Heart & lung : the journal of critical care
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Review Case Reports
Treatment strategies in shock: use of oxygen transport measurements.
Shock has traditionally been categorized according to its cause. Shock can result from hemorrhage, primary cardiac failure, central nervous system failure, trauma, or sepsis. Therapeutic principles have been developed for each etiologic type. ⋯ These variables are easily calculated by using data obtained from pulmonary artery catheter and laboratory measurements. The physician or nurse caring for critical ill patients should have a thorough understanding of the rationale for the use of oxygen transport calculations and the methods of manipulating oxygen delivery. A simple explanation of these principles including the importance of hemoglobin, cardiac index, and percent saturation of hemoglobin and suggested treatment strategies are presented.
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Randomized Controlled Trial Clinical Trial
Electrode site preparation techniques: a follow-up study.
A posttest-only control group design was used to study the effect of electrode site preparation techniques on reducing electrical potential across a pair of disposable skin electrodes. One hundred twenty healthy volunteers were randomly assigned into one control and three treatment groups of 30 subjects each. The three treatments were One Step Skin Prep used once, ECG Prep Pad used five times, and ECG Prep Pad used once. ⋯ Skin preparation done by using One Step Skin Prep or the ECG Prep Pads used once significantly decreased skin potentials by 2.3 mV and 3.3 mV respectively. There was no significant difference in the control group and the group in which ECG Prep Pads were used five times. These findings extend the knowledge of techniques available to reduce the amount of noise (electrical potential) in physiologic measurement using skin electrodes.
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Comparative Study
Incidence of pulmonary aspiration in intubated patients receiving enteral nutrition through wide- and narrow-bore nasogastric feeding tubes.
A descriptive study was performed to compare the incidence of pulmonary aspiration in 25 critically ill patients who had endotracheal tubes in place and were receiving enteral nutrition through a narrow-bore nasogastric tube (n = 10) or a wide-bore nasogastric tube (n = 15). Results of chi-square analysis of this comparison were not significant, p less than 0.05. Aspiration occurred in one subject. ⋯ The number of checks for residual feeding was found to be significantly greater in the wide-bore tube group. A comparison of the assessment of nasogastric tube placement on x-ray examination showed that tube placement was reported on x-ray results with more frequency in the wide-bore group. Questions are raised by these observations regarding the use of narrow-bore tubes in the critically ill population with endotracheal tubes in place.