Critically ill patients need advanced support to remain alive and prevent serious
complications. However, patients may experience either pleasant or unpleasant memories during their stay in ICU. Unpleasant experiences can affect patients or lead to later negative consequences. Critical care nurses have a pivotal role in identifying traumatic experiences in order to improve care. This study aims to explore the intensive care experiences among ICU survivors. This study was conducted in the general wards of three selected hospitals in Malaysia. One hundred and forty-two(142) participants agreed to take part in this study and to answer the Intensive Care Experience Questionnaire (ICEQ) which included additional questions that covered four domains: awareness of surroundings, frightening experiences, recall of experiences, and satisfaction with care. There sults of the study were as follows: Half of the samples reported a high awareness of their surroundings. The less aware group reported not being aware of people, place and time. About70% (67.6%)of the samples reported high levels of frightening experiences.Pain experienced by the participants came from medical procedures or by the disease process. Only 17.6% of the samples reported being able to recall precisely what happened in the ICU.Participants recalled seeing scary things but having enough sleep in the ICU.The results showed that43.0% reported being highly satisfied with their care, and claimed that the staff waskind and delivered the best care to patients.This result indicates that critically ill patients, especially in the ICU,need strong support physically and psychologically in order to minimize unpleasant experiences and, later, negative consequences by providing a conducive environment and care with sympathetic concern.

Flolan (iFLO) and Veletri (iVEL) are 2 inhaled epoprostenol formulations. There is no published literature comparing these formulations in critically ill patients with refractory hypoxemia.
Objective: To compare efficacy, safety, and cost outcomes in patients who received either iFLO or iVEL for hypoxic respiratory failure. Methods: This was a retrospective, single-center analysis of adult, mechanically ventilated patients receiving iFLO or iVEL for improvement in oxygenation. The primary end point was the change in the PaO2/FiO2 ratio after 1 hour of pulmonary vasodilator therapy.
Secondary end points assessed were intensive care unit (ICU) length of stay (LOS), hospital LOS, duration of study therapy, duration of mechanical ventilation, mortality, incidence of adverse events, and cost.
Results: A total of 104 patients were included (iFLO = 52; iVEL = 52). More iFLO patients had acute respiratory distress syndrome compared with the iVEL group (61.5 vs 34.6%; P = 0.01). There was no difference in the change in the PaO/FiO ratio after 1 hour of therapy (33.04
± 36.9 vs 31.47 ± 19.92; P = 0.54) in the iFLO and iVEL groups, respectively. Patients who received iVEL had a shorter duration of mechanical ventilation (P < 0.001) and ICU LOS (P < 0.001) but not hospital LOS (P = 0.86) and duration of therapy (P = 0.36). No adverse events were attributed to pulmonary vasodilator therapy, and there was no difference in cost.
Conclusions: We found no difference between iFLO and iVEL when comparing the change in the PaO/FiO ratio, safety, and cost in hypoxic, critically ill patients. There were differences in secondary outcomes, likely a result of differences in underlying indication for inhaled epoprostenol.

Clinical practice guidelines are published and promoted, often by professional societies, because they provide a current and transparently analyzed review of relevant research and are written with the aim to guide clinical practice. The 2018 Pain, Agitation/sedation, Delirium, Immobility (rehabilitation/mobilization), and Sleep (disruption) (PADIS) guidelines first 1) builds on this mission by updating the 2013 PAD guidelines ; 2) by adding two inextricably related clinical care topics (immobility and sleep); 3) by including patients as collaborators and coauthors; and 4) by inviting panelists from high-income countries as an early step toward incorporating more diverse practices and expertise from the global critical care
community.