AACN Advanced Critical Care is a quarterly, peer-reviewed publication of in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles, and columns of interest to critical care and progressive care clinicians. AACN Advanced Critical Care contains concisely written, practical information for immediate use and future reference. Continuing education units are available for selected articles in each issue.     AACN Advanced Critical Care is an official publication of the American Association of Critical-Care Nurses.

AACN Advanced Critical Care is a quarterly, peer-reviewed journal designed for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue features a topic-based symposium, feature articles, and columns of interest to critical care and progressive care clinicians. The journal provides concise, practical information for immediate use and future reference. Continuing education units are available for selected articles in each issue. AACN Advanced Critical Care is an official publication of the American Association of Critical-Care Nurses.

《AACN Advanced Critical Care》是一本季度出版的同行评审期刊，专为在床边工作的经验丰富的重症监护和急救临床医生、高级实践护士以及临床和学术教育者而设。每期包含一个主题研讨会、特色文章以及与重症监护和渐进护理临床医生相关的专栏。期刊提供简明实用的信息，便于立即使用和未来参考。每期的部分文章还提供继续教育学分。该期刊是美国重症护理护士协会的官方出版物。

AACN Advanced Critical Care

Traumatic brain injury is a devastating, life-changing event in most cases. After the primary brain insult, it is helpful to use evidence-based monitoring techniques to guide implementation of essential interventions to minimize secondary injury and thereby improve patient outcomes. An update on multimodal neuromonitoring is provided in this narrative review, with discussion of tools and techniques currently used in the treatment of patients with brain injury. Neuroprotective treatments, from the well-studied targeted temperature management to new potential therapeutics under investigation, such as glyburide, also are presented.

Maureen Scarboro

Karen A. McQuillan

Traumatic Brain Injury Update

创伤性脑损伤最新进展

Despite progress in the management of adults with severe traumatic brain injury, several controversies persist. Among the unresolved issues of greatest concern to neurocritical care clinicians and scientists are the following: (1) the best use of technological advances and the data obtained from multimodality monitoring; (2) the use of mannitol and hypertonic saline in the management of increased intracranial pressure; (3) the use of decompressive craniectomy and barbiturate coma in refractory increased intracranial pressure; (4) therapeutic hypothermia as a neuroprotectant; (5) anemia and the role of blood transfusion; and (6) venous thromboembolism prophylaxis in severe traumatic brain injury. Each of these strategies for managing severe traumatic brain injury, including the postulated mechanism(s) of action and beneficial effects of each intervention, adverse effects, the state of the science, and critical care nursing implications, is discussed.

Patricia A. Blissitt

Controversies in the Management of Adults With Severe Traumatic Brain Injury

成人严重创伤性脑损伤管理中的争议

Iatrogenic withdrawal syndrome is an increasingly recognized issue among adult patients in the intensive care unit. The prolonged use of opioids and benzodiazepines during the intensive care unit stay and preexisting disorders associated with their use put patients at risk of developing iatrogenic withdrawal syndrome. Although research to date is scant regarding iatrogenic withdrawal syndrome in adult patients in the intensive care unit, it is important to recognize and adequately manage iatrogenic withdrawal syndrome in order to prevent possible negative outcomes during and after a patient's intensive care unit stay. This article discusses in depth 8 studies of iatrogenic withdrawal syndrome among adult patients in the intensive care unit. It also addresses important aspects of opioid and benzodiazepine iatrogenic withdrawal syndrome, including prevalence, risk factors, and assessment and considers its prevention and management.

Carmen Mabel Arroyo-Novoa

Milagros I. Figueroa-Ramos

Kathleen A. Puntillo

Opioid and Benzodiazepine Iatrogenic Withdrawal Syndrome in Patients in the Intensive Care Unit

重症监护病房患者阿片类和苯二氮卓类药物医源性戒断综合征

Patients in the intensive care unit (ICU) increasingly are expected to eventually return home after acute hospital care. Yet transitional care for ICU patients and their families is often delayed until the patient is about to be transferred to another location or level of care. Transitions theory is a middle-range nursing theory that aims to provide guidance for safe and effective nursing care and research while an individual experiences a transition. Intensive care unit nurses are well positioned to provide ICU transitional care planning early. This article applies the transitions theory as a theoretical model to guide the study of the transition to home after acute hospital care for ICU patients and their families. This theory application can help ICU nurses provide holistic patient- and family-centered transitional care to achieve optimal outcomes by addressing the predischarge and postdischarge needs of patients and families.

HyunBin You

Sharron L. Docherty

Deepshikha C. Ashana

Tolu O. Oyesanya

Transition of Intensive Care Unit Patients and Their Families to Home After Acute Hospital Care

急性住院治疗后重症监护病房患者及其家属向家庭环境的过渡

The interplay of pain, discomfort, and fear can cause agitation in critically ill children. Therefore, sedation and analgesia are essential components in the intensive care unit setting and are best managed with a multidisciplinary team approach. No one standard approach exists to assess and manage pain and anxiety. Many tools are available for the assessment of pain and sedation, but each tool has its advantages and disadvantages. Clinicians should consider adopting a validated tool for routine continuous assessment. Multiple pharmacological therapies are available to manage pain, anxiety, fear, and agitation. Dosing of these agents can be influenced by age-related pharmacokinetic and pharmacodynamic changes. Agents should be selected on the basis of the child's disease state, desired level of sedation, and cardiac and respiratory status.

Peter N. Johnson

Jamie L. Miller

Tracy M. Hagemann

Sedation and Analgesia in Critically Ill Children

重症儿童的镇静与镇痛

Alarm bells are sounding internationally as climate change impacts planet Earth and its inhabitants. Health care organizations must consider the role they play in working toward environmental sustainability in terms of mitigation, resilience, leadership, and equity. Institutions need to address the effects of climate change on the physical health and mental well-being of patients and their families as well as employees. Awareness of the complexities of sustainability initiatives and disaster management related to inclement weather and weather-related events is critical for health care organizations to avoid precipitating the illnesses and diseases they endeavor to prevent and heal.

Abbreviation	AACN Adv. Crit. Care
Journal Impact	1.82
Quartiles(Global)	NURSING(Q2)

ISSN	1559-7768, 1559-7776, 2149-0481
h-index	48

Publication Information	Publisher: American Association of Critical-Care Nurses，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2006，Proportion of original research papers: 90.00%，Self Citation Rate:0.00%， Gold OA Rate: 1.04%

AACN Advanced Critical Care

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Traumatic Brain Injury Update

Controversies in the Management of Adults With Severe Traumatic Brain Injury

Opioid and Benzodiazepine Iatrogenic Withdrawal Syndrome in Patients in the Intensive Care Unit

Transition of Intensive Care Unit Patients and Their Families to Home After Acute Hospital Care

Sedation and Analgesia in Critically Ill Children

Climate Change: Time for Hospitals to Respond

Transforming the Work Environment: A Different Approach to Combating Nurse Burnout

Climate Change and Environmental Sustainability in Acute and Critical Care

Evidence-Based Practice in Pediatric Critical Care Nursing

Anticoagulation Reversal Management