Table of Content

10 May 2026, Volume 7 Issue 5 Previous Issue   

Research Paper

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Construction and application of a multicomponent exercise training program for pre-frail patients undergoing maintenance hemodialysis YING Jinping, CHEN Linglin, CAI Genlian, ZHANG Yujiao, ZHANG Liuqian, ZHANG Jing, ZHOU Jinjin, YING Yayong 2026, 7 (5):  517-523.  doi: 10.3761/j.issn.2096-7446.2026.05.001 Abstract ( )   HTML ( )   PDF (1372KB) ( )   Save Objective To construct a multicomponent exercise training program for pre-frail patients undergoing maintenance hemodialysis（MHD） and explore its application effects. Methods The final multicomponent exercise training program was developed through literature analysis and Delphi expert consultation. 46 pre-frail MHD patients were selected by convenience sampling from a tertiary hospital in Zhejiang Province between November 2024 and December 2024. And then they were randomly divided into an experimental group and a control group，with 23 cases in each group. The experimental group received the multicomponent exercise training program，while the control group received conventional care. Frailty-related indicators were compared between the two groups. Results The constructed program included 4 first-level items，10 second-level items，and 25 third-level items. The preliminary application results of the program showed that the incidence of frailty was 26.1% in the control group and 4.3% in the experimental group. The experimental group was superior to the control group in frailty total score，grip strength，physical activity，and fatigue（P<0.05）. Conclusion The multicomponent exercise training program constructed in this study helps to reduce the occurrence of frailty，enhance the grip strength and physical activity levels，and alleviate fatigue in MHD patients. Figures and Tables | References | Related Articles | Metrics

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The effects of combined abdominal breathing and resistance exercise program on preventing delirium in ICU patients with mechanical ventilation LI Changxin, CHEN Yingxue, LUO Chenjuan, ZHENG Wangmin, LIN Ruyu, CHEN Qiaoling 2026, 7 (5):  524-531.  doi: 10.3761/j.issn.2096-7446.2026.05.002 Abstract ( )   HTML ( )   PDF (1245KB) ( )   Save Objective To explore the application effects of the combined limb and abdominal breathing resistance exercise program in ICU patients with mechanical ventilation. Methods From September 2023 to September 2024，192 patients who underwent mechanical ventilation treatment in the general ICU of two tertiary grade A hospitals in Nanping City，Fujian Province，were selected as the research subjects. Using the simple random grouping method，they were divided into the combined limb and abdominal breathing resistance exercise group，the early progressive activity group，and the conventional activity group. The incidence of delirium，anxiety and depression score，sleep quality score，ICU mechanical ventilation time，and ICU hospitalization time of research subjects in the three groups were observed. Results Comparison of the incidence of delirium among the three groups of research subjects showed that the incidence in combined limb and abdominal breathing resistance exercise group was lower than the early progressive activity group and the conventional activity group（P<0.05）. Comparison of anxiety and depression scores and sleep quality scores during ICU stay showed that the combined limb and abdominal breathing resistance exercise group and the early progressive activity group were lower than the conventional activity group（P<0.05）. And the lengths of mechanical ventilation and ICU hospitalization in the three groups were compared，the combined limb and abdominal breathing resistance exercise group was shorter than the early progressive activity group and the conventional activity group，and the differences were statistically significant（P<0.05）. Conclusion The combination of limb and abdominal breathing resistance exercise can reduce the incidence of delirium in ICU patients with mechanical ventilation，improve the anxiety and depression of critically ill patients，improve the sleep quality of critically ill patients，shorten the duration of mechanical ventilation and ICU hospitalization，and is conducive to improving the clinical outcomes of critically ill patients. Figures and Tables | References | Related Articles | Metrics

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The construction and applicability analysis of a respiratory rehabilitation management program for the early postoperative period in patients undergoing cardiopulmonary bypass cardiac surgery LI Zunzhu, CHANG Xiaowei, CAO Qianqian, ZHAO Mingxi, LUO Hongbo, JING Jie, SUN Jianhua, LAN Yuanmei, WU Xinjuan 2026, 7 (5):  532-539.  doi: 10.3761/j.issn.2096-7446.2026.05.003 Abstract ( )   HTML ( )   PDF (1252KB) ( )   Save Objective To develop a respiratory rehabilitation program suitable for implementation in the early postoperative period in the ICU for patients undergoing cardiopulmonary bypass cardiac surgery. Methods A draft program was developed by synthesizing the best evidence through a systematic literature review. The Delphi method was then used to conduct two rounds of expert consultation with 15 specialists in critical care medicine and critical care nursing from 13 tertiary hospitals in 9 provinces across China，and the final program was established. Results The effective questionnaire recovery rates for the two rounds of Delphi consultation were 93.75% and 100%，respectively. The expert authority coefficients were 0.930 and 0.907，and the variation coefficients of each item were 0-0.13 and 0-0.22. After the second round，Kendall’s coefficient of concordance reached 0.323（P<0.001），indicating convergence of expert opinions. The final program comprises 12 themes and 37 items，covering the entire process of multidisciplinary collaboration，timing of initiation of respiratory rehabilitation，mechanical ventilation management，sedation and analgesia，lung recruitment strategies，respiratory muscle training，early mobilization，nutritional management，and safety monitoring. Conclusion This program is tailored to the ICU setting，specifies initiation of respiratory rehabilitation within 24 hours after surgery，and refines multidisciplinary roles and operational parameters，thereby translating guideline recommendations into executable clinical steps. It demonstrates strong scientific basis，practicality，and operability，and can provide systematic and standardized guidance for early postoperative respiratory rehabilitation in patients undergoing cardiopulmonary bypass cardiac surgery. Figures and Tables | References | Related Articles | Metrics

Special Planning—Risk Identification and Management Practice in Pediatric Critical Care

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Construction of a decision tree model for risk prediction of metabolic acidosis in maintenance hemodialysis children and analysis of its predictive performance XIA Lei, ZHAO Lei, CHEN Dan 2026, 7 (5):  540-545.  doi: 10.3761/j.issn.2096-7446.2026.05.004 Abstract ( )   HTML ( )   PDF (1525KB) ( )   Save Objective To analyze the risk factors of metabolic acidosis in children undergoing maintenance hemodialysis and construct a decision tree model. Methods The clinical data of 205 children undergoing maintenance hemodialysis admitted to a tertiary general hospital from November 2022 to November 2024 were retrospectively selected. They were divided into metabolic acidosis group and non-metabolic acidosis group according to the occurrence of metabolic acidosis. Univariate and multivariate logistic regression analyses were used to analyze the risk factors affecting metabolic acidosis in children undergoing maintenance hemodialysis. Decision tree algorithm and logistic regression algorithm were used to construct risk prediction models，and the predictive values of the two models for metabolic acidosis in children undergoing maintenance hemodialysis were compared. Results Among the 205 children undergoing maintenance hemodialysis，101 cases developed metabolic acidosis，with an incidence rate of 49.27%. Multivariate logistic regression analysis showed that diabetes mellitus，malnutrition，blood urea nitrogen，serum unsaturated iron binding capacity and blood potassium were risk factors for metabolic acidosis in children undergoing maintenance hemodialysis（P<0.05）. A decision tree model was constructed based on the risk factors，which selected 5 explanatory variables including blood potassium，blood urea nitrogen，diabetes mellitus，serum unsaturated iron binding capacity and malnutrition，with a total of 5 layers and 22 nodes. Among them，blood potassium was the most important influencing factor for metabolic acidosis in children undergoing maintenance hemodialysis. The AUC value of the decision tree model for metabolic acidosis in children undergoing maintenance hemodialysis was 0.928（95%CI：0.883~0.959），and the AUC value of the logistic regression model was 0.901（95%CI：0.852~0.938）. The Delong test results of the two models showed Z=2.453，P<0.001. Conclusion Diabetes mellitus，malnutrition，blood urea nitrogen，serum unsaturated iron binding capacity and blood potassium are risk factors for metabolic acidosis in children undergoing maintenance hemodialysis. The decision tree risk prediction model constructed based on these risk factors has high predictive efficiency，providing a scientific and effective theoretical basis for clinical medical staff to provide more accurate prediction and implement targeted preventive measures. Figures and Tables | References | Related Articles | Metrics

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Evidence-based nursing practice for evaluation and insertion of peripheral arterial catheters in children in pediatric intensive care unit ZHOU Min, WANG Linjuan, LI Jiajia, YANG Na, WANG Qiaoxia, FU Kunhui, HUANG Quelan, MENG Lingyu 2026, 7 (5):  546-553.  doi: 10.3761/j.issn.2096-7446.2026.05.005 Abstract ( )   HTML ( )   PDF (1292KB) ( )   Save Objective To synthesize and apply the best evidence of peripheral arterial catheter（PAC） placement in the pediatric intensive care unit（PICU）. Methods Utilizing the Joanna Briggs Institute（JBI） evidence-based nursing framework and the Ottawa Model of Research Use，ten pieces of best evidence were discerned and converted into twelve clinical audit criteria. A comparative analysis was performed the baseline phase and the post-implementation re-audit phase to evaluate nurses’ adherence to evidence，initial success rates of PAC insertion，and the occurrence of complications. Results During the post-implementation re-audit phase，total compliance with the 12 audit criteria markedly improved（48.24% vs. 80.22%，χ2=189.379，P<0.001）. Significant enhancements were noted in both the assessment and insertion domains（P<0.001），with seven critical indicators—evaluation of indications，coagulation status assessment，collateral circulation，operator qualifications，infection prevention，and pain management—demonstrating statistically significant increases（P<0.05）. The success rate of initial attempts dramatically increased（58.9% vs. 82.2%，χ2=10.899，P=0.001），while the occurrence of insertion-related problems greatly diminished（22.4% vs. 4.2%，χ2=11.208，P<0.001）. Conclusion The best evidence application of PAC insertion into nursing practice in the PICU can standardize nurses’ behavior，improve evidence adherence of nurses，and prevent procedure-related complications in critically ill pediatric patients. Figures and Tables | References | Related Articles | Metrics

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Summary of the best evidence for prevention and nursing of high-flow intestinal fistula after enterostomy in neonates with necrotizing enterocolitis WAN Shanshan, CHEN Lihua, ZHU Jihua 2026, 7 (5):  554-560.  doi: 10.3761/j.issn.2096-7446.2026.05.006 Abstract ( )   HTML ( )   PDF (1231KB) ( )   Save Objective To summarize the best evidence for the prevention and nursing care of high-flow intestinal fistula after enterostomy in neonates with necrotizing enterocolitis，and to provide a basis for the clinical practice of preventing high-flow intestinal fistula after enterostomy. Methods The literatures related to the prevention and care of high-flow intestinal fistula after enterostomy in neonates with necrotizing enterocolitis were retrieved from domestic and foreign databases，guideline websites and websites of relevant professional associations. The retrieval period was from the establishment of the database to April 30，2025. The quality of the included literature was evaluated，data was extracted and evidence was summarized. Results A total of 17 articles were included，including 5 clinical guidelines，8 expert consensuses，3 systematic reviews，and a clinical decision. Eighteen pieces of best evidence were summarized from five aspects，including assessment of high-flow intestinal fistula after enterostomy in neonatal necrotizing enterocolitis，related risk factors，preventive nursing intervention measures，preventive feeding measures，and health education and follow-up. Conclusion The best evidence of high-flow intestinal fistula after enterostomy summarized in this study can provide a reference for clinical practice，and it is suggested that medical staff formulate relevant nursing strategies based on the specific clinical situation. Figures and Tables | References | Supplementary Material | Related Articles | Metrics

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Nursing care of a premature infant with difficulty in catheterization and PICC catheter placement via thoracoepigastric vein YU Xiangling, ZHAO Xiaoyan, CHEN Fan, LIN Yumin, DENG Sufen, HUANG Yufeng 2026, 7 (5):  561-563.  doi: 10.3761/j.issn.2096-7446.2026.05.007 Abstract ( )   HTML ( )   PDF (666KB) ( )   Save To summarize the nursing experience of successfully placing a peripherally inserted central catheter （PICC） via the thoracoepigastric vein in an extremely low birth weight infant with difficult catheterization. The following nursing measures were adopted to address issues such as prematurity，prolonged illness，poor vascular conditions，and severe catheterization difficulties. We conducted a thorough risk assessment before catheterization and selected the thoracoepigastric vein as the PICC insertion site，overcame the impact of chest movements during catheterization by choosing appropriate puncture techniques and timing to ensure puncture success，used methods such as gentle soothing and warming the disinfectant to prevent vascular contraction，and assisted with bedside ultrasound guidance，actively monitored for PICC-related complications after catheterization. Ultimately，the PICC was successfully placed via the thoracoepigastric vein，ensuring timely completion of treatments. The catheter functioned well for 19 days without any complications. During a 2-year outpatient follow-up after discharge，the infant was in good condition. References | Related Articles | Metrics

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Research progress on enteral nutrition management for infants with postoperative chylothorax following congenital heart disease surgery YAN Qingtian, LI Minmin, LI Yuxin 2026, 7 (5):  564-568.  doi: 10.3761/j.issn.2096-7446.2026.05.008 Abstract ( )   HTML ( )   PDF (916KB) ( )   Save Postoperative chylothorax following congenital heart disease surgery is a challenge in the enteral nutrition management of infants. This article reviews the nursing assessment，intervention strategies，outcome evaluation，and home-based continuity care for this population，aiming to provide a reference for standardizing enteral nutrition management and effectively improving clinical prognosis. References | Related Articles | Metrics

Guideline and Standard

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Interpretation of the group standard “Endotracheal Suctioning Technology for Adult Patients with Inhalation Injury after Tracheotomy” WANG Shujun, LU Hongyan, YANG Linna 2026, 7 (5):  569-573.  doi: 10.3761/j.issn.2096-7446.2026.05.009 Abstract ( )   HTML ( )   PDF (993KB) ( )   Save The group standard entitled Endotracheal Suctioning Technology for Adult Patients with Inhalation Injury after Tracheotomy was released by the China Medical Education Association in November 2023，which standardizes this specialized technique for patients with inhalation injury who have undergone tracheotomy. This paper interprets the key and difficult points of the standard，covering the basic requirements（appropriate ambient temperature and humidity，restricted visitor access，and a comfortable patient posture），pre-suction preparation，and standardized suction timing. Furthermore，it stipulates that location-specific suctioning should be performed in accordance with the top-down anatomical sequence，the suction catheter should be inserted under non-zero negative pressure，and effective prevention，observation，and emergency treatment of critical complications should be well conducted. References | Related Articles | Metrics

Emergency Care Research

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Clinical characteristics observation and nursing care of 67 patients with Chikungunya hemorrhagic fever HUANG Shaojuan, LI Shufang, CHEN Wenyuan, CHEN Xing, LIANG Yangui, MA Xiaojun, HUANG Qinghua, WU Xiaokun, ZHANG Gai, CHEN Ping 2026, 7 (5):  574-580.  doi: 10.3761/j.issn.2096-7446.2026.05.010 Abstract ( )   HTML ( )   PDF (2067KB) ( )   Save Objective To explore the epidemiological characteristics，clinical manifestations，and laboratory findings of patients with Chikungunya fever，and to offer evidence-based references for clinical nursing practice. Methods A retrospective analysis was performed on 67 hospitalized patients diagnosed with Chikungunya fever who were admitted to a tertiary grade A hospital between July 17 and August 5，2025. We collected and analyzed the data，including demographic features，epidemiological history，clinical symptoms and signs，traditional Chinese medicine （TCM） syndrome patterns，comorbidities，and laboratory findings. Results Among the 67 patients，43（64.18%） were female and 24（35.82%） were male，with an age range of 14-85 years（49.19 ± 18.28）. Cases were predominantly clustered in late July（62.69%）. The clinical characteristics are mainly mild（98.51%），with the main clinical mani-festations being the triad of arthritis（86.57%），rash（71.64%），and fever（67.16%）. The most common TCM syndrome pattern was damp-heat accumulation syndrome（34.33%）. Comorbidities（≥2 types） were present in 26.87% of patients，and 72.2% of these comorbid patients were aged ≥60 years. Laboratory findings showed that the CT value of the Chikungunya virus nucleic acid test was （28.27±7.59），markers（IL-6，CRP，TNF-α） and D-dimer levels were generally elevated，while the estimated glomerular filtration rate（eGFR），serum potassium，and albumin levels were commonly reduced. Conclusion The 2025 Chikungunya fever outbreak in Foshan，Guangdong Province，exhibited obvious seasonal clustering，with mild cases being more common in young and middle-aged females. Arthritis was a prominent clinical feature，accompanied by inflammatory activation and metabolic disturbances. During the endemic season of mosquito-borne diseases，nursing staff should prioritize the early identification of high-risk groups during pre-admission triage. Guided by TCM syndrome differentiation and laboratory findings，dynamic monitoring of inflammatory and coagulation markers should be strengthened，and individualized symptom management implemented to improve clinical outcomes. Figures and Tables | References | Related Articles | Metrics

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Development and psychometric testing of a scale for measuring early rehabilitation readiness of critical trauma patients HUI Yanhong, XU Guodong, WU Yu, GENG Qingqing 2026, 7 (5):  581-587.  doi: 10.3761/j.issn.2096-7446.2026.05.011 Abstract ( )   HTML ( )   PDF (1012KB) ( )   Save Objective To develop a scale for early rehabilitation readiness of critically injured patients and test its reliability and validity. Methods Using the Health Belief Model as the theoretical framework，we developed an item pool through literature analysis，semi-structured interviews，and theoretical analysis. After two rounds of Delphi expert consultations and a pilot test with a small sample size，we finalized the preliminary questionnaire. Through convenience sampling，we recruited critically ill trauma patients hospitalized at three Grade III-A general hospitals in Shandong Province for investigation. The questionnaire items were then screened and validated for reliability and validity. Results The scale comprises six dimensions with 35 items. Exploratory factor analysis identified six common factors，accounting for a cumulative variance contribution rate of 74.175%. Confirmatory factor analysis demonstrated stable factor structure. The total scale showed Cronbach’s α coefficient of 0.948，with half-reliability at 0.925 and retest reliability at 0.931. Content validity index of the scale was 0.982，with individual items demonstrating content validity from 0.900 to 1.000. Conclusion The early rehabilitation readiness scale for critically injured patients has good reliability and validity，and can be used as a tool to evaluate the early recovery readiness of critically injured patients. Figures and Tables | References | Related Articles | Metrics

Critical Care Research

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Postoperative nursing care of a patient with pancreatic cancer undergoing total gastrectomy and pancreatectomy combined with autologous small bowel transplantation WANG Sisi, BIAN Lifang, LI Yan 2026, 7 (5):  588-590.  doi: 10.3761/j.issn.2096-7446.2026.05.012 Abstract ( )   HTML ( )   PDF (761KB) ( )   Save To summarize the postoperative nursing experience of a pancreatic cancer patient undergoing total gastrectomy and pancreatectomy combined with autologous small bowel transplantation. To address postoperative complications including infections，thrombosis，anastomotic leakage，and nutritional issues，a multidisciplinary collaborative management team was established. The team implemented early infection detection and control，dynamic anticoagulation management to prevent bleeding and thrombosis，proactive nursing care for gastrointestinal anastomosis complications，real-time blood glucose monitoring for hypoglycemia prevention，whole process nutritional support，and enhanced multimodal diarrhea management. After 25 days of intensive treatment and meticulous nursing care，the patient achieved stable condition and was discharged. Three months of follow-up showed the patient gained 2 kg in body weight. References | Related Articles | Metrics

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Nursing care of a patient with wet beriberi and multiple organ failure caused by thiamine deficiency DONG Lianlian, LUO Xueli, WEI Wenjing, CHEN Lingxin, REN Hongyan, GONG Xiaoyan 2026, 7 (5):  591-594.  doi: 10.3761/j.issn.2096-7446.2026.05.013 Abstract ( )   HTML ( )   PDF (713KB) ( )   Save To summarized the nursing experience of a patient with wet beriberi and multiple organ dysfunction caused by thiamine deficiency due to chronic alcoholism. For the patient with atypical clinical manifestations，sudden onset of refractory shock，and multi-organ failure，a multidimensional assessment strategy was adopted to rapidly and accurately identify wet beriberi. A step-down vitamin B1 protocol was formulated to ensure safe supplementation of thiamine. Precision volume management was implemented to correct congestive heart failure，individualized ventilation and rehabilitation strategy was applied to promote lung pulmonary recovery. Renal replacement therapy was early initiated to correct acidosis and improve renal injury. Health education was guided by dyadic coping theory and information-motivation-behavioral model. Through timely treatment and meticulous care，the patient was transferred to a general ward after 7 days，discharged on day 13，and showed good recovery at 3-month follow-up. References | Related Articles | Metrics

Career Deveolopment of Nurses

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Analysis of the current status and influencing factors of core competencies in ECMO nursing care among ICU nurses ZHAO Lihua, ZHENG Yimei, YUAN Cui, ZHANG Jianxia, YE Jing 2026, 7 (5):  595-601.  doi: 10.3761/j.issn.2096-7446.2026.05.014 Abstract ( )   HTML ( )   PDF (1181KB) ( )   Save Objective To investigate the current status of core competencies in extracorporeal membrane oxygenation（ECMO） nursing among ICU nurses in tertiary grade-A hospitals across China’s seven major regions （North China，Northeast China，East China，Central China，South China，Southwest China，and Northwest China），and to analyze the influencing factors. Methods Using a convenience sampling method，462 ICU nurses from 26 tertiary hospitals were assessed from September 2023 to October 2024. Data collection instruments included a demographic questionnaire and a self-developed ECMO Nursing Core Competency Scale. Competency scores were described using median （interquartile range），both univariate analysis and multiple linear regression model were em-ployed to identify influencing factors. Results The median total score of ECMO nursing core competencies was 216（190，242）. After standardized conversion，professional development competency（75.24%） and nursing management competency（77.00%） demonstrated the lowest attainment rates. Key influencing factors included years of ECMO nursing experience（β=0.149），completion of systematic ECMO training（β=0.144），nursing ladder（β=0.532），number of independent ECMO cases managed（β=0.165），and nurse manager status（β=0.128），collectively explaining 19% of variance（adjusted R2=0.190，P<0.001）. Conclusion ECMO nursing competencies among ICU nurses in Chinese tertiary hospitals exhibit multidimensional imbalance，maintaining an intermediate overall level with notable deficiencies in professional development and management domains. In the future，guided by the standardized training and hierarchical certification system of the Global Guidelines for Extracorporeal Life Support Organizations，a specialized development path based on evidence-based training system，guided by clinical practice，and supported by hierarchical management of abilities can be constructed. At the same time，the empowerment of nursing management functions in multidisciplinary teams can be optimized，to systematically enhance the quality of ECMO nursing. Figures and Tables | References | Related Articles | Metrics

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A qualitative study on the emergency department nurses’ experience of practicing humanistic care CUI Mengjiao, CHEN Lu, HUANG Ping, FANG Fang, XIA Ying, MEI Tianshu 2026, 7 (5):  602-607.  doi: 10.3761/j.issn.2096-7446.2026.05.015 Abstract ( )   HTML ( )   PDF (931KB) ( )   Save Objective To explore the experience of emergency department nurses in practicing humanistic care，identify facilitating and hindering factors，and promote the development of emergency humanistic care practices. Methods Using purposive sampling，semi-structured interviews were conducted with 14 emergency department nurses from two tertiary hospitals in Jiangsu Province in May 2025. Data were collated and analyzed using Colaizzi’s phenomenological analysis method. Results The study identified four key themes，including dilemmas in practicing humanistic care in the emergency department，emotional exhaustion and self-protection，driving forces behind humanistic care practice in the emergency department，and organizational-level empowerment needs. Conclusion The humanistic care provided by emergency nurses is driven by their intrinsic values，and team support yet challenged by multiple challenges such as time pressure, environmental constraints，and emotional exhaustion，necessitating organizational empowerment to remove structural barriers and effectively improve the quality of humanistic care in emergency nursing.. Figures and Tables | References | Related Articles | Metrics

Evidence Synthesis Research

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Risk prediction models of oral mucosal pressure injury in patients with oral endotracheal intubation in ICU：a systematic review LIU Li, TU Ping, HUANG Siyao, XIONG Yan, XU Jianmei 2026, 7 (5):  608-615.  doi: 10.3761/j.issn.2096-7446.2026.05.016 Abstract ( )   HTML ( )   PDF (1393KB) ( )   Save Objective To systematically review prediction models for the risk of oral mucosa pressure injury in ICU patients with orotracheal intubation，aiming to assist clinical healthcare professionals in selecting or designing appropriate assessment tools. Methods We systematically searched PubMed，Embase，Web of Science，Cochrane Library，CINAHL，China National Knowledge Infrastructure，VIP Database，Wanfang Database，and China Biological Medicine Literature Database for studies published from database inception to February 1，2025，focusing on the development of risk prediction models for oral mucosa pressure injuries in ICU patients with orotracheal intubation. Two researchers independently performed literature screening and data extraction. The Prediction model Risk of Bias Assessment Tool（PROBAST） was applied to assess the risk of bias in the included studies. Results Ten studies involving 10 distinct prediction models were included. The top five most frequently reported predictor variables were duration of intubation，albumin level，acute physiology and chronic health evaluationⅡ（APACHEⅡ），Richmond Agitation-Sedation Scale score（RASS），and bite block usage. Eight studies reported area under the receiver operating characteristic curve（AUC） values ranging from 0.600 to 0.930. While the applicability of all ten studies was rated as good，they universally exhibited a high risk of bias，particularly in the domain of analysis. Conclusion Research on prediction models for oral mucosa pressure injury risk in ICU patients with orotracheal intubation remains in its early stages. Future studies should focus on conducting high-quality research，incorporating artificial intelligence to optimize model development and clinical translation. Emphasis should be placed on strengthening both internal and external validation of models，with particular attention to core predictors such as duration of intubation，APACHE Ⅱ score，and bite block usage. Figures and Tables | References | Supplementary Material | Related Articles | Metrics

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The effect of early mobilization in adult patients with extracorporeal membrane oxygenation：a meta-analysis ZHANG Tianyu, CHENG Lingling, CHENG Zhen, SHAO Weiying, SHI Aili 2026, 7 (5):  616-622.  doi: 10.3761/j.issn.2096-7446.2026.05.017 Abstract ( )   HTML ( )   PDF (1114KB) ( )   Save Objective This study aims to evaluate the effect of early mobilization in patients with extracorporeal membrane oxygenation（ECMO）. Methods The databases of CNKI，Wanfang，VIP，CBM，PubMed，Embase，Cochrane Library，and Web of Science were searched by computer，and the retrieval time was from the establishment of the database to March 17，2025. Two researchers independently searched and screened the literature，and evaluated the quality of the literature. RevMan 5.4 software was used for meta-analysis. Results A total of 8 studies involving 9 054 patients were included. The results of meta-analysis showed that，compared with the non-early mobilization group，early mobilization could reduce the mortality of ECMO patients，and the difference was statistically significant[RR=0.65，95%CI（0.46，0.93），P<0.001]. However，the effect on the duration of mechanical ventilation[SMD=-0.37，95%CI（-1.46，0.72），P=0.510] and ECMO support[SMD=-0.33，95%CI（-0.86，0.20），P=0.220] was not clear. In subgroup analysis，there was a statistically significant difference in mortality between patients with veno-venous extracorporeal membrane oxygenation（V-V ECMO） and veno-arterial extracorporeal membrane oxygenation（V-A ECMO）[RR=1.34，95%CI（1.05，1.71），P=0.020]. Conclusion The intervention of early mobilization can reduce the mortality of ECMO patients. But it is limited by the quality of the included studies，the number of subjects and the heterogeneity of study results，more high-quality studies are still needed to further verify the safety，feasibility and effectiveness of early mobilization in ECMO patients，and formulate professional progressive mobilization programs for different types of ECMO patients. Figures and Tables | References | Supplementary Material | Related Articles | Metrics

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Analysis of the connotation and characteristics of medical staff ’s caring behaviors during family visits in the ICU LIU Li, GAN Xiuni, GAO Yan, YANG Ruiqi 2026, 7 (5):  623-630.  doi: 10.3761/j.issn.2096-7446.2026.05.018 Abstract ( )   HTML ( )   PDF (1235KB) ( )   Save Objective To explore the characteristics of caring behaviors of medical staff in ICU visiting，aiming to provide references for promoting the development of humanistic care practice in ICU. Methods A systematical research was conducted across domestic and foreign databases from the establishment of databases to October 10，2025. Directed content analysis was applied to summarize the characteristics of medical staff’s caring behaviors during ICU visiting. Results A total of 31 studies were finally included，consisting of 18 randomized controlled trials（RCTs），3 systematic reviews，3 standards or guidelines，4 consensuses，and 3 evidence summaries. The caring behaviors of medical staff in ICU visiting were categorized into 5 themes and 18 subcategories，including understanding individual needs，providing emotional companionship，offering practical assistance，enabling family capabilities，and facilitating strategies for care implementation. Among the themes，enabling family capabilities was recorded with the highest frequency（31 times），while providing emotional companionship had the lowest frequency（15 times）. Conclusion The care practice of medical staff during ICU visiting consists of a series of behaviors that can be learned and practiced. With organizational support，medical staff should uphold positive beliefs and further conduct ICU visitation practices centering on the core caring practices，including understanding patients’ needs，providing effective companionship，offering practical assistance and empowering family members，so as to continuously advance the development of humanistic care practices in the ICU. Figures and Tables | References | Supplementary Material | Related Articles | Metrics

Review

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Advances in the application of pupillometry for pain assessment in critically ill patients ZANG Ruijin, LI Lingling, ZHENG Miao, ZHONG Juanping, NAN Ruiling, WANG Xinglei, DOU Xinman 2026, 7 (5):  631-635.  doi: 10.3761/j.issn.2096-7446.2026.05.019 Abstract ( )   HTML ( )   PDF (756KB) ( )   Save Accurate identification of pain perception in critically ill patients is critical for effective pain management. Pupillometry，as a technology capable of objectively quantifying pain-related responses，captures dynamic pupillary changes to accurately assess pain perception and analgesic needs. This review summarizes the commonly used tools，target populations，and clinical application value of pupillometry for pain assessment in critically ill patients. It aims to provide healthcare professionals with a novel approach for evaluating pain in critically ill patients. Future research should focus on establishing standardized pupillometry assessment protocols and operational procedures to enhance its clinical utility. References | Related Articles | Metrics

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The application of large language models in emergency and critical care nursing ZHEN Haiyan, QIN Zilan, ZHANG Zhigang, WU Yuchen, YUE Weigang, AN Yuyan 2026, 7 (5):  636-640.  doi: 10.3761/j.issn.2096-7446.2026.05.020 Abstract ( )   HTML ( )   PDF (764KB) ( )   Save With the continuous advancement of interdisciplinary research in medical engineering，large language models have demonstrated innovative potential in the medical field. In emergency and critical care clinical nursing，the integration of large language models has shown remarkable efficacy in disease diagnosis assistance，clinical nursing decision support，medical documentation automation，and patient health guidance and consultation. This paper systematically reviews the technological evolution of large language models，focusing on their current applications in emergency and critical care medicine. It also conducts an in-depth analysis of challenges in incorporating large language models into healthcare systems，including data privacy and security，legal and ethical considerations and model reliability，aiming to provide a reference for the standardized implementation of artificial intelligence technology in emergency and critical care nursing. References | Related Articles | Metrics