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Purpose: Intensive care patients often struggle to communicate due to the technical equipment used for mechanical ventilation and their critical illness. The aim of the study was to achieve a deeper understanding of how mechanically ventilated intensive care patients construct meaning in the unpredictable trajectory of critical illness. Methods: The study was a part of a larger study in which ten patients were video recorded while being in the intensive care. Five patients engaged in interviews about their experiences from the intensive care stay after being discharged and were offered the possibility to see themselves in the video recordings. A narrative, thematic analysis was applied to categorize the patients' experiences from the intensive care. Results: A pattern of shared experiences among intensive care patients were identified. Three main themes capture the patient's experiences: 1) perceiving the intensive care stay as a life-changing turning point, 2) being dependent on and cared for by others, and 3) living with negative and positive ICU experiences. Conclusion: The patients' narratives revealed how being critically ill affected them, and how they understood their experiences in relation to themselves and their surroundings. The results can be used to pose important questions about our current clinical practice. [ABSTRACT FROM AUTHOR]

Background: In recent decades, intra‐aortic balloon pump (IABP) technology has made significant progress (sheathless insertion technique, different balloon diameters, percutaneous technique and fibre optic IABP) in reducing complications and increasing patient support. Nonetheless, IABP‐related complications are still frequent and are associated with a poor prognosis. Aim: The aim of this systematic review was to identify complications associated with IABP treatment in critically ill patients with a compromised cardiac function. Study Design: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines based on searches in CINAHL (EBSCO), Medline and Embase (Ovid) from January 2012 to April 2023. Quantitative studies were included if they reported as their primary outcome(s) complications of IABP in adult patients because of cardiovascular conditions and were published in English, Norwegian, Swedish or Danish. Study selection, methodological quality assessment and data extraction were performed independently by two authors. The results were synthesized narratively. Results: A total of nine studies were included in the review, most of which were retrospective (eight of nine). Bleeding was the most frequently occurring complication, followed by limb ischaemia, stroke, infection, IABP malfunction, haematoma and other vascular complications. In addition, a correlation between IABP duration and vascular complications was found in three out of nine studies. Lastly, the incidence rate of stroke was higher in patients with axillary IABP than in those with femoral IABP. Conclusions: This systematic review revealed that bleeding and limb ischaemia were the two most frequent complications associated with IABP therapy. We identified a correlation between (a) IABP support time and the development of vascular complications and (b) stroke and implantation of IABP catheter in the axillary artery. Further studies are needed to explore these findings directly. Relevance to Clinical Practice: Increasing critical care nurses' knowledge regarding complications related to IABP support could lead to early identification, potentially lowering the incidence rate of complications. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to perform a concept analysis of communication with mechanically ventilated patients in intensive care units and present a preliminary model for communication practice with these patients. Design: The Im & Meleis approach for concept analysis guided the study. Search Methods: A literature search was performed in January 2022 in MEDLINE, Embase, CINAHL, psycINFO and Scopus, limited to 1998–2022. The main medical subject headings search terms used were artificial respiration, communication and critical care. The search resulted in 10,698 unique references. Review Methods: After a blinded review by two authors, 108 references were included. Core concepts and terminology related to communication with mechanically ventilated patients were defined by content analytic methods. The concepts were then grouped into main categories after proposing relationships between them. As a final step, a preliminary model for communication with mechanically ventilated patients was developed. Results: We identified 39 different phrases to describe the mechanically ventilated patient. A total of 60 relevant concepts describing the communication with mechanically ventilated patients in intensive care were identified. The concepts were categorized into five main categories in a conceptual map. The preliminary model encompasses the unique communication practice when interacting with mechanically ventilated patients in intensive care units. Conclusion: Highlighting different perspectives of the communication between mechanically ventilated patients and providers through concept analysis has contributed to a deeper understanding of the phenomena and the complexity of communication when the patients have limited possibilities to express themselves. Impact A clear definition of concepts is needed in the further development of guidelines and recommendations for patient care in intensive care, as well as in future research. The preliminary model will be tested further. Patient or Public Contribution: No patient or public contribution, as this is a concept analysis of previous research. [ABSTRACT FROM AUTHOR]

Background: Patients in intensive care units are generally more conscious and alert when they are on mechanical ventilation than in previous years because of the many potential benefits of being under less sedation. The endotracheal tube blocks the vocal cords when patients are on ventilation, thus making it impossible to speak. Many patients report that they struggle to make themselves understood. Aim: The aim of this study was to assess previous knowledge about interaction and communication between health care personnel and conscious and alert patients under mechanical ventilation in intensive care units. Design and methods: A literature review was performed following the steps of a scoping review. Studies published between 1998 and 2017 were identified in several databases: Cinahl, Embase, Medline, PsycINFO and Scopus. The first search returned 7386 unique references. The inclusion criteria consisted of empirical studies or studies related to interactions between health care personnel and patients over 18 years of age on mechanical ventilation. The relevant studies were summarized in a standardized data‐charting sheet. Results: The inclusion criteria were met by 46 articles; 16 were qualitative studies, 17 were quantitative, 6 were mixed‐methods studies, and 7 were pilot or feasibility studies. Of the studies, 37 were from nurses, 4 from physicians, 4 from speech language pathologists and 1 from psychologists. The most common topics investigated in the studies were 'experiences with communication on mechanical ventilation' and 'communication exchanges'. Conclusions: A variety of communication aids that appear to have some effect on patients should be made available in intensive care units. More multidisciplinary approaches in future studies could enhance the knowledge in the field. Relevance to clinical practice: The education of intensive care unit personnel in the use of such aids should be a prioritized field, as should be the implementation of a variety of communication aids. [ABSTRACT FROM AUTHOR]