Background Mechanical ventilation (MV) is often applied in critically ill patients in intensive care unit (ICU) to protect the airway from aspiration, and supplement more oxygen. MV may result in ventilator-associated pneumonia (VAP) in ICU patients. This study was to estimate the 90-day and 180-day mortalities of ICU patients with VAP, and to explore the influence of VAP on the outcomes of ICU patients. Methods Totally, 8182 patients who aged ≥18 years and received mechanical ventilation (MV) in ICU from Medical Information Mart for Intensive Care III (MIMIC III) database were involved in this study. All subjects were divided into the VAP group (n = 537) and the non-VAP group (n = 7626) based on the occurrence of VAP. Clinical data of all participants were collected. The effect of VAP on the prognosis of ICU patients was explored by binary logistic regression analysis. Results The results delineated that the 90-day mortality of VAP patients in ICU was 33.33% and 180-day mortality was 37.62%. The 90-day and 180-day mortality rates were higher in the VAP group than in the non-VAP group. After adjusting the confounders including age, ethnicity, heart failure, septicemia, simplified acute physiology score II (SAPSII) score, sequential organ failure assessment (SOFA) score, serum lactate, white blood cell (WBC), length of ICU stay, length of hospital stay, length of ventilation, antibiotic treatment, Pseudomonas aeruginosa (P.aeruginosa), methicillin-resistant Staphylococcus aureus (MRSA), other pathogens, the risk of 90-day and 180-day mortalities in VAP patients were 1.465 times (OR = 1.465, 95%CI: 1.188–1.807, P < 0.001) and 1.635 times (OR = 1.635, 95%CI: 1.333–2.005, P < 0.001) higher than those in non-VAP patients, respectively. Conclusions Our study revealed that ICU patients with VAP had poorer prognosis than those without VAP. The results of this study might offer a deeper insight into preventing the occurrence of VAP.

We aimed to explore the real experience of patients after liver transplantation in the intensive care unit (ICU).Objective sampling method was used to select patients transferred to the ICU in 10 hospitals in Zhuhai from May 2018 to August 2020. Patients need liver transplantation due to advanced liver cancer and decompensated cirrhosis. The eligibility criteria of patients mainly included liver transplant patients who were clear-minded and willing to participate in the study and had stayed in ICU. Phenomenological research methods and in-depth interviews were used in this qualitative study.The results showed that the true experience of patients after liver transplantation during ICU stay was summarized into four themes. The strengths of our qualitative research are that we can find the trend from a phenomenon through interviews and other methods to provide a directional foundation for future quantitative research. Its limitations are that it requires a lot of manpower and time, and its objectivity and universality are limited.Hospitalization experience in the ICU may lead to many negative experiences for liver transplant patients. Nurses should fully understand and pay attention to the psychological changes in patients. Nurses should take effective targeted measures to reduce or eliminate patients’ fear of ICU stay and promote rehabilitation.

Purpose There are few studies comparing robotic-assisted surgery (RAS) and laparoscopic-assisted surgery (LAS) in Hirschsprung’s disease (HSCR). This study aimed to compare intraoperative and postoperative outcomes between RAS and LAS performed during the same period. Methods All consecutive 75 patients with pathologically diagnosed as HSCR who underwent RAS or LAS Swenson pull-through from April 2020 to Nov 2022, were included. Patients were assigned to either RAS or LAS groups and a retrospective study was performed. Results A total of 75 patients were included, among which, 23 patients received RAS and 44 received LAS. The RAS and LAS groups had similar ages, sex, weight, postoperative hospital stays, and fasting times. Compared with LAS, blood loss (p = 0.002) and the incidence of Hirschsprung-associated enterocolitis (p = 0.046) were significantly lower in the RAS group. The first onset of Hirschsprung-associated enterocolitis in patients younger than 3 months occurred significantly earlier (p = 0.043). Two patients experienced anastomotic leakage in the LAS group. The cost of RAS was significantly higher than that of LAS (p < 0.0001). Conclusion RAS is a safe and effective treatment for HSCR, and can be considered as ideal alternative for the treatment in selected HSCR children (> 6 months or > 7.5 kg), without considering its cost.

Background To explore the safety, efficacy, advantages and disadvantages of robotic-assisted splenectomy (RS) in children by analyzing and comparing the clinical data of RS and traditional laparoscopic splenectomy (LS). Methods The clinical data of 35 children who underwent laparoscopic or robotic assisted splenectomy or partial splenectomy from February 2010 to October 2022 were included. A retrospective analysis based on general information, clinical data and prognosis were performed. Results Among 35 cases, 14 cases and 21 cases underwent RS and LS, respectively. The average operation time was 167 (120 to 224) minutes in the RS group and 176 (166 to 188) minutes in the LS group, the average intraoperative blood loss was 20 (8.7 to 27.5) ml in the RS group and 51 (23.5 to 75.5) mL in the LS group, the average length of hospital stay was 8 (7 to 9.25) days in the RS group and 10 (9 to 12) days in the LS group; the average hospitalization cost was 69 (67 to 71) thousand RMB in the RS group and 32 (31 to 34) thousand RMB in the LS group. There were no cases of conversion to laparotomy in the RS group, but two cases in the LS group. In terms of postoperative complications, there were one and three cases in the RS and LS group, respectively. Conclusion The Robotic Surgical System was safe and feasible in pediatric splenectomy or partial splenectomy which had the advantages of shortening the operation and hospitalization time, reducing intraoperative blood loss, the rate of conversion to laparotomy and the incidence of postoperative complications, but RS had a significantly higher hospitalization cost than LS.