Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · Nov 2008
ReviewUpdate on the management of infection in patients with severe sepsis.
Morbidity and mortality associated with the development of severe sepsis remain unacceptably high. However, with the introduction of a protocol called early goal-directed therapy, significant benefits in terms of patient's outcome have been demonstrated. ⋯ The treatment of severe sepsis includes 3 main essentials: (1) eradication of the inciting infection using source control measures and empiric antimicrobials, (2) hemodynamic resuscitation of tissue hypoperfusion using fluids and inotropic drugs to prevent life-threatening organ damage, and (3) sustained organ support using mechanical interventions to diminish organ injury. This review article highlights the anti-infective approach of the management of sepsis.
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Dimens Crit Care Nurs · Nov 2008
Randomized Controlled TrialMenstrual cycle-related variations in postoperative analgesia with the preemptive use of N-methyl D-aspartate antagonist ketamine: a pilot study.
Several studies have supported that N-methyl-D-aspartate receptor antagonist can reduce the perception of postoperative pain. Hormonal fluctuations throughout the human menstrual cycle can influence pain pathways. In this pilot study, we evaluated postoperative pain in 22 female participants between the ages of 20 and 56 years undergoing laparoscopic abdominal procedures. ⋯ Total equipotent analgesic administration was also recorded. We found trends suggesting that women receiving ketamine and women in the luteal phase of their menstrual cycle had lower visual analog scale scores upon arrival to the unit. Ketamine recipients also received less rescue analgesic medication in the unit.
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Dimens Crit Care Nurs · Nov 2008
Controlled Clinical TrialInnovative solutions: the effect of a workshop on reducing the experience of moral distress in an intensive care unit setting.
Moral distress is the knowledge of the ethically appropriate action to take but the inability to act upon it. This phenomenon is one experienced in the critical care setting. ⋯ The workshop consisted of discussions of distressing situations in the intensive care unit, didactic information on moral distress, formulation of an individual plan to reduce stress, and strategies to deal with moral distress in the intensive care unit. This article discusses the workshop and its effect on participants' coping with moral distress.