Dimensions of critical care nursing : DCCN
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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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Visitation in adult critical care units is an important aspect of patient care, and thus should be incorporated into the patient's plan of care. There is no longer a question as to whether visitation should be liberalized or restricted; instead, visitation is individualized in each situation to best meet the patient's needs. One method of incorporating visitation into the care plan is by contracting with patients and family members.
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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.