WstępCelem tego systematycznego przeglądu było podsumowanie obecnej literatury na temat upośledzenia funkcji poznawczych u osób dorosłych po zabiegach operacyjnych.Materiał i metodyPrześledzono bazy MEDLINE: PubMed, OVID, Web of Science, EBSCO, używając odpowiednich słów kluczowych. Dokonano przeglądu literatury na temat zaburzeń poznawczych po zabiegach operacyjnych oraz analizy czynników ryzyka wystąpienia POCD.WynikiPrześledzono wyniki z siedmiu artykułów opisujących badania neuropsychologiczne 2796 pacjen-tów. Testy przeprowadzane były w bardzo krótkim czasie od zabiegu (7 dni), krótkim czasie (3 miesięcy) oraz odległej perspektywie (12 – 60 miesięcy). POCD w bardzo krótkim czasie po operacji występowało z różną częstością: od 17 do 56% z tendencją do ustępowania w miarę upływu czasu (3 – 34,2%). Zidentyfikowano czynniki ryzyka POCD: zaawansowany wiek, insuliooporność, krótki okres kształcenia. Rodzaj operacji, znieczulenia oraz mikrozatorowość związana z użyciem CPB nie wpływają na występowanie POCD.WnioskiPatomechanizm powstawania pooperacyjnych zaburzeń poznawczych nie jest do końca znany, jed-nak wydaje się, że należy skupić uwagę na poszukiwaniu pozaproceduralnych czynników ryzyka oraz opracować zalecenia postępowania okołooperacyjnego, co mogłoby być korzystne dla pacjen-tów zagrożonych upośledzeniem funkcji poznawczych po zabiegach operacyjnych.

AbstractBackgroundSleep disturbances in intensive care unit (ICU) patients have been studied worldwide for over 30 years. Factors contributing to sleep disturbances are still being identified, and therapeutic procedures aimed at the mitigation of such ailments are consequently being developed.ObjectivesThe aim of this study was to review the literature on sleep disturbances in intensive care unit patients.Material and MethodsMEDLINE PubMed, OVID, Web of Science, and EBSCO databases have been searched using adequate keywords.ResultsSleep disorders in ICUs were common among all of the analysed articles. Noise plays a significant role in sleep interruption (11.5 - 17% of awakenings). It was noted that the introduction of “white noise” into the ICU environment proved unsuccessful in reducing the magnitude of changing noise levels. Nursing care activities significantly disturb nocturnal rest, and 42.7 such procedures per every 12-hour night shift were registered. Aggregating nursing care interventions was suggested in order to reduce the number of stimuli experienced by the patient.ConclusionChanges in sleep structure developing during an ICU stay may significantly contribute to sleep disorders once the hospitalisation is over.

Background: One of the key elements of patient care is the relief and prevention of pain sensations. The importance of pain prevention and treatment has been emphasized by many international organizations. Despite the recommendations and guidelines based on evidence, contemporary research shows that the problem of pain among patients in neonatal intensive care units (NICUs) in various centers is still an important and neglected problem. Aim: The aim of this study was to assess the level of knowledge of the medical personnel and their perception of the issue of pain in neonatal patients. Methods: A quantitative descriptive study carried out in 2019. The study used a nurses’ perceptions of neonatal pain questionnaire. Results: A total of 43 Polish hospitals and 558 respondents participated in the project. 60.9% (n = 340) and 39.1% (n = 218) of respondents were employed in secondary and tertiary referral departments, respectively. Conclusion: Our analyses indicate that despite the availability of pain assessment tools for neonatal patients, only a few centers use standardized tools. The introduction of strategies to promote and extend the personnel’s awareness of neonatal pain monitoring scales is necessary.

Introduction: Recently, interest in the problem of proper prevention and monitoring of pain, especially acute, has been increasing in relation to various age groups. Greater awareness of the problem prompts discussion about the purpose of analgesia in newborns treated with mechanical ventilation. Aim: The purpose of the systematic review was to analyze current research on the use of pain scales in newborns treated with mechanical ventilation in the Neonatal Intensive Care Unit. Methods: Medline databases: PubMed, OVID, EBSCO, Web of Science and Cochrane Library were traced using the appropriate keywords. The search was limited to studies in English. The review took into account the years 2006-2019. Considering the criteria, 12 articles were included in further analysis, to which full access was obtained. Results: The analyzed scientific research showed differences in beliefs about the validity and credibility of the scales used. Researchers indicated that staff with practical experience in using scales in their daily practice was very skeptical of the results obtained on their basis. Conclusion: Based on this review, no explicit evidence can be obtained to support the use of one proper scale in pain assessment. It can be inferred that the COMFORT and N-PASS scales are effective for pain assessment and for determining the need for analgesics in mechanically ventilated neonates. These scales may be equally effective in assessing chronic pain, especially in mechanically ventilated children. On the other hand, the PIPP and CRIES scales are most commonly recommended for assessing acute and postoperative pain.

Cardiac arrest (CA) due to cardiovascular disease is the leading cause of death in developed countries. It is estimated that over 350,000 people in Europe suffer from out-of-hospital cardiac arrest. According to the literature, the longer the episode of cardiac arrest, the greater the risk of cognitive impairment, especially short-term memory, as well as immediate and delayed recall. Other common dysfunctions include attention deficits and executive function disorders. The aim of this systematic review was to summarize current research on cognitive impairment in patients after sudden cardiac arrest. The electronic databases PubMed/MEDLINE, OVID, Web of Science, and EBSCO were searched using the following key words: ‘sudden cardiac arrest’, ‘out-of-hospital cardiac arrest’, ‘cognitive function’, ‘cognitive impairment’, ‘functional outcome’, ‘cardiopulmonary resuscitation’. The most recent studies from the last 7 years (2011–2018) were included. Cognitive disorders occurred in a broad range of cases: from 13% to even 100%. In one study, cognitive deficits did not occur at all. Amongst the reviewed articles only two studies were carried out on a large group of patients. The remaining studies were conducted on a small group of respondents; therefore there was no possibility to generalize the results to the entire population. The areas in which the most cognitive impairment occurred were memory, executive functions and visual–motor skills. One of the conclusions derived from the reviewed literature is the importance of continuous training of cognitive functions, especially for people with cardiovascular risk.