zexiang Bao, Marvel Gyeyock Tella, Emmanuel Delali Kofi Fiagbey, Salama Habibu Saad, Bongani Mbambara, Chernor Sulaiman Bah, Asha Khatib Iddi, Rui Ding, Yanna Si, Yuan Zhang, Jianjun Zou
Journal of Cardiovascular Translational Research.2025; 18(4): 909. CrossRef
Preliminary Insights into the Association Between Room Transfer and Delirium Symptoms After Orthopedic Surgery: A Retrospective Case-Control Study
Yusuke Nitta, Yuri Nakai, Reiko Hashimoto, Hisao Nakai
Cureus.2025;[Epub] CrossRef
Optimizing Sleep Hygiene in the Hospital Environment
Liz Timple, Sanil Gandhi, Robert L. Owens, Joseph E. Tonna, Biren B. Kamdar
Sleep Medicine Clinics.2025; 20(4): 455. CrossRef
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Rapid response system
Effect of a rapid response system on code rates and in-hospital mortality in medical wards: Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee, Sulhee Kim, Eunjin Yang, Hyun Joo Lee, Hannah Lee, Ho Geol Ryu, Seung-Young Oh, Eun Jin Ha, Sang-Bae Ko, Jaeyoung Cho; Acute Crit Care. 2019;34(4):246-254. Published online November 29, 2019; DOI: https://doi.org/10.4266/acc.2019.00668

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Abstract PDF

Background
To determine the effects of implementing a rapid response system (RRS) on code rates and in-hospital mortality in medical wards.
Methods
This retrospective study included adult patients admitted to medical wards at Seoul National University Hospital between July 12, 2016 and March 12, 2018; the sample comprised 4,224 patients admitted 10 months before RRS implementation and 4,168 patients admitted 10 months following RRS implementation. Our RRS only worked during the daytime (7 AM to 7 PM) on weekdays. We compared code rates and in-hospital mortality rates between the preintervention and postintervention groups.
Results
There were 62.3 RRS activations per 1,000 admissions. The most common reasons for RRS activation were tachypnea or hypopnea (44%), hypoxia (31%), and tachycardia or bradycardia (21%). Code rates from medical wards during RRS operating times significantly decreased from 3.55 to 0.96 per 1,000 admissions (adjusted odds ratio [aOR], 0.29; 95% confidence interval [CI], 0.10 to 0.87; P=0.028) after RRS implementation. However, code rates from medical wards during RRS nonoperating times did not differ between the preintervention and postintervention groups (2.60 vs. 3.12 per 1,000 admissions; aOR, 1.23; 95% CI, 0.55 to 2.76; P=0.614). In-hospital mortality significantly decreased from 56.3 to 42.7 per 1,000 admissions after RRS implementation (aOR, 0.79; 95% CI, 0.64 to 0.97; P=0.024).
Conclusions
Implementation of an RRS was associated with significant reductions in code rates during RRS operating times and in-hospital mortality in medical wards.

Citations

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Case Report

Acute Mercury Vapor Inhalation Toxicity after Burning Charms: A Case Report: Hong Yeul Lee, Gyoung Hoon Kang, Ki Ho Nam, Mi Hye Kim, Bock Hyun Jung, Hui Dong Kang, Se Hyun Oh, Jaemin Lim; Korean J Crit Care Med. 2010;25(3):182-185.; DOI: https://doi.org/10.4266/kjccm.2010.25.3.182

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Abstract PDF: Cinnabar is the mineral with mercury in combination with sulfur, and it has been used to make charms in China and Korea. If cinnabar is overheated, mercury vapor that is extremely hazardous or sometimes fatal can be released. We experienced 5 patients of a family who were exposed to mercury vapor when they burnt charms. One of them developed severe acute respiratory failure and the patient needed mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Despite treatment with cortiocosteroid, D-penicillamine, ECMO and plasmapheresis, the radiologic findings of a patient worsened and he died.

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