Table of Content

10 May 2025, Volume 6 Issue 5 Previous Issue   

Research Paper

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Construction and validation of a risk assessment tool for acute skin failure in ICU patients ZHANG Jian, WANG Xiaoping, SHI Xusheng, XUE Xue, GAI Yubiao, GAO Silong, Guo Xiaojing, WEI Lili 2025, 6 (5):  517-523.  doi: 10.3761/j.issn.2096-7446.2025.05.001 Abstract ( )   HTML ( )   PDF (1238KB) ( )   Save Objective To develop and validate a risk assessment tool for acute skin failure in ICU patients，aiming to provide a scientific assessment tool for evaluating the risk of acute skin failure in ICU patients. Methods Based on the theory of risk management，combined with literature review and Delphi expert consultation，an initial assessment tool was formed. Using convenience sampling，217 patients in the ICU of a tertiary general hospital in Shandong Province from June to July 2023 were selected as the research subjects，and item analysis and reliability and validity tests were conducted. A preliminary validation was carried out on 1，036 patients in the ICU of the same hospital from August 2023 to February 2024 to test the predictive value of the assessment tool and verify its predictive value. Results The assessment tool for acute skin failure in ICU patients included 6 first-level indicators and 15 second-level indicators. The Cronbach’s α coefficient of the tool was 0.757，and the content validity index was 0.940. The area under the receiver operating characteristic curve was 0.976（95%CI：0.968~0.985），Kappa coefficient was 0.861（P<0.001）. with a sensitivity of 92.1% and a specificity of 95.7%. The optimal cut-off value was 12 points，and the total score risk level was classified into low risk（12~15 points），medium risk 16~20 points），high risk（21~27 points）. The higher the score，the higher the risk of acute skin failure in ICU patients. Conclusion The risk assessment tool for ICU patients developed in this study has good reliability and validity，and has good sensitivity and practicality，which can effectively predict the occurrence of acute skin failure in ICU patients. Figures and Tables | References | Related Articles | Metrics

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Survey on the implementation of group standard for adult airway suctioning by ICU nurses in tertiary hospitals in Jiangsu Province ZHANG Kun, LIAO Bo, WANG Xuemei, LIU Xili, CHEN Chao, GONG Ling, CHEN Jie, SHEN Liquan, LU Yuyu, ZHU Yanping 2025, 6 (5):  524-529.  doi: 10.3761/j.issn.2096-7446.2025.05.002 Abstract ( )   HTML ( )   PDF (1145KB) ( )   Save Objective This study evaluated ICU nurses in tertiary hospitals in Jiangsu Province on their implementation of the 2021 “Adult Invasive Mechanical Ventilation Endotracheal Suctioning Technique Standard （T/CNAS 10-2020）” issued by the Chinese Nursing Association. Methods A cross-sectional survey was conducted using a self-developed questionnaire distributed through the “Questionnaire Star” applet，employing a convenience sampling method. The survey explored four aspects of the endotracheal suctioning（ETS） process，including assessment，planning，implementation，and evaluation. Results A total of 614 ICU nurses from tertiary hospitals participated in the survey. Multiple stepwise linear regression analysis revealed several significant findings：nurses’ competency level was negatively correlated with ETS assessment（B=-0.396，P=0.001）；in the airway suctioning planning dimension，females performed better than males（P=0.023）；and the highest educational level was negatively correlated with both ETS implementation and total score（B=-1.016，P=0.005；B=-1.746，P=0.038）. Conversely，years of specialized experience was positively correlated with ETS evaluation ability（B=0.149，P=0.003）. Conclusion Gaps remain in the implementation of ICU nurses in Jiangsu Province regarding the ETS standard. It is recommended to strengthen skill reinforcement training for high-competency nurses，improve planning abilities among male nurses，and provide nurses with advanced degrees more opportunities for clinical practice to better integrate theoretical knowledge with practical application. Figures and Tables | References | Related Articles | Metrics

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Survey on distribution characteristics of carbapenem-resistant organism in intensive care units of different specialties JIN Dingping, WANG Xuejin, HU Yanyan, WANG Mengmeng, WU Feiyu, YANG Xiaoxuan, LU Qun 2025, 6 (5):  530-535.  doi: 10.3761/j.issn.2096-7446.2025.05.003 Abstract ( )   HTML ( )   PDF (1074KB) ( )   Save Objective To analyze the distribution characteristics of carbapenem-resistant gram-negative organisms （CRO） in ICU wards of different specialties，and to provide a basis for adopting infection control measures with characteristics of specialty diseases. Methods From September 2023 to November 2023，samples were collected from 4 hospital districts，10 specialized ICUs and 6 general wards of a comprehensive tertiary general hospital in Hangzhou，Zhejiang Province. Random samples were collected from nursing staff’s hands and environmental object surfaces. Meropenem was used to screen for CRO strains，and all CRO strains were analyzed for homology. Results A total of 1，170 samples，including 334 hands and 836 surfaces，were collected. A total of 209 CRO strains were detected，with a CRO carriage rate of 17.9%. The burn ICU had the highest carriage rate，accounting for 44.0%. Among them，carbapenem-resistant Acinetobacter baumannii complex，carbapenem-resistant Klebsiella pneumoniae，carbapenem-resistant Enterobacter cloacae，and carbapenem-resistant Pseudomonas aeruginosa accounted for 67.9%，14.8%，11.0%，and 6.2%，respectively. Homology analysis showed clonal transmission of the strains detected in the ICUs，including “hand-to-surface” transmission in three intensive care units，but no interdepartmental or hospital-based transmission was found. Conclusion Different specialized ICUs have carbapenem-resistant Gram-negative bacteria，mainly Acinetobacter baumannii，and clonal transmission of CRO strains within the same ICU unit is more common，including “environment-object-surface” and “hand-object-surface” transmission. This suggests that nursing managers should strengthen the standardized implementation of cluster management of multidrug-resistant bacteria. Figures and Tables | References | Related Articles | Metrics

Special Planning—Risk Management and Practice of Pediatric Critical Care

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Research on the construction and validation of a risk prediction model for neonatal pressure injury using machine learning methods SHI Xieli, ZHU Kexin, HU Xiaoli, WANG Fang 2025, 6 (5):  536-542.  doi: 10.3761/j.issn.2096-7446.2025.05.004 Abstract ( )   HTML ( )   PDF (1324KB) ( )   Save Objective To construct prediction models for the risk of neonatal pressure injury using machine learning，and compare the performance of the models，in order to provide insights for predicting，early prevention and treatment of neonatal pressure injury. Methods Clinical data of neonates from a tertiary class A hospital in Zhejiang Province were collected and randomly divided into a training set and a validation set according to a ratio of 8：2. The main outcome was whether pressure injury occurred. Through literature review and risk factor analysis，14 common clinical features were selected as predictors，and four machine learning algorithms，logistic regression，random forest，support vector machine and decision tree，were used to construct prediction models for the risk of neonatal pressure injury. The model was tested and calibrated by five-fold cross validation，and the model performance was evaluated and compared by accuracy，precision，recall，F score and area under the receiver operating characteristic curve（ROC AUC）. Decision curve analysis（DCA） was used to evaluate the clinical utility of the models，and the importance of the features was displayed by SHAP. Results A total of 1 642 neonates were included，251 of which developed pressure injury（15.3%）. All four prediction models had good predictive performance，and the AUC values of logistic regression，random forest，support vector machine and decision tree models were 0.85，0.88，0.90 and 0.84，respectively. The accuracy rates were 0.78，0.80，0.83 and 0.79，respectively. Accuracy were 0.72，0.75，0.77，0.73. The recall rates were 0.91，0.93，0.94，0.91，respectively. The F scores were 0.80，0.83，0.85 and 0.81，respectively. DCA showed that under the threshold probability of 0.1-0.4，the random forest model had the highest net benefit. The use of non-invasive respiratory support，gestational age at birth，and birth weight were the top three most important clinical characteristic variables for the SVM and random forest models. Conclusion Machine learning can be used to construct the risk prediction models of neonatal pressure injury. The model based on random forest is the best considering both on the performance and clinical utility. Figures and Tables | References | Related Articles | Metrics

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Psychological and social adaptation in children post-intensive care：a qualitative study ZHU Jiajia, CHUI Linbo, JIN Hongcheng, ZHU Jihua 2025, 6 (5):  543-547.  doi: 10.3761/j.issn.2096-7446.2025.05.005 Abstract ( )   HTML ( )   PDF (1050KB) ( )   Save Objective This study explored the psychological and social adaptation process of children after intensive care，aiming to provide scientific evidence for clinical interventions and family support. Methods A descriptive phenomenological approach was employed，using purposive sampling to recruit 15 children who had been hospitalized in the PICU of a tertiary pediatric hospital in Hangzhou from July to September 2023. Results Three themes and nine subthemes were identified：impact of the intensive care experience（memories of fear and discomfort，sleep disturbances and rhythm disruption，emotional fluctuations and personality changes）；re-adaptation to family and society（unfamiliarity and adaptation to the family environment，deterioration and rebuilding of social skills，recovery and challenges in learning abilities）；and psychological adjustment during rehabilitation（enhanced health awareness and self-management，reformation and acceptance of self-identity，acquisition of social support and gratitude）. Conclusion Children who experience intensive care face various psychological and social adaptation challenges. Strengthening emotional management，establishing a hospital-family-school integrated support system，optimizing follow-up services，and enhancing family health education are essential for improving their long-term adaptation. Figures and Tables | References | Related Articles | Metrics

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The factors influencing unplanned endotracheal extubation in critically ill children：a meta-analysis ZHANG Yueqi, WANG Youfang, PAN Meng, XIANG Xuan 2025, 6 (5):  548-554.  doi: 10.3761/j.issn.2096-7446.2025.05.006 Abstract ( )   HTML ( )   PDF (1055KB) ( )   Save Objective To systematically review the factors for unplanned extubation of endotracheal intubation in critically ill children. Methods CNKI，WanFang Data，VIP，SinoMed，PubMed，Embase，Cochrane Library and Web of Science databases were electronically searched to collect relevant cohort，case-control or cross-sectional studies on factors of unplanned extubation of endotracheal intubation in critically ill children from inception to May 2024. Two researchers independently screened literature，extracted data and assessed the quality of included studies. Meta-analysis was then performed by using RevMan 5.3. Results A total of 15 articles were included，involving 6 cohort studies，4 case-control studies and 5 cross-sectional studies. The studies included a total of 54 397 ill children，with a total of 2 401 unplanned extubation. The risk factors were age ≤2（OR=1.32） ， male（OR=1.34） ， underweight（OR=1.56） ， prematurity（OR=1.63） ， secretions（OR=7.27） ， sedation（OR=3.82）， agitation（OR=1.88），mechanical ventilation duration（OR=1.03） ， inadequate fixation（OR=2.12） ， ventilator weaning phase（OR=2.23） ， tube with cuff（OR=0.47） ， nurse/patient ratio（OR=2.66） ， work shift（OR=2.85）and nurse experience（OR=2.29）. Conclusion Medical staff can make a dynamic assessment according to the influencing factors and take targeted preventive measures to minimize the incidence of unplanned extubation of endotracheal intubation in critically ill children. Figures and Tables | References | Related Articles | Metrics

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Evidence summary of early mobilization for mechanically ventilated pediatric patients SHI Jiahui, ZHONG Yongmei, LUO Jinling, CHUN Xiao 2025, 6 (5):  555-562.  doi: 10.3761/j.issn.2096-7446.2025.05.007 Abstract ( )   HTML ( )   PDF (1285KB) ( )   Save Objective To search and summarize the best evidence of early mobilization of children with mechanical ventilation，and provide evidence-based evidence for medical staff in ICU to guide children with mechanical ventilation to carry out scientific and effective early rehabilitation mobilization. Methods The literature on early mobilization in mechanically ventilated pediatric patients were searched from domestic and foreign guideline websites and databases from January 2010 to March 2024. Two researchers extracted，graded and summarized the evidence. Results Finally 13 literatures were included，including a clinical decision，two guidelines，four expert consensuses，three systematic reviews and three cohort studies. A total of 37 pieces of evidence across 9 themes were extracted. Conclusion The best evidence summarized provides evidence-based basis for the early rehabilitation activities of children with mechanical ventilation in order to improve the prognosis of children. Figures and Tables | References | Related Articles | Metrics

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Perioperative nursing of a premature infant with type Ⅲb esophageal atresia complicated with pulmonary hypertension LI Qing, LU Xian, ZHU Shuzhen, TANG Yunfei, XUE Yan, FENG Xiaoyan, HUA Lingling 2025, 6 (5):  563-565.  doi: 10.3761/j.issn.2096-7446.2025.05.008 Abstract ( )   HTML ( )   PDF (676KB) ( )   Save To summarize the perioperative nursing care of a premature infant with type Ⅲb esophageal atresia and pulmonary hypertension treated with thoracoscopic assistance. The key points of the perioperative nursing care were as follows：maintaining a patent airway，maintaining stable cardiac function，avoiding hypoxemia before the surgery；strengthening airway management，developing an deoxygenation training plan，preventing anastomotic fistula，maintaining systemic blood pressure，paying attention to enteral and parenteral nutritional support after the surgery；implementing family-empowerment nursing to enhance the caregiver’s ability after discharge. After active treatment and meticulous nursing care，the infant’s condition stabilized and she was discharged in good health. The follow-up results were satisfactory. References | Related Articles | Metrics

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Research progress on influencing factors and intervention strategies of pediatric chronic critical illness HONG Liuyu, CHEN Xiangping, LAO Yuewen, CHEN Qianqian, GONG Xiaoyan 2025, 6 (5):  566-569.  doi: 10.3761/j.issn.2096-7446.2025.05.009 Abstract ( )   HTML ( )   PDF (747KB) ( )   Save Pediatric chronic critical illness（PCCI） refers to children with complex and chronic diseases. Compared to ordinary pediatric patients，children with PCCI face higher readmission rates and mortality risks，and their nursing needs are also more complex. At present，the family and social care support system for children with PCCI is not yet perfect，making it difficult for them to receive coherent and coordinated nursing services，which has a negative impact on recovery process. This article reviews the definition and diagnostic criteria，epidemiology，influencing factors，and intervention strategies of PCCI，aiming to enhance the professional awareness of nursing staff in the field of PCCI，and provide theoretical support and practical guidance for standardizing PCCI nursing practice in China. Figures and Tables | References | Related Articles | Metrics

Emergency Care Research

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Nursing care of a patient undergoing emergency coronary intervention combined with left ventricular assist device therapy after cardiac arrest MO Minhua, Lo Wan Po Joanna, Shum Hoi Ping, Chang Li Li 2025, 6 (5):  570-572.  doi: 10.3761/j.issn.2096-7446.2025.05.010 Abstract ( )   HTML ( )   PDF (692KB) ( )   Save To summarize the nursing experience of a patient with cardiac arrest who underwent emergency percutaneous coronary intervention combined with left ventricular assist device after resuscitation and was transferred to the ICU with left ventricular assist device after surgery. Checklists were used to closely check the steps performed and monitor the process，including daily management，complication observation，weaning and extubation care. The left ventricular assist device was successfully removed after 49.25 h. After 94 hours，the patient was removed from the endotracheal intubation，and after 8 days of ICU treatment，he was transferred to the general ward. References | Related Articles | Metrics

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Nursing care of a patient with severe frostbite caused by staying overnight in the wilderness after binge drinking in southern China LU Dianxia, MEI Yiju, CHEN Yu, CHEN Yuyue, WANG Ji, CAO Xueting, ZHANG Jinsong 2025, 6 (5):  573-575.  doi: 10.3761/j.issn.2096-7446.2025.05.011 Abstract ( )   HTML ( )   PDF (550KB) ( )   Save To summarize the nursing experience of a patient with severe hypothermia and third-degree frostbite caused by staying overnight in the wild after binge drinking in winter. Nursing priorities included gradient rewarming strategy（external electric blanket combined with continuous renal replacement therapy in vivo） to achieve core body temperature recovery within 7.25 h，frostbite wounds treated with moist burn ointment and silver sulfadiazine sequential therapy，combining sedation and analgesia with daily arousal strategies to manage impairment of consciousness. After 7 days of treatment，the patient was discharged from the hospital，and the function of the frostbitten limb was fully recovered two months later. It is suggested that for severe frostbite cases in non-cold areas，early and precise rewarming，wound stratification management，and comprehensive prevention and treatment of multi-system complications are the keys to successful treatment. References | Related Articles | Metrics

Critical Care Research

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Nursing of a patient with thrombotic microangiopathy after renal transplantation YANG Rui, LI Bingyu, LI Lu 2025, 6 (5):  576-578.  doi: 10.3761/j.issn.2096-7446.2025.05.012 Abstract ( )   HTML ( )   PDF (543KB) ( )   Save This study summarized the nursing experience of a patient with thrombotic microangiopathy following renal transplantation. The patient presented with symptoms including microvascular hemolytic anemia，thrombocytopenia，and anuria due to kidney damage. Nursing measures were implemented，which included multi-system monitoring of high-risk factors，dynamic adjustments to immunosuppressive treatment，maintenance of safe blood purification，prevention of bleeding risks，infection management，psychological interventions，and nutritional support，along with rehabilitation guidance. After 45 days of treatment and care，the patient was discharged. A follow-up conducted two weeks post-discharge indicated that the patient had recovered well. References | Related Articles | Metrics

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Postoperative nursing of a patient with type Ⅱ Abernethy malformation complicated with pulmonary hypertension undergoing liver transplantation SHEN Xiaomin, HE Wenjing, YANG Tongnan, WANG Dandan, ZHAO Wenjing 2025, 6 (5):  579-581.  doi: 10.3761/j.issn.2096-7446.2025.05.013 Abstract ( )   HTML ( )   PDF (533KB) ( )   Save To summarize the nursing experience associated with managing a patient diagnosed with type II Abernethy malformation complicated with pulmonary hypertension，who underwent liver transplantation followed by veno-arterial extracorporeal membrane oxygenation（VA-ECMO）. Based on the pathological and physiological characteristics of pulmonary hypertension following liver transplantation，analgesia and sedation was adopted to protect the organs. The targeted medications in conjunction with ECMO was used to reduce pulmonary artery pressure and improve right heart function. Monitoring oxygenation during ECMO operation along with anticoagulation management and prevention of complications such as lower limb ischemia，individualized fluid therapy to avoid new liver reperfusion syndrome were also implemented. Through meticulous nursing care and multidisciplinary collaboration，the patient successfully recovered and was discharged. References | Related Articles | Metrics

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Nursing care of patients undergoing double-tunnel PICC catheterization via the axillary vein guided by intracavitary electrocardiography CHENG Qiuqin, ZHANG Xinzheng, ZHOU Jianhong, GAO Xuetong 2025, 6 (5):  582-584.  doi: 10.3761/j.issn.2096-7446.2025.05.014 Abstract ( )   HTML ( )   PDF (512KB) ( )   Save To summarize the nursing experience of 8 patients undergoing double-tunnel PICC via the axillary vein guided by intracavitary electrocardiography. In view of the risks and difficulties of catheterization caused by poor upper extremity venous conditions，high catheterization difficulty，and susceptibility to bloodstream infections and venous thrombosis，we established an interdisciplinary PICC catheterization team，and implemented detailed analysis of catheterization difficulties，real-time monitoring of catheterization risks，comprehensive assessment of potential complications，and heightened emphasis on catheter maintenance. Through meticulous nursing care，the eight patients successfully underwent PICC catheterization. Patients had a good experience with the catheter during the follow-up period，with no catheter-related complications. References | Related Articles | Metrics

Quality and Safety

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The effect of the first-aid and emergency dual channel management scheme on the treatment efficiency of emergency patients treated by ambulance ZHANG Jinqiu, SHEN Xiulan, WANG Liping 2025, 6 (5):  585-589.  doi: 10.3761/j.issn.2096-7446.2025.05.015 Abstract ( )   HTML ( )   PDF (917KB) ( )   Save Objective To construct a first-aid and emergency dual channel management scheme，and to explore its application effects on the treatment of emergency patients treated by ambulance. Methods A team was established to construct a first-aid and emergency dual-channel management scheme，optimize the layout of emergency department entrance channels，improve the medical treatment process for patients treated by ambulance，implement zoning treatment and rapid triage for critically ill patients in the resuscitation unit. From October to December of 2023，patients admitted to the emergency room were selected as the experimental group，and patients from another hospital campus in the same period were selected as the control group. The experimental group adopted a dual-channel management scheme，and the control group implemented a conventional protocol. The differences in triage time，examination time，definitive treatment time，and green channel stay time of patients in the "three major centers” were compared between the two groups. Results 132 patients in the experimental group and 122 patients in the control group were included. After the implementation of dual-channel management scheme，the time of patient triage was shortened from 3.6（2.0，4.0） min to 2.1（2.0，3.0） min（P<0.001），the time for examination was shortened from 58.7（29.0，73.0） min to 33.4（10.0，43.0） min（P<0.001），and the time to definitive treatment was shortened from 76.6（31.0，98.0） min to 45.6（11.0，57.0） min（P<0.001）. The stay time of the green channel for patients in the “three major centers” was shortened from 56.7（41.0，75.0） min to 31.0（17.0，41.0） min （P<0.05）. Conclusion The application of the first-aid and emergency dual channel management can reduce the triage time of patients transported by ambulance，shorten the examination time，treatment time and the green channel stay time for patients in the “three major centers”，thereby improving the treatment efficiency. Figures and Tables | References | Related Articles | Metrics

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An analysis of barriers and facilitators to evidence-based practice of comprehensive ICU nursing handoff DENG Yingyi, XU Wenjing, LIAO Changju, Li Yuanyuan, ZHANG Cuicui, MING Shulan, WANG Min, DING Juan, CHEN Xiaoli 2025, 6 (5):  590-595.  doi: 10.3761/j.issn.2096-7446.2025.05.016 Abstract ( )   HTML ( )   PDF (920KB) ( )   Save Objective To explore the barriers and facilitators of evidence-based practice of comprehensive ICU nursing handoff，and provide basis for promoting clinical transformation of evidence. Methods Objective sampling method was used to select nursing managers and clinical nurses in comprehensive ICU ward of a tertiary grade A hospital in Zigong，Sichuan Province as research objects. The interview outline was constructed based on the consolidated framework for implementation research（CFIR），and 11 clinical nurses and nursing managers were interviewed by semi-structured interview method，and the interview contents were coded by directional content analysis method. Results A total of 6 barriers and 14 facilitators covering 4 fields of CFIR framework were obtained through interviews. There were 4 themes summarized. At the practitioner level，comprehensive ICU nurses had fully recognized the importance of handoff，and prioritized the evidence-based practice plan of handoff，but they lacked their own knowledge of evidence-based nursing. At the program level，the handoff evidence-based practice program was scientific and effective，but its complexity hindered its implementation. At the resource level，the implementation of the handoff evidence-based practice program needed manpower，time and information system support. In terms of organizational environment，department culture，atmosphere，and leadership promoted the implementation of evidence-based practice programs for transition. Conclusion This study identified the barriers and facilitators in the clinical transformation of evidence related to nursing handoff from the four levels of practitioners，program，available resources and organizational environment，and provided a basis for improving the clinical applicability of program and drafting implementation strategies. Figures and Tables | References | Related Articles | Metrics

Career Development of Nurses

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Development and validation of the Crisis Leadership Scale for Nursing Staff under major infectious disease epidemics CHEN Changchang, MU Hezi, HE Shizhe, YANG Qian, LANG Hongjuan 2025, 6 (5):  596-602.  doi: 10.3761/j.issn.2096-7446.2025.05.017 Abstract ( )   HTML ( )   PDF (1127KB) ( )   Save Objective To develop the Crisis Leadership Scale for Nursing Staff（CLS-NS） under major infectious diseases epidemics and test its reliability and validity. Methods A conceptual model of nursing crisis leadership was constructed based on the six-aspect model of crisis leadership combined with literature analysis and qualitative interviews. We initially constructed the scale，primarily through literature review，qualitative interviews，Delphi questionnaire and two-round pre-surveys. 646 nursing staff from three tertiary general hospitals in Shanaxi Province were selected as respondents in July 2023 to assess the scale’s reliability and validity. Results The CLS-NS included 36 entries in 5 dimensions. We extracted 5 common factors via the exploratory factor analysis，namely early warning ability，loading the responsibility，control power，cohesiveness，and growing power，with a cumulative variance contribution of 88.063%. Validation factor analysis results revealed a well-fitted model and stable structural factors of the questionnaire. S-CVI and I-CVI were both 1.00. The Cronbach’s α coefficient of the total scale was 0.973，the odd-even split reliability was 0.930，and the re-measurement reliability was 0.795. Conclusion The CLS-NS has shown favorable reliability and validity and can be used as an instrument to assess crisis leadership of nursing staff. Figures and Tables | References | Related Articles | Metrics

Evidence Synthesis Research

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Evidence summary for perioperative airway management in patients with ankylosing spondylitis complicated with difficult airway MA Yaojing, WANG Xinxin, YU Qunfei, LUO Chunmei, WU Xiaoyan, WANG Xiaobo, ZHU Yan, REN Ying 2025, 6 (5):  603-609.  doi: 10.3761/j.issn.2096-7446.2025.05.018 Abstract ( )   HTML ( )   PDF (1044KB) ( )   Save Objective To collect and summarize the effective evidence of perioperative airway management in patients with ankylosing spondylitis complicated with difficult airway. Methods We comprehensively and systematically searched literatures related to perioperative airway management in patients with ankylosing spondylitis complicated with difficult airway from relevant domestic and foreign guide websites，Cochrane Library，PubMed，OVID，Embase，Web of Science，CNKI，Wanfang and other databases. The literature types included clinical decision，best practices，guidelines，expert consensus，systematic reviews，and randomized controlled trials. The retrieval period was from the establishment of the database to May 19，2023. Two researchers independently evaluated literature quality and extracted data. Results Thirteen articles were included，including 3 clinical decisions，1 best practice，3 guidelines，4 expert consensuses，1 systematic review and 1 randomized controlled trial. The 22 best evidences were summarized from four aspects：preoperative assessment，anesthesia strategy，intraoperative monitoring，and postoperative rehabilitation. Conclusion This study provides clinical healthcare professionals with scientific evidence-based guidance，which helps to optimize the perioperative airway management strategies for patients with ankylosing spondylitis complicated with difficult airway，reduce the risk of complications，accelerate the rehabilitation process of patients，and improve the overall quality of nursing and treatment outcomes. Figures and Tables | References | Related Articles | Metrics

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Summary of best evidence on monitoring and management for hypothermia in patients with continuous renal replacement therapy CHEN Lihua, SHENG Qingqing, HUANG Yao, WANG Xinning, TAN Yufeng, HE Tingting, ZHANG Shuqin 2025, 6 (5):  610-615.  doi: 10.3761/j.issn.2096-7446.2025.05.019 Abstract ( )   HTML ( )   PDF (1129KB) ( )   Save Objective To retrieve，evaluate and synthesize the best evidence on monitoring and management for hypothermia in patients with continuous renal replacement therapy，and to provide reference for clinical evidence-based practice. Methods We searched UpToDate，BMJ Best Practice，National Institute for Health and Clinical Excellence，Guidelines International Network，Registered Nurses Association of Ontario，Scottish Intercollegiate Guidelines Network，Yimaitong guide network，Cochrane Library，PubMed，Embase，Web of Science，CINAHL，CNKI，Wanfang for guidelines，expert consensus，expert recommendations，systematic reviews，clinical decisions，best practices，and original studies on monitoring and management for hypothermia in patients with continuous renal replacement therapy. The search limit was from the time of database establishment to June 2，2024. Two researchers independently assessed methodological quality of included papers and extracted data. Results A total of 15 articles were included，including one clinical decision，two guidelines，two expert consensuses，one expert recommendation，three systematic reviews，three randomized controlled trials，two case-controlled studies，one cohort study. Finally，18 pieces of best evidence were summarized from 5 aspects，namely the team composition，risk factor identification，monitoring frequency，monitoring location，prevention and management. Conclusion The best evidence on monitoring and management for hypothermia in patients with continuous renal replacement therapy summarized in this study is scientific and comprehensive，and provides evidence-based basis for medical staff in standardized management for hypothermia in patients with continuous renal replacement therapy. Figures and Tables | References | Supplementary Material | Related Articles | Metrics

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Effect of different body temperature on prognosis in septic patients：a meta-analysis LI Ji, JIN Jingfen, ZHANG Yuping, CHENG Yifeng, WANG Xuyang 2025, 6 (5):  616-623.  doi: 10.3761/j.issn.2096-7446.2025.05.020 Abstract ( )   HTML ( )   PDF (1041KB) ( )   Save Objective To investigate the effect of body temperature on prognosis in septic patients. Methods PubMed，Embase，the Cochrane Library，Web of Science，China Biomedical Literature Database，Wanfang Data Knowledge Service Platform，China National Knowledge Infrastructure，VIP database were electronically searched to collect case-control studies，prospective or retrospective cohort studies on the effect of body temperature on the prognosis of septic patients from inception of database to June 1，2024. Two reviewers performed independent literature screening，data extraction，and evaluating the risk of bias in the included studies，then performed meta-analysis by RevMan 5.4.1 software. Results 23 articles were included，with a total of 3 516 745 patients. The results showed that fever and hypothermia had significant effects on hospital mortality and 28d mortality（P<0.01），and the impact on the length of hospitalization and ICU stay was not yet clear（P>0.05）. Conclusion This meta-analysis showed that fever and hypothermia can increase the hospital mortality and 28d mortality in patients with sepsis. Therefore，during the process of clinical diagnosis and treatment and nursing，it is necessary to closely observe the change of body temperature，take the corresponding body temperature control strategies in time，and improve patient’s outcome. Figures and Tables | References | Related Articles | Metrics

Review

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A scoping review of kinesiophobia research in stroke patients ZHANG Xiaping, LUO Songna 2025, 6 (5):  624-630.  doi: 10.3761/j.issn.2096-7446.2025.05.021 Abstract ( )   HTML ( )   PDF (1055KB) ( )   Save Objective To conduct a scoping review of the research on kinesiophobia in stroke patients，and sort out the status quo，influencing factors，assessment tools and intervention methods of kinesiophobia，so as to provide reference for promoting active rehabilitation of stroke patients. Methods Guided by the scoping review methodology，the databases of CNKI，Wanfang Database，Chinese Biomedical Literature database，web of Science，PubMed，CINAHL and Cochrane Library were searched by computer. The retrial limit was from the establishment of the databases until May 17，2024. The included literature was screened，summarized and analyzed. Results Fifteen literatures were included. The incidence of kinesiophobia in stroke patients ranged from 24.17% to 78.3%. Tampa Scale for Kinesiophobia and the Tampa Scale for Kinesiophobia Heart were used to evaluate kinesiophobia. The influencing factors of kinesiophobia in stroke patients included demographic factors，social psychological factors，physical health factors and disease history. Intervention methods included stimulating care，pain neuroscience education，and cognitive behavioral therapy. Conclusion The research on kinesiophobia in stroke patients is still in the development stage. The incidence of kinesiophobia is high and affected by multiple factors. It is necessary to strengthen the research on localized assessment tools in stroke patients，increase the study sample size，timely identify kinesiophobia in stroke patients and conduct intervention，and develop and improve it at the level of family，community and Internet technology in the future. Figures and Tables | References | Related Articles | Metrics

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Research progress on nursing strategies for adult brain death donor organ maintenance in ICU JING Jiamei, WEI Xiaojing, WANG Zhenzhen, CUI Bowen, LIANG Hongxia 2025, 6 (5):  631-635.  doi: 10.3761/j.issn.2096-7446.2025.05.022 Abstract ( )   HTML ( )   PDF (820KB) ( )   Save The organ maintenance period care is provided by ICU nurses to provide basic nursing care and humanistic support for brain death donors in order to improve the success rate of organ transplantation. This article reviews the criteria of brain death donors，nursing measures during the organ maintenance period，as well as the ethical and emotional needs that arise. The brain death judgment and donor organ maintenance in China not only improves the ability of ICU nurses to implement precise nursing care，but also creates greater ethical and emotional challenges between clinical work and family communication，so that nursing care during the organ maintenance period requires further standardized processes and policy support. References | Related Articles | Metrics

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A review on mechanical ventilation withdrawal nursing for obese patients in ICU ZHOU Feifei, GAO Chunhua, CHU Junqing, LIN Yan, WANG Xiaohong, QIAO Wenbo, REN Yayu 2025, 6 (5):  636-640.  doi: 10.3761/j.issn.2096-7446.2025.05.023 Abstract ( )   HTML ( )   PDF (794KB) ( )   Save Due to the special pathophysiological structure of obese patients in ICU，difficulties in mechanical ventilation weaning and an increased risk of secondary intubation after weaning often occur，presenting considerable challenges to airway management. Professional clinical judgment，appropriate timing for weaning，and optimized weaning strategies are key to successful weaning of obese patients. Currently，there is limited research on weaning care for obese patients with mechanical ventilation in ICU in China. This article aims to review the factors affecting weaning in obese patients with mechanical ventilation in ICU，pre-weaning nursing assessment and preparation，weaning nursing strategies，and comprehensive post-weaning care，and provide a reference for weaning care of obese patients in ICU. References | Related Articles | Metrics