Conectar
by Lin Zhang, Feng Luo, Yalin Chai, Lijie Sun, Xuan Wang, Le Yin, Congjuan Luo
Acute kidney injury (AKI) remains a major clinical challenge due to its high morbidity and mortality, with ischemia-reperfusion injury (IRI) as one of its primary causes. Severe IRI-associated AKI (IRI-AKI) can progress to irreversible renal failure, yet no effective therapies are currently available. Ferroptosis, an iron-dependent regulated cell death, has recently been implicated in the pathogenesis of IRI-AKI. Moreover, IL-22 may alleviate AKI by modulating the ferroptosis process through regulation of the P62-Keap1-Nrf2 signaling axis. In this study, we examined the protective role of the immune cytokine interleukin-22 (IL-22) in IRI-AKI and its mechanistic association with ferroptosis. Using a murine IRI model and an HK-2 cell hypoxia/reoxygenation system, we systematically assessed the impact of IL-22 treatment. IL-22 administration significantly enhanced renal function, reduced histological injury, and limited both reactive oxygen species accumulation and ferroptotic cell death. Further mechanistic studies demonstrated that IL-22 suppresses ferroptosis in vitro through an Nrf2-dependent mechanism and is associated with activation of the P62-Keap1-Nrf2 signaling pathway. These findings offer experimental evidence supporting IL-22 as a potential therapy for IRI-AKI and highlight ferroptosis modulation as a promising therapeutic strategy.Dysphagia is a prevalent and critical issue in critically ill patients who have undergone mechanical ventilation. The knowledge, attitude, and practice (KAP) of ICU nurses are determinants of the effectiveness of post-extubation dysphagia (PED) management. However, existing evidence regarding the current KAP status of PED among ICU nurses remains insufficient.
This study aimed to assess the current status of ICU nurses' KAP regarding PED, along with associated individual and organisational factors.
From August to September 2024, a cross-sectional, multicentre study was conducted on a convenience sample of 305 ICU nurses from 15 tertiary hospitals in 10 cities of Guangdong Province, China. An online self-reported structured questionnaire was used to collect data on the KAP of PED among ICU nurses.
A total of 305 valid questionnaires were analysed. The overall mean score was (70.08 ± 15.34). The mean scores of knowledge, attitude, and practice were (78.10 ± 28.98), (80.02 ± 13.27), and (52.13 ± 22.94), respectively. Multivariate analysis revealed that the individual factors related to the total score included confidence in PED management (β = 0.356, p < 0.001), and the organisational factors included leadership support (β = 0.210, p < 0.001), unit compliance with PED screening and treatment protocols (β = − 0.169, p = 0.001), and availability of PED educational resources (β = 0.156, p = 0.002).
ICU nurses possess a relatively extensive knowledge base and exhibit positive attitudes toward PED, but there is still room for practice improvement. Besides strengthening the training of ICU nurses on PED-related knowledge, formulating standardised protocols, establishing a multidisciplinary management team, creating a favourable improvement atmosphere, and providing sufficient training resources are indispensable measures for enhancing the quality of clinical PED management.
To enhance the quality of PED management, it is advisable to formulate a multi-aceted support strategy targeting both organisations and individuals, thereby facilitating the implementation of relevant practices.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement of cross-sectional studies was followed for reporting in the study.
No patient or public involvement.
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