Health Care Utilization and Costs in Ventilator-Dependent Children and Adults Receiving an eHealth Intervention During the COVID-19 Pandemic.

During the COVID-19 pandemic, we implemented the Long-term In-Home Ventilator Engagement (LIVE) intervention to provide virtual specialist care. Using a matched home mechanical ventilation control group, we compared publicly funded health-service utilization and costs for ventilator-dependent children and adults receiving the LIVE eHealth intervention. LIVE users were matched to controls on age, sex, ventilation type, years on ventilation, and reason for ventilation.

Driving the Development of Innovative Digital Health: Creating Open Access Co-Design Training Resources.

Co-design describes the adoption of methods which actively involve a broad range of stakeholders throughout the design process. Research suggests that co-design is vital for the successful development of complex health innovations, including those in digital health. Although the benefits of co-design in digital health are evident, there is limited open-access and accessible training to support the continued development of a range of professionals to co-design for digital health.

Family Caregivers of Individuals With Neuromuscular Disease Participating in a Randomized Controlled Trial of a Digital Peer Support Program: Nested Qualitative Study.

Background: Family caregivers have primary responsibility for providing care in the home for people with neuromuscular diseases (NMDs). This may negatively affect caregiver health. Peer support may enhance quality of life and reduce stress among family caregivers, but few trials have been conducted in NMD caregivers.

Outcomes and measures in studies of techniques to promote secretion clearance in individuals with neuromuscular conditions: a scoping review.

Background: Techniques to support secretion clearance for individuals with neuromuscular conditions and respiratory muscle weakness include mechanical insufflation-exsufflation and chest wall vibrations. Assessing the comparative efficacy of these techniques is challenging due to the absence of a core outcome set. We sought to describe outcomes and measurement instruments reported in studies of airway clearance techniques for individuals with neuromuscular conditions living in the community.

Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children.

Rationale: Automated closed-loop systems may improve the adaptation of mechanical ventilatory support to an individual's ventilatory needs. They may also facilitate systematic and early recognition of the patient's ability to breathe spontaneously and come off the ventilator. This is an update of a Cochrane review originally published in 2013 and last updated in 2014.

Optimising Paediatric Transition to Intensive Care for Adults (OPTICAL): study protocol for a mixed method study.

Introduction: An increasing number of teenagers and young adults (TYA) with chronic conditions and complex needs are transitioning from paediatric to adult services, including admission to intensive care units (ICUs). As these services are often ill-equipped to care for TYA, there is a risk of compromised care. Despite recent guidelines from the UK Paediatric Critical Care and Intensive Care Societies highlighting the importance and urgency of improving ICU transition, current recommendations are not evidence-based and established pathways for ICU transition remain limited.

A mixed-method evaluation of the acceptability, appropriateness, and feasibility of using an actionable processes of care checklist for patients with persistent critical illness.

Background: Patients with persistent critical illness have care priorities distinct from those experiencing acute critical illness. We developed a checklist called "Action 11" incorporating actionable priorities of care for these patients.

Objective: The objective of this study was to evaluate the acceptability, appropriateness, and feasibility of using the Action 11 checklist.

Expert consensus on research priorities for the prevention of delirium in adult ICU patients.

Objective: To identify research priorities for the prevention of delirium in adult intensive care unit (ICU) patients.

Research Methodology: We conducted an iterative, consensus-based modified Delphi methodology combined with initial literature search to establish a prioritized research agenda. As a first round of an anonymised modified Delphi procedure, a 10-member international expert panel, selected on basis of their academic and clinical expertise, were asked to add topics they perceived missing from a list of potential research gaps regarding ICU delirium prevention.

Factors enhancing critical care nurses' utilization frequency of behavioral pain assessment tools for critically ill adults unable to self-report.

Aim: This study investigated the factors associated with nurses' often and routine utilization of behavioral pain assessment tools for critically ill adults unable to self-report.

Background: Few studies have explored the factors associated with critical care nurses' utilization frequency of behavioral pain assessment tools.

Methods: This cross-sectional study used a questionnaire to collect data from critical care nurses.

Diarrhea in Mechanically Ventilated Patients: A Nested Multicenter Substudy.

Objective: The aim of this study was to examine the prevalence and incidence of diarrhea, diarrhea risk factors, processes of care, and clinical outcomes associated with diarrhea in invasively ventilated patients in the ICU.

Design: Bedside nurses prospectively documented each patient's bowel movement (BM) using the Bristol Stool Chart type and number. Research Coordinators collected baseline and daily data evaluating risk factors for diarrhea and patient outcomes.

Implementation of a Quality Improvement Tool "Recover25" to Guide the Care of Patients Experiencing Prolonged Critical Illness: A Mixed-Method Feasibility Study.

Objectives: Few quality improvement (QI) tools are specifically designed to manage the care of patients experiencing prolonged critical illness. This risks omissions in care. To determine the implementation feasibility and clinician acceptability of our QI tool "Recover25," we focused on actionable processes of care for patients with an ICU stay of over 7 days and their families.

Development of a Core Outcome Set for Intervention Studies in Adults With Laryngotracheal Stenosis.

Objective: Adult acquired laryngotracheal stenosis (LTS) is a chronic condition with heterogeneous treatment options and a significant symptom burden. Synthesis of data across research studies to guide clinical decision-making is challenging due to inconsistent outcome selection and use of unvalidated measures. Our objective was to establish a core outcome set (COS) for studies of LTS interventions in adults.

Sedation for moderate-to-severe traumatic brain injury in adults.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of sedative, analgesic, and anaesthetic drugs on neurological outcomes in adults with moderate-to-severe traumatic brain injury.

Extracorporeal membrane oxygenation and diurnal analgosedation: A comparative retrospective study in ventilated patients.

Background: Diurnal variation of analgosedation may worsen patient outcomes. However, there is no data reporting diurnal variation in patients receiving extracorporeal membrane oxygenation (ECMO).

Objectives: To compare diurnal variation of analgosedation doses in mechanically ventilated adult patients and those receiving ECMO.

Family Caregiver Perspectives on Digital Methods to Measure Stress: Qualitative Descriptive Study.

Background: Family caregivers provide essential care in the home to millions of individuals around the globe annually. However, family caregiving results in considerable burden, financial hardship, stress, and psychological morbidity. Identifying and managing stress in caregivers is important as they have a dual role in managing their own health as well as that of the person they care for.

Core Outcome Set for Studies Investigating Secretion Clearance Interventions Used in the Community by Patients With Neuromuscular Disease.

Several treatments are used in the community to improve secretion clearance for patients with neuromuscular disease (NMD). However, the optimal intervention remains unclear with further research required. We aimed to develop a core outcome set (COS) for studies investigating secretion clearance interventions used in the community by patients with NMD.

Digital Health Interventions Supporting Recovery for Intensive Care Patients and Their Family Members: A Scoping Review.

Digital innovation in interventions to promote recovery for intensive care unit (ICU) patients and their family members holds promise for enhancing accessibility and improving physical, psychological, and cognitive outcomes. This scoping review provides a comprehensive overview of digital health interventions designed to support the recovery of ICU patients and their family members described in peer-reviewed publications. We searched 6 databases (inception to September 2023); 2 reviewers independently screened citations against predefined eligibility criteria and extracted data.

A Bayesian Network model of pregnancy outcomes for England and Wales.

Efforts to fully exploit the rich potential of Bayesian Networks (BNs) have hitherto not seen a practical approach for development of domain-specific models using large-scale public statistics which have the potential to reduce the time required to develop probability tables and train the model. As a result, the duration of projects seeking to develop health BNs tend to be measured in years due to their reliance on obtaining ethics approval and collecting, normalising, and discretising collections of patient EHRs. This work addresses this challenge by investigating a new approach to developing health BNs that combines expert elicitation with knowledge from literature and national health statistics.

Fostering tEAmwork for ResiLiEnt Staff and Safe care in ICU (FEARLESS ICU): study protocol.

In intensive care units (ICUs), various healthcare professions work together in interprofessional teams to deliver high-quality, effective care. These teams and their teamwork practices have implications for staff retention, burnout, and wellbeing, as well as patient safety and care outcomes. However, the United Kingdom's (UK) annual National Health Service (NHS) Staff Survey indicates that reported rates of high-quality teamwork are waning.

Low-Dose Melatonin for Prevention of Delirium in Critically Ill Patients: A Multicenter, Randomized, Placebo-Controlled Feasibility Trial.

Background: Delirium is a common and serious syndrome of acute brain dysfunction associated with negative outcomes. Melatonin may have a role in delirium prevention for critically ill adults based on data from noncritically ill patient populations. Our objective was to assess the feasibility of a multicenter, randomized, placebo-controlled trial testing the hypothesis that low-dose melatonin prevents delirium in adults who are critically ill.