BACKGROUND & AIMS:Refeeding syndrome (RFS) is characterized by electrolyte and metabolic disturbances that may occur following the initiation of nutritional support. Given the potential for these disturbances to contribute to clinically important complications, there is substantial interest in ensuring timely recognition of RFS and identifying patients at increased risk. This systematic review and meta-analysis aimed to systematically evaluate the incidence and risk factors of RFS in critically ill patients to support risk stratification and optimize nutritional management. METHODS:This study was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420261363559). A comprehensive search of PubMed, Embase, Cochrane Library, CINAHL, CNKI, Wanfang, VIP, and CBM databases was performed from inception to January 2026. Study quality was assessed using the Newcastle-Ottawa Scale, and meta-analysis was performed using Stata 18.0. RESULTS:A total of 49 studies involving 24,778 critically ill patients were included. The pooled incidence of RFS was 35% (95% CI: 27%-44%), with substantial heterogeneity across studies. Nineteen significant factors were identified across 31 studies. Factors associated with RFS included older age, markers of greater disease severity, indicators of poor nutritional status, diabetes mellitus, mechanical ventilation, and several feeding-related exposures, including higher caloric and protein intake, initiation of feeding within 48 h of ICU admission, feeding rates >50 mL/h, and the use of parenteral nutrition. CONCLUSIONS:This systematic review and meta-analysis highlights the relatively high incidence and multifactorial nature of RFS among critically ill patients. The findings underscore the importance of early risk assessment, careful monitoring during nutritional rehabilitation, and individualized nutritional strategies tailored to patients' metabolic risk profiles. Future research should focus on standardized diagnostic criteria and prospective validation to improve prevention and management.

BACKGROUND:Although the survival rates of patients in the Intensive Care Unit (ICU) have improved, cognitive impairments following ICU discharge continue to be a significant concern, directly impacting long-term rehabilitation and quality of life. Consequently, the research and implementation of effective assessment tools for these cognitive impairments are particularly critical. AIM:The aim of this study was to evaluate the comparative effectiveness of the Montreal Cognitive Assessment (MoCA) and the Telephone Interview for Cognitive Status-modified (TICS-m) for assessing cognitive impairment in critically ill individuals after leaving the ICU. STUDY DESIGN:Using convenience sampling, we recruited ICU patients admitted from January 2021 to November 2022 at a hospital in China. We assessed their cognitive status using the MoCA and TICS-m scales on the day of hospital discharge, comparing the efficacy of the two scales in identifying cognitive impairment after ICU and analysing their correlation. RESULTS:A total of 396 patients were recruited for the study. The total scores of MoCA and TICS-m scales were 24.73 ± 4.64 and 33.20 ± 8.38, respectively, showing a correlation of r = 0.570 (p < 0.001). The incidence of cognitive impairment as assessed by the MoCA was 41.4%, compared to 44.2% for the TICS-m, with no significant difference between the two (χ2 = 1.571, p = 0.152). 51.01% of ICU patients were assessed with normal cognitive function on both MoCA and TICS-m scales, whereas 36.62% were assessed with cognitive impairment on both MoCA and TICS-m scales. The Kappa consistency test results showed a value of 0.747, p < 0.001. The sensitivity of the TICS-m scale compared to the MoCA scale is 0.884, specificity is 0.871, positive predictive value is 0.829, and negative predictive value is 0.914. CONCLUSIONS:Both the MoCA and TICS-m scales demonstrated strong consistency and reliability in assessing cognitive impairment among ICU patients. The TICS-m scale, with its telephone questionnaire format, enables effective follow-up on patients' cognitive status post-ICU. RELEVANCE TO CLINICAL PRACTICE:Given the efficacy of the TICS-m scale in detecting cognitive dysfunction among critically ill patients post-discharge, it is recommended that healthcare professionals incorporate its use for the ongoing assessment of cognitive function in patients following their discharge from the ICU. Future research could assess the scale's predictive value across different clinical settings.

To compare the safety and effectiveness of distal radial artery (DRA) versus conventional radial artery (CRA) catheterization for invasive arterial blood pressure monitoring. This meta-analysis followed PRISMA guidelines. Randomized controlled trials published up to December 30, 2025 were systematically searched in PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, CNKI, Wanfang, VIP, and SinoMed. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Meta-analyses were conducted using Review Manager 5.4 and Stata 18.0, and evidence quality was evaluated with the GRADE system. 12 randomized controlled trials (RCTs) involving 1,790 participants were included. For the primary outcomes, compared with CRA, DRA was associated with lower incidences of haematoma (RR = 0.42, 95

Background Mucous membrane pressure injury is a common but often underrecognized complication in critically ill patients, associated with medical device use and adverse clinical outcomes. Objectives This systematic review and meta-analysis aimed to determine the incidence, prevalence, and associated risk and protective factors of mucous membrane pressure injury in adult intensive care unit patients. Methodology A systematic search was conducted across PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CNKI, Wanfang, VIP, and CBM databases. This review was conducted in accordance with the PRISMA 2020 guidelines and was registered in the International Prospective Register of Systematic Reviews (CRD420251180937). Results Thirty-two studies comprising 22,111 ICU patients were included. The pooled incidence was 28% (95% CI: 23%-34%), and the pooled prevalence was 13% (95% CI: 9%-17%). Sixteen factors were identified across 21 studies. Twelve were risk factors: longer duration of endotracheal intubation, higher APACHE II score, vasopressor use, hypoalbuminemia, use of bite blocks, prone position ventilation, diabetes, elevated hematocrit, tracheal fixation devices, increased oral sputum colony counts, advanced age, and sedative use; four were protective factors: higher serum albumin levels, longer duration of nutritional therapy, increased platelet count, and elevated hemoglobin levels. Conclusion This systematic review and meta-analysis provides comprehensive epidemiological evidence on mucous membrane pressure injury among adult ICU patients, highlighting its substantial burden and multifactorial etiology. The findings emphasize the need for standardized diagnostic criteria and multicenter prospective studies to improve mucous membrane pressure injury prevention and management. Implications for clinical practice Systematic assessment and early identification of mucous membrane pressure injury are essential in ICU settings. Identification of 16 associated factors, including several modifiable clinical and procedural risks, provides a foundation for targeted preventive measures. These findings underscore the importance of early detection and individualized management to minimize the incidence and severity of mucous membrane pressure injury.

OBJECTIVES:To investigate the incidence and risk factors of sepsis-associated delirium (SAD) in ICU patients, with the goal of providing evidence for risk stratification and guiding ICU delirium management. METHODS:The study protocol was registered at PROSPERO on August 2, 2025 (CRD420251118228). A systematic search was conducted across PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP, and CBM databases. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using Stata software (version 18.0). RESULTS:Fifty-two studies comprising 89,789 ICU patients were included. The pooled incidence of SAD was 43% (95% CI: 39%-47%). Seventeen significant factors were identified across 32 studies that reported risk factors. High-evidence-strength factors (≥5 studies) included higher APACHE II score, SOFA score, advanced age, neuron-specific enolase, mechanical ventilation, lactate, S100β protein, and cerebrovascular disease. Mechanical ventilation showed the strongest association with SAD (OR = 2.623). Other factors also identified in fewer studies. In contrast, history of surgery, total bilirubin, and peripheral perfusion index appeared to be protective factors, although supported by limited evidence and should be interpreted with caution. CONCLUSION:This systematic review and meta-analysis demonstrated incidence of SAD was high in ICU patients and identified multiple associated risk factors. These findings support early risk identification and targeted nursing interventions. Future research should focus on standardized diagnosis and nurse-led prevention strategies. IMPLICATIONS FOR CLINICAL PRACTICE:Nurses should perform routine delirium screening in high-risk patients with sepsis and implement targeted interventions, including minimizing sedation, optimizing mechanical ventilation, and monitoring metabolic parameters such as blood glucose and lactate. Early mobilization and individualized care may be beneficial for patients at risk of SAD.

AimsTo evaluate the effectiveness of psychological interventions in alleviating Post-Intensive Care Syndrome (PICS) in ICU patients and PICS-Family (PICS-F) in their families.DesignSystematic review and meta-analysis of randomized controlled trials (RCTs).Data sourcesPubMed, Web of Science, Cochrane Library, and Embase were searched from database inception until December 2nd, 2025.Review methodsTwo reviewers independently screened the studies, extracted the data, and evaluated the risk of bias of the evidence. A systematic review and meta-analysis approach was employed, integrating both qualitative synthesis and quantitative statistical methods to analyze the included RCTs. We included RCTs that compared any form of psychological intervention against any type of control intervention.ResultsA total of 25 RCTs involving 3, 849 participants were included. Among them, 22 studies included 3, 070 ICU patients, and 5 studies included 779 family members of ICU patients. The main findings are summarized as follows: (1) patients: psychological interventions demonstrated potential in reducing anxiety symptoms, with effects sustained into short-term follow-up. While depression improved immediately post-intervention, this benefit was not maintained at follow-up. No significant effects were observed for sleep quality, PTSD, or quality of life. (2) families: no statistically significant improvements were found across all assessed outcomes.ConclusionThis meta-analysis comprehensively evaluates psychological interventions for ICU patients and their families. Preliminary evidence suggests that specific interventions may improve anxiety and depression in patients, though effects varied and evidence is limited by small trials and heterogeneity. No significant effects were found for family outcomes. Current evidence remains insufficient to draw definitive conclusions, highlighting the need for larger, high-quality trials with clearly defined interventions.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251003303, CRD420251003303.

DesignPatients admitted to the Intensive Care Unit (ICU) often experience severe health complications, which results in restricted ward access and limited family visitation opportunities. This frequently leaves families inadequately informed about the patient’s condition. The Patient and Family-Centered Visitation (PFCV) model promotes a more open and flexible visitation approach, emphasizing patient autonomy and fostering an environment of mutual respect and trust among healthcare providers, patients, and families. Currently, no hospitals in China have implemented a fully family-centered visitation system.AimTo understand the evolving landscape of family-centered visitation in China, this study aimed to explore the advantages, disadvantages, and implementation potential of such a system in clinical practice from the perspectives of healthcare professionals (doctors and nurses), patients, and their families.ResultsUsing a phenomenological qualitative approach, this study involved physicians, nurses, patients, and family members from a tertiary hospital in Lanzhou City. Data were organized and coded using the qualitative analysis software NVivo 11.0 Plus and were subsequently analyzed through Colaizzi’s seven-step method to derive final themes.ConclusionThe establishment of a family-centered visitation system in the ICU faces significant challenges related to workforce, environmental constraints, and management. However, opportunities exist for family involvement in certain aspects of patient care. To address these challenges effectively, hospital administration must provide tailored support for implementing a context-appropriate family-centered visitation system.

Delirium is a common and serious complication in critically ill patients, and family-centered care has emerged as a promising non-pharmacological strategy. However, evidence on structured, nurse-led family participatory support (NFPS) intervention remains limited. To evaluate the effectiveness and safety of NFPS in critically ill adult patients. Adult patients admitted to intensive care units (ICU) from three tertiary hospitals in Gansu Province were allocated to either the NFPS group or a usual care group without family participation (non-NFPS). In the NFPS group, trained family members participated in care under the guidance of ICU nurses. The primary outcome was the incidence of delirium. After 1:1 propensity score matching, 365 patients were included in each group. The NFPS group demonstrated significant reductions in incidence of delirium [26.85

Aim(s)The aim of this study is to assess the impact of a stress management intervention on the prevention of Post-Intensive Care Syndrome-Family (PICS-F).DesignA single-center, prospective, parallel-design, randomized controlled trial (RCT) study.MethodsThis study will recruit 56 family members of ICU patients from a hospital in China. Participants will be randomly assigned to either the experimental group or the control group. The control group will receive standard care, and the experimental group will receive standard care plus a stress management intervention. The primary outcome is a composite score of psychological distress (integrating perceived stress, anxiety, and depression) measured immediately post-intervention. Secondary outcomes include the longitudinal trajectories of individual psychological symptoms (stress, anxiety, depression), symptoms of post-traumatic stress, and sleep quality across multiple follow-ups up to 90 days. Data analysis will be performed utilizing IBM SPSS version 27.0 software.DiscussionThis study protocol describes a RCT aimed at evaluating the effectiveness of the stress management intervention measures in preventing the occurrence of the PICS-F among family members of patients in the intensive care unit.Clinical trial registrationhttps://www.chictr.org.cn/bin/project/edit?pid=272710, identifier ChiCTR2500102953.

BACKGROUND:Sepsis, a leading cause of ICU mortality and high healthcare costs, results from a systemic inflammatory response to infection. Early detection is crucial but challenging. Machine learning models present a promising solution by analyzing diverse data for real-time predictions. PURPOSE:To evaluate the impact of ML models on sepsis prediction, assess the methodological and reporting quality of existing research, and report on model accuracy, sensitivity, specificity, and clinical applicability. METHODS:The studies included were RCTs, cohort studies, or nested case-control studies utilizing ML for sepsis prediction. Independent reviewers used the APPRAISE-AI tool to extract and assess data across six domains: clinical relevance, data quality, methodological conduct, result robustness, reporting quality, and reproducibility. RESULTS:The review included 53 papers, mainly retrospective cohort studies from 2020-2024. Evaluated with the APPRAISE-AI tool, most studies were of moderate quality. Model AUC values ranged from 0.64 to 0.98, with Light GBM and MLP models performing best at 0.98. AI models generally outperformed non-AI methods in predicting sepsis. CONCLUSION:Machine learning models hold promise for accurately predicting sepsis, but study quality varies, with notable flaws in methodology, robustness, and reproducibility. Future research should enhance data quality, advance algorithms, and perform multi-center prospective studies for validation.

OBJECTIVE:Fear of falling is a common and serious psychological challenge after stroke, yet its longitudinal patterns remain poorly understood. Current evidence often fails to capture individual heterogeneity in recovery trajectories. This study aimed to identify distinct longitudinal trajectories of fear of falling and explore associated factors to inform targeted rehabilitation strategies in post-stroke patients. DESIGN:A prospective longitudinal study. METHODS:From August 2023 to December 2024, we enrolled 166 stroke patients from the neurology wards of two hospitals in Lanzhou, China, forming a hospital-based sample within an urban healthcare setting. Fear of falling was assessed using a single-item question and the Short Falls Efficacy Scale-International at four time points: 2 weeks, 1 month, 3 months, and 6 months post-stroke. Data were analyzed using latent class growth modeling in Mplus 8.0. RESULTS:The prevalence of fear of falling was 48.8%, 49.4%, 45.8%, and 34.3% at 2 weeks, 1 month, 3 months, and 6 months, respectively. Mean Short Falls Efficacy Scale-International scores were 11.30 (±4.74), 9.84 (±3.40), 9.61 (±3.13), and 8.00 (±1.22) at these time points. Three distinct fear of falling trajectories were identified: high-level continuous decline (20.48%), medium-level steady decline (26.51%), and low-level fear (53.01%). Age, anxiety levels, and depression levels were significant factors associated with these trajectories. CONCLUSION:Fear of falling after stroke demonstrates heterogeneous longitudinal trajectories that are significantly influenced by age, anxiety, and depression. These findings highlight the importance of individualized assessment and targeted psychological support during stroke rehabilitation. CLINICAL RELEVANCE:Fear of falling is a dynamic psychological challenge during stroke recovery. Routine screening for fear of falling, anxiety, and depression may help nurses identify patients at risk for persistent fear trajectories. Tailored rehabilitation and psychological interventions may improve rehabilitation participation and recovery outcomes. PATIENT OR PUBLIC CONTRIBUTION:No patient or public engagement.

Background Advances in intensive care medicine have increased the use of life-sustaining treatments for critically ill patients, resulting in a growing number of end-stage patients receiving end-of-life care in the intensive care unit (ICU). Because many patients lack decision-making capacity, family members are often required to participate in complex end-of-life decision-making under conditions of emotional stress and uncertainty. Understanding family members’ experiences and needs is essential for improving clinical decision support in ICU settings. Methods A qualitative study was conducted using semi-structured interviews with 10 family members of end-stage ICU patients who experienced difficulties in end-of-life decision-making. Participants were recruited using purposive sampling. Interview data were audio-recorded, transcribed verbatim, and analyzed usingColaizzi’s seven-step method. Results 4 themes and 12 sub-themes were identified: (1) decision-making experiences (hesitation, emotional pain and distress, acceptance of reality); (2) decision-making status (decision-making dilemmas, conflict between quality and length of life, and challenges in understanding and communicating the patient’s condition); (3) influencing factors (patient-related, family-related, sociocultural and medical factors); (4) decision-making needs (information needs and decision support needs). Family members reported substantial emotional distress and uncertainty throughout the decision-making process. Conclusions Family members of end-stage ICU patients experience complex psychological and informational challenges during end-of-life decision-making. Limited decision-making capacity, insufficient information, and multiple contextual influences hinder effective participation in decision-making. Providing timely, structured communication and psychological support is essential to improve the quality of end-of-life decision-making in ICU settings. Trial registration Not applicable.

Background:The stress hyperglycemia ratio (SHR) is defined as the admission blood glucose level divided by the estimated average glucose derived from glycated hemoglobin (HbA1c). Previous studies have demonstrated that higher SHR levels are associated with increased all-cause mortality among intensive care unit (ICU) patients. However, the relationship between SHR and mortality risk specifically in patients with sepsis remains controversial. Objectives:This study aimed to systematically evaluate, through a systematic review and meta-analysis, the association between SHR and all-cause mortality among adult ICU patients with sepsis. Methods:A comprehensive search was performed in PubMed, Web of Science, Embase, and the Cochrane Library databases. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects model was employed to pool relative risks (RR) with corresponding 95% confidence intervals (CIs). All statistical analyses were conducted using Stata version 18.0. Results:A total of 11 retrospective cohort studies comprising 37,790 participants were included. Pooled analyses showed that higher SHR levels were significantly associated with increased risks of in-hospital mortality (RR = 2.11, 95% CI: 1.79-2.50; I 2 = 36.3%), short-term mortality (RR = 1.56, 95% CI: 1.38-1.77; I 2 = 0%), and long-term mortality (RR = 1.52, 95% CI: 1.40-1.65; I 2 = 10.3%). Subgroup analyses based on follow-up duration (60 days, 90 days, and 1 year) revealed no statistically significant differences in effect size (p = 0.511), suggesting that follow-up duration was not a major source of heterogeneity. Meta-regression analysis indicated that studies with a higher proportion of diabetic patients showed a stronger association between SHR and in-hospital mortality (p = 0.026). The overall methodological quality of the included studies was high. Conclusion:This systematic review and meta-analysis demonstrated that elevated SHR is an independent predictor of in-hospital, short-term, and long-term all-cause mortality among ICU patients with sepsis. SHR, as a simple and valuable prognostic biomarker, may aid in early risk stratification of patients with sepsis. Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/view/CRD420251139874, Identifier CRD420251139874.

Background: Numerous studies have identified a correlation between sleep disorders and delirium; however, the causal relationship remains ambiguous. This bidirectional two-sample Mendelian randomization (MR) study, combined with colocalization and enrichment analyses, aims to investigate the potential causal relationship between sleep-associated phenotypes and delirium. Methods: We performed a two-sample bidirectional Mendelian randomization analysis using 10 gene variants associated with sleep phenotypes to investigate the causal relationship between sleep disorders and delirium. Five methods for MR Analysis. Moreover, sensitivity analyses were conducted to assess the robustness of our findings. Enrichment and colocalization analyses were conducted to uncover the genetic mechanisms linking sleep phenotypes and delirium. Results: The IVW method showed that insomnia positively correlates with delirium (OR = 2.523, 95 % CI: 1.048-6.079, P = 0.039). Morning person is causally negatively associated with delirium (OR = 0.869, 95 % CI: 0.774-0.977, P = 0.018). Conversely, delirium is negatively associated with daytime napping (OR = 0.987, 95 % CI: 0.984-0.990, P < 0.001), insomnia (OR = 0.985, 95 % CI: 0.981-0.989, P < 0.001), snoring (OR = 0.991, 95 % CI: 0.985-0.997, P = 0.002), and single item chronotype (beta =-0.161, 95 % CI:0.241-0.081, P = 0.002). Insomnia-related genes are enriched in neuro-metabolic and epigenetic pathways, while Morning person is linked to circadian rhythm regulation. A morning person shares genetic signals with delirium at the rs2398144 locus on chromosome 16 (PPH4 > 0.5). Conclusions: Our findings provide evidence for a potential causal relationship between sleep disorders and delirium. These findings may support better prevention and management of delirium in older adults.

OBJECTIVES:The objective of the study was to investigate the incidence of exposure keratopathy (EK) in prone position ventilation patients and to analyze the risk factors. METHODS:We conducted a cross-sectional study in two ICUs located in two tertiary level hospitals. Medical records of patients receiving prone position ventilation between November 2022 and October 2024 were collected and their eye conditions were assessed using corneal fluorescein sodium ophthalmic test strips and cobalt blue light slit-lamp configuration. Univariate analysis and Logistic regression were used to analyze risk factors. RESULTS:EK was observed in 129 of 252 patients (51.2 %). Richmond agitation-sedation scale (OR = 0.033 95 %CI: 0.004 ∼ 0.288), positive end-expiratory pressure (OR = 2.125 95 %CI: 1.443 ∼ 3.127), prone position ventilation time (OR = 2.537 95 %CI: 1.658 ∼ 3.881), frequency of prone position ventilation (OR = 7.147 95 %CI: 2.831 ∼ 18.041), eyelid insufficiency (OR = 7.643 95 %CI: 1.130 ∼ 51.709), ocular surface secretions (OR = 7.869 95 %CI: 1.855 ∼ 33.380) can increase the risk of EK. CONCLUSIONS:Clinical staff need to closely monitor prone position ventilation patients with high risk factors and take proactive preventive measures to reduce the risk of EK. IMPLICATIONS FOR CLINICAL PRACTICE:The occurrence of EK in prone ventilation patients is closely related to the parameters of mechanical ventilation, depth of sedation and ocular conditions. Based on this finding, clinical staff should focus on observing these high-risk patients and give intervention measures to prevent the occurrence of EK as soon as possible.

This study aims to explore the experiences of mechanically ventilated ICU patients receiving early active mobilization, with a focus on their perceptions, emotions, and psychological impacts to inform nursing practices. A qualitative approach using semi-structured interviews and thematic content analysis was employed, with interviews conducted face-to-face between March and December 2021 across 5 comprehensive hospitals. Data from 14 patients were analyzed using Colaizzi’s 7-step method, revealing 3 main themes: (1) Significant physical discomfort, including feelings of weakness, foreign body sensation, pain, and fatigue; (2) Complex psychological experiences, with perceived benefits, negative self-perception, and diverse emotional responses; and (3) Expectations for treatment, such as a desire for family support, rehabilitation goals, and humanized care. The study found that mechanically ventilated ICU patients undergoing early active mobilization experienced significant physical discomfort, complex psychological responses, and had specific expectations for treatment, highlighting the need for holistic nursing practices that address these aspects.

BACKGROUND:The Chelsea Critical Care Physical Assessment Tool (CPAx) may be an optimal tool for diagnosing intensive care unit-acquired weakness (ICU-AW). However, we do not know the cut-off point for the diagnosis of ICU-AW. AIM:To ascertain the best cut-off point for CPAx to diagnose ICU-AW in adult patients with mechanical ventilation. STUDY DESIGN:A multicentre, prospective cross-sectional study. Participants were recruited from five ICUs in China that ranged from 20 June 2021 to 31 July 2023. The Medical Research Council Sum Scale (MRC-ss) <48 was taken as the standard to calculate the area under the curve (AUC) of CPAx. The cut-off point was determined by the maximum value of Youden Index (YImax). The kappa (κ) test was used to test the consistency of the MRC-ss and CPAx. RESULTS:The AUC at baseline, weaning and discharge time point was 0.87 (95% CI 0.81-0.93), 0.96 (95% CI 0.92-0.99) and 0.91 (95% CI 0.86-0.96), respectively. Correspondingly, The YImax was 0.62, 0.91 and 0.65. The best cut-off point of CPAx score to diagnose ICU-AW at baseline, weaning and discharge time point was 30.5 (sensitivity = 72%, specificity = 89%), 31.5 (sensitivity = 95%, specificity = 90%) and 31.5 (sensitivity = 94%, specificity = 71%), respectively. Due to the CPAx being an ordinal scale, it was determined preliminarily that the cut-off point for the CPAx to diagnose ICU-AW was 31 points. We took CPAx ≤31 and MRC-ss <48 as criteria to diagnose ICU-AW and test the consistency of MRC-ss and CPAx. The results showed that there was no significant difference in the incidence of ICU-AW at different time points. CONCLUSIONS:The optimal cut-off point for the CPAx to diagnose ICU-AW is a score of 31 and it has good sensitivity and specificity. RELEVANCE TO CLINICAL PRACTICE:The CPAx ≤31 score to diagnose ICU-acquired weakness (ICU-AW) has good sensitivity and specificity, and it can help to predict the risk of ICU-AW and guide medical personnel to make interventions.

BACKGROUND:Early active mobilisation (EAM) of patients receiving mechanical ventilation can reduce complications caused by prolonged immobilisation. However, little is known about the experiences of intensive care unit (ICU) nurses and physicians implementing EAM. AIM:This study aimed to explore the experiences of ICU nurses and physicians in implementing EAM for patients with mechanical ventilation. STUDY DESIGN:A phenomenological qualitative design was used, employing semi-structured interviews. Participants were recruited from five ICUs across five tertiary hospitals in western China between March and December 2021. Audio recordings were transcribed verbatim and analysed thematically using NVivo version 12. RESULTS:A total of 31 participants (20 nurses and 11 physicians) were interviewed. Four themes emerged from nurses: 'Coexistence of diverse emotions', 'Perceived professional benefits', 'Implementation challenges' and 'Suggestions and expectations'. Five themes emerged from physicians: 'Recognizing the necessity of EAM', 'Need for improved mobilization plans', 'Factors influencing decision-making', 'Professional role perception' and 'Suggestions for improvement'. CONCLUSIONS:The experiences of ICU staff significantly influence the implementation and effectiveness of EAM. Improved resource allocation, comprehensive planning and interdisciplinary collaboration are essential for optimising patient recovery outcomes. RELEVANCE TO CLINICAL PRACTICE:The findings offer critical insights for critical care nurses, highlighting both the psychological and operational aspects of EAM. Tailored training, institutional support and collaborative practice can enhance the efficiency and confidence of nurses during mobilisation efforts.

To compare the efficiency and safety of double-lumen bronchial tube (DLBT) and bronchial blocker (BB) for one-lung ventilation (OLV) in patients with thoracic surgery. A systematic search was conducted across Chinese databases and English databases from the inception of the databases until December 31, 2024. Two researchers independently screened the literature and extracted data. A meta-analysis was then performed using Review Manager 5 and Stata 18.0 software. The quality of the studies was assessed using the Cochrane bias risk assessment tool, and a summary of findings (SoF) table was generated using GRADEprofiler Version 3.6.1. A total of 39 RCTs were included, comprising 1360 patients in the BB group and 1349 patients in the DLBT group. The excellent rate of lung collapse quality in the BB group was 0.94 times that in the DLBT group [I2 = 32