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Aims: Nowadays, noncontiguous diseases have been extended due to the renovation of societies, technology promotion and density of population on urban zones, life and style changes and tendency of population to unsuitable habits. Cardiovascular diseases are from these failures and are the most widespread death cause in the most nations of universe and also Iran and the most important cause of unhealthy. The aim of this study was to evaluate the effect of family-centered empowerment model on the life style of the myocardial infarction patients. Methods: This clinical trial study accomplished from August to December 2007 on all of myocardial infarction patients hospitalized in Shari’ati Hospital coronary care unit. After sampling by randomized clustering, subjects (70 patients) were randomly assigned to experimental and control group. For experimental group, family-centered empowerment model was implemented with four dimensions of perceived threat (severity and sensitivity), self-efficacy, educational partnership and evaluation and usual care was done for control group members. The research tools were demographic, lifestyle and four empowerment dimensional questionnaires. Results: There were no significant difference between two groups in demographic data (p>0.05). In lifestyle dimension, tests revealed no significant difference between two groups before the intervention (p>0.05) but after the intervention, all modes differences were deeply significant (p< 0.001) except physical healthy (p>0.05). Conclusion: Performing family-centered empowerment model for patients with myocardial infarction is practically feasible and associated with improvement or modification of patients and his or her families’ lifestyle.

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Background and aim: Pulmonary atelectasis is one of the major problems in most chest surgeries, especially open heart surgery. This study was performed to investigate the effect of standard nursing care package (appropriate bed height, breathing exercises and postural drainage) on the severity of atelectasis in patients after open heart surgery.
Methods: In the present randomized clinical trial, 60 eligible patients who had open heart surgery were selected by available sampling method and then randomly divided into four blocks of intervention (30 patients) and control (30 patients). They got. In the control group, routine care was performed in the ward and for the intervention group. Data collection tools, data sheet and chest radiography were used to diagnose atelectasis.
Results: The results showed that the intervention and control groups did not differ significantly in terms of demographic characteristics. The results also showed that although the incidence of atelectasis was lower in the intervention group than the control group, but this difference was not statistically significant (P> 0.05).
Conclusion: Due to the lack of effect of care package on reducing the incidence of atelectasis, it is suggested that due to the temporal and spatial limitations of this study, wider studies should be performed in other centers and more patients.
 

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Background and aim: Due to the side effects of invasive techniques, the use of non-invasive techniques with continuous monitoring has been considered by health centers. In this study, invasive and non-invasive techniques for monitoring arterial blood gases were compared during patients' weaning from mechanical ventilation after cardiac surgery.
Methods: In a descriptive-cross-sectional study, 70 patients who were candidates for cardiac surgery were assessed during 1397 at Jamaran Heart Hospital and the values for oxygen saturation and carbon dioxide measured by non-invasive methods (pulse oximetry and capnography) and invasive (ABG) were compared
Results: The results of the study showed that there is a difference of 1.7±4.54 between the copography and PaCO2 values, and a difference of 0.92±2.29 between the SPO2 and SaO2 values. There was a positive and significant correlation between ETCO2 and PaCO2 (P<0.001, r=0.43). There was also a correlation between SPO2 and SaO2 numbers (P=0.03, r=0.25). The results of the linear regression test showed that ETCO2 and SPO2 can predict PaCO2 and SaO2 using the following formula, respectively. PaCO2=20.61+0.45(ETCO2), SaO2=63.65+0.25(SPO2).
Conclusion: Capnography and pulse oximetry can be used as non-invasive, inexpensive, and safe methods in weaning patients from mechanical ventilation after cardiac surgery. For a more detailed examination, it is recommended that studies be performed with a larger sample size, as well as in patients with different physical conditions and severity of the disease.

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Background and Aim: Sleep disorders in patients in Intensive Care Units (ICUs) are one of the most important causes of increased length of stay, decreased recovery, delirium and neurological and psychological problems. Nursing interventions can be effective in improving sleep disorders. The purpose of this systematic review is to determine the effect of nursing interventions on the improvement of sleep disorders in patients admitted to ICUs.
Methods: This systematic review was conducted in the first half of 2021 by searching Persian and English articles in the period from the beginning of 1980 to the first half of 2021. The search strategy and keywords were defined based on the PICO system and inclusion criteria. Search with a combination of Persian keywords: "sleep disorder", "nursing care", "intensive care unit" and their English equivalents sleep disorder, hyper somnolence, insomnia, dyssomnia, sleep apnea, sleep deprivation, intensive care, critical care, ICU, CCU, nursing intervention nursing care in Persian-language databases Scientific Jihad (SID) and information of national publications (Magiran) and English Scopus, Web of Science, Pub Med, Science Direct and Proquest also performed using Google scholar search engine Has been. Qualitative evaluation of articles was performed with Jadad scale. Of the 18,799 initially retrieved studies, 97 reached the final review stage.
Results: The results showed that reducing ambient noise, leisure time protocol, use of ear and eyeglasses, music therapy, aromatherapy and pharmacotherapy, especially oral melatonin, had the greatest effect on the quality and quantity of sleep. Interventions with less impact and application included massage, acupuncture, physiotherapy, milk and honey combination before bed, cognitive-behavioral therapy, spiritual care, follow-up care model, ventilator modes, relaxation and guided visualization. Also, a variety of pharmacological interventions are used as an alternative or in combination with non-pharmacological interventions.
Conclusion: The findings of this study showed that simple and low-cost interventions such as reducing the number of direct care visits, reducing noise and ambient light and using blindfolds and earplugs are the most effective nursing interventions in improving the quality and quantity of sleep in ICUs. After recognizing the cases that cause sleep disorders in patients admitted to ICUs, nurses can prevent the occurrence of complications of sleep disorders in patients with these interventions.

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Background & aim: Cardiac arrest and heart attack are the most common cardiovascular diseases in the world. Most of the time, during a cardiac arrest, there is a person as an observer who can prevent brain death and save the patient's life in the golden time (first 4 to 6 minutes of cardiopulmonary arrest) by performing resuscitation. The aim of this study was to compare two methods of basic cardiopulmonary resuscitation training in person and virtual on the level of learning resuscitation skills (awareness and performance) in military families.
Methods: In this clinical trial study, 100 people from families living in selected organizational areas were randomly assigned to two groups of face-to-face training (50 people) and virtual training (50 people). In the face-to-face training group, during a 2-hour session, cardiopulmonary resuscitation and how to deal with cardiac arrest victims were taught theoretically and practically (mannequins). In the virtual educational group, educational materials were presented by using virtual channels (once-up Weita platform) and sending animation videos, photos, short texts, and PDF files of educational booklets during two weeks. In order to collect data, a demographic form, an awareness questionnaire including 14 four-choice questions, and a performance assessment checklist including 13 items were used to assess the skill in cardiopulmonary resuscitation. At the end, the collected data were compared between the two groups.
Results: Data related to age (P = 0.468), sex (P = 0.812), education (P = 0.307), occupation (P = 0.055) had no significant difference in the two groups. The U-Man-Whitney test showed that there was no statistically significant difference before the intervention between the two groups of face-to-face and virtual education in terms of knowledge and skill levels (P>0.05). Wilcoxon's statistical test showed that the difference in the mean score of knowledge and skill level before and after the intervention in both face-to-face and virtual education groups was statistically significant (P<0.05). Furthermore, the U-Man Whitney test showed that there is a statistically significant difference after the intervention between the two groups of face-to-face and virtual training in terms of knowledge and skill level (P<0.05).
Conclusion: In this research, in both face-to-face and virtual training groups, the amount of knowledge and skill increased significantly compared to before and after the training. However, by comparing the two groups, it was observed that the amount of knowledge in the participants of the virtual training group was higher and the amount of skill in the participants of the face-to-face training group were more. Despite the belief of the effectiveness of face-to-face training, the findings of this research showed that virtual training can be as effective as face-to-face training.

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Introduction: A large number of patients are admitted to intensive care units due to the need for mechanical ventilation. In mechanical ventilators, various modes and settings are used according to the patients' needs, which can significantly impact patient outcomes. One of these modes is Adaptive Support Ventilation (ASV), for which more evidence is needed regarding its effects. This study aims to elucidate the impact of Adaptive Support Ventilation on the outcomes of patients admitted to intensive care units.
Methods: This is a systematic review study conducted by searching relevant sources from the beginning until April 5, 2023, in both English and Persian languages, without any time restrictions. The literature search was performed using Persian keywords including: Adaptive Support Ventilation, intensive care, patient outcomes, mechanical ventilation, and their English equivalents: adaptive support ventilation, ASV, intensive care, critical care, mechanical ventilation, patients outcomes, utilizing the operators AND and OR. Subsequently, the selected articles were categorized, proceeded to the final stage, and the data were extracted.
Results Out of 492 retrieved articles, 130 were included in the final stage of the study. A total of 107 studies reported outcomes on the impact of Adaptive Support Ventilation, including reduced weaning time, lung protection and safe ventilation, reduced hospital stay duration, less clinical intervention, and reduced manpower requirements. Two study further examined the weaning duration and the impact of this mode on children and adolescents. Eleven studies did not observe any effects on weaning or the protective impact of this mode, and finally, ten studies reported complications associated with Adaptive Support Ventilation.
Conclusion: The use of Adaptive Support Ventilation can reduce the patient's need for a ventilator and the number of breaths, while increasing tidal volume to prolong exhalation time in patients with chronic obstructive pulmonary disease (COPD) and reduce air trapping. This mode is recommended for patients in intensive care units after heart surgery who need rapid extubation. However, caution is advised when using it in children, infants, and obese patients who have undergone open-heart surgery. Adaptive Support Ventilation can be used as an effective intervention for patients in intensive care units.