Introduction: Patient safety incidents, including medical errors and adverse events, frequently occur in intensive care units, leading to a significant psychological burden on healthcare workers. This burden results in second victim syndrome, which impacts the psychological and psychosomatic well-being of these workers. However, a systematic review focusing specifically on this condition among intensive care unit healthcare workers is lacking. Therefore, we aimed to conduct a systematic review and meta-analysis to examine the occurrence of second victim syndrome among intensive care unit healthcare workers, including the types, prevalence, risk factors, and recovery time associated with this condition. Methods: We conducted a comprehensive search of the MEDLINE, CINAHL, PsycINFO, and Igaku Chuo Zasshi databases. The eligibility criteria encompassed retrospective, prospective, and cross-sectional studies and controlled trials, with no language restrictions. Data on the type, prevalence, risk factors, and recovery time of second victim syndrome were extracted and pooled. Prevalence estimates from the included studies were combined using a random-effects meta-analytic model. Results: Of the 2,245 records retrieved, 16 potentially relevant studies were identified. Following full-text evaluation, five studies met the inclusion criteria and were included in the review. The findings revealed that 58% of intensive care unit healthcare workers experienced second victim syndrome. Frequent symptoms included guilt (12–68%), anxiety (38–63%), anger at self (25–58%), and lower self-confidence (7–58%). However, specific risk factors exclusive to intensive care unit healthcare workers were not identified in the review. Furthermore, approximately 20% of individuals took more than a year to recover or did not recover at all from the second victim syndrome. Conclusions: Thus, this condition is prevalent among intensive care unit healthcare workers and may persist for extended periods, potentially exceeding a year. The risk factors for second victim syndrome in the intensive care unit setting are unclear and require further investigation.

Previous systematic review and meta-analysis indicates that rehabilitation within a week of intensive care unit (ICU) admission benefits physical function in critically ill patients. This updated systematic review and meta-analysis aim to clarify effects of initiating rehabilitation within 72 h of ICU admission on long-term physical, cognitive, and mental health. We systematically searched the MEDLINE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi for randomized controlled trials (RCTs) between April 2019 and November 2022 to add to the previous review. Two investigators independently selected and extracted data. Pooled effect estimates for muscle strength, cognitive function, mental health after discharge, and adverse events were calculated. Evidence certainty was assessed via Grading of Recommendations, Assessment, Development, and Evaluations. Eleven RCTs were included in the meta-analysis. Early rehabilitation may improve muscle strength (three trials; standard mean difference [SMD], 0.16; 95% confidence interval [CI], −0.04–0.36) and cognitive function (two trials; SMD, 0.54; 95% CI, −0.13–1.20). Contrastingly, early mobilization showed limited impact on mental health or adverse events. In summary, initiating rehabilitation for critically ill patients within 72 h may improve physical and cognitive function to prevent post-intensive care syndrome without increasing adverse events. The effect on mental function remains uncertain.

Aim: We investigated adverse events (AEs) in a Japanese intensive care unit (ICU) and evaluated the impact of cause‐specific AEs on mortality and length of stay.Design: A retrospective observational study in the ICU of an academic hospital.Methods: We reviewed medical records with the Global Trigger Tool.Results: Of the 246 patients, 126 (51%) experienced one or more AEs with an incidence of 201 per 1000 patient‐days and 115 per 100 admissions. A total of 294 AEs were detected with 119 (42%) adverse drug events, 67 (24%) procedural complications, 63 (22%) surgical complications, 26 (9%) nosocomial infections, 5 (2%) therapeutic errors and 4 (1%) diagnostic errors. Adverse event (AE) presence was associated with length of ICU stay (β = 2.85, 95% confidence interval [CI]: 1.09–4.61). Adverse drug events, procedural complications and nosocomial infections were strongly associated with length of ICU stay (β = 2.38, 95% CI: 0.77–3.98; β = 3.75, 95% CI: 2.03–5.48; β = 6.52, 95% CI: 4.07–8.97 respectively).

Dyspnea is a common, distressing symptom of cardiopulmonary and neuromuscular diseases and is defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.” However, Japanese intensive care units (ICUs) do not routinely screen for dyspnea, as no validated Japanese version of the Respiratory Distress Observation Scale (RDOS) is available. Therefore, we aimed to translate the English version of this questionnaire into Japanese and assess its validity and reliability. To translate the RDOS, we conducted a prospective observational study in a 12-bed ICU of a universal hospital that included 42 healthcare professionals, 10 expert panels, and 128 ventilated patients. The English version was translated into Japanese, and several cross-sectional web-based questionnaires were administered to the healthcare professionals. After completing the translation process, a validity and reliability evaluation was performed in the ventilated patients. Inter-rater reliability was evaluated using Cohen’s weighted kappa coefficient. Criterion validity was ascertained based on the correlation between RDOS and the dyspnea visual analog scale. The area under the receiver operating characteristic curve analysis was used to evaluate the ability of the RDOS to identify patients with self-reported dyspnea. The average content validity index at the scale level was 0.95. Data from the 128 patients were collected and analyzed. Cohen’s weighted kappa coefficient and the correlation coefficient between the two scales were 0.76 and 0.443 (95% confidence intervals 0.70–0.82 and 0.23–0.62), respectively. For predicting self-reported dyspnea, the area under the receiver operating characteristic curve was 0.81 (95% confidence interval 0.67–0.97). The optimal cutoff used was 1, with a sensitivity and specificity of 0.89 and 0.61, respectively. Our findings indicated that the Japanese version of the RDOS is acceptable for face validity, understandability, criterion validity, and inter-rater reliability in lightly sedated mechanically ventilated patients, indicating its clinical utility.

Critically ill patients admitted to the intensive care unit (ICU) experience various symptoms and discomfort. Although thirst is a typical distressing symptom and should be assessed daily, it is crucial to understand its prevalence and risk factors in the ICU setting. Nevertheless, currently, systematic reviews of prevalence and risk factors are lacking. This study evaluated the prevalence and risk factors of thirst in critically ill patients. We conducted a comprehensive search of the MEDLINE, Cochrane Library, and CINAHL databases. The study design included cohort, cross-sectional, and intervention studies, including randomized and non-randomized controlled trials with control groups. The point estimates from each study were combined using a random-effects meta-analysis model. We aggregated the prevalence of thirst in ICU patients and calculated the point estimates and 95% confidence intervals. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool and Newcastle-Ottawa Scale. Fifteen studies were eligible for inclusion, of which seven reported the prevalence of thirst. A total of 2,204 patients were combined, with a prevalence estimate of 0.70. The risk factors for thirst were categorized as patient and treatment factors: four patient factors (e.g., serum sodium concentration and severity of illness) and six treatment factors (e.g., nil per os and use of diuretics) were identified. However, the results showed high heterogeneity in the prevalence of thirst among critically ill patients. It was established that 70% of critically ill patients experienced thirst. Additional investigations are required to obtain a more comprehensive overview of thirst among these patients. Systematic review registration number The protocol was registered in PROSPERO (ID: CRD42023428619) on June 6, 2023. (URL: https://www.crd.york.ac.uk)