Dimensions of critical care nursing : DCCN
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Dimens Crit Care Nurs · Jan 1995
ReviewRefining chest tube management: analysis of the state of practice.
Critical care nurses routinely care for patients who require chest tube management. To obtain the best patient outcome, critical care nurses develop standards of practice from research derived recommendations. Although there are several studies recommending chest tube management practices, there is limited research in some areas of chest tube management. The authors analyze the body of research and recommend clinical practice changes and timely research projects on chest tube management.
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Dimens Crit Care Nurs · Nov 1993
Review Case ReportsPressure support ventilation: reducing the work of breathing during weaning.
Pressure support ventilation decreases the work of breathing by providing the patient with positive airway pressure during the inspiratory phase. The use of this type of ventilatory support is likely to increase over the next few years for patients, especially during the weaning period. By understanding how pressure support ventilation works and what patient parameters need to be monitored, the critical care nurse can help patients decrease respiratory muscle fatigue during weaning and thus decrease the weaning time for these patients.
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Septic shock, with its associated high morbidity and mortality, has long been a challenge to the critical care nurse. A promising new development in the treatment of this condition is the use of monoclonal antibodies to inactivate two prime mediators that induce the cascade of events that culminate in septic shock and multiple organ failure: bacterial endotoxin and tumor necrosis factor (TNF). The effectiveness of this immunotherapy depends on its timely administration, which necessitates the early identification of sepsis.
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Dimens Crit Care Nurs · Sep 1991
ReviewPressure controlled inverse ratio ventilation in respiratory failure.
Since the earliest use of mechanical ventilation for respiratory insufficiency the search has been on for optimal ventilation attuned to different degrees of pulmonary involvement. Pressure controlled inverse ratio ventilation is a recently described ventilatory modality, in which the conventional inspiratory to expiratory ratio is reversed. This method of ventilation allows for stabilization of pulmonary units and diffusion of gases.
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Nurses have access to continuous SvO2 monitoring as one parameter for evaluating the hemodynamic status in critically ill patients. The research studies on SvO2 monitoring have demonstrated inconsistent results regarding the utility of SvO2 as an assessment tool. Hence, it is necessary to carefully review these research findings for their impact on nursing practice. Nurses must be aware of the possibility of overreliance on continuous SvO2 monitoring and of the limitations of the SvO2 measurement itself.