Heart & lung : the journal of critical care
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Review Comparative Study
Pharmacodynamics, pharmacokinetics, and clinical uses of fentanyl, sufentanil, and alfentanil.
To review the basic and clinical pharmacology of three opioids to assist in the nursing care of postoperative patients. ⋯ Fentanyl, sufentanil, and alfentanil are potent synthetic opioids that are used for anesthesia and postoperative analgesia. The advantages of these opioids compared with morphine are short duration of action, lack of hyperglycemic response to surgery, decrease in catecholamine levels, and high lipid solubility. The nursing care of patients receiving these opioids involves frequent assessment of the degree of analgesia and monitoring for and treatment of side effects.
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Randomized Controlled Trial Clinical Trial
Critical care unit noise and rapid eye movement (REM) sleep.
To determine if Critical Care Unit (CCU) sound levels suppress rapid eye movement (REM) sleep. ⋯ Although generalization of the results to CCU patients is limited (because of the use of laboratory subjects), the results provided convincing support for a causal relationship between CCU sound levels and suppression of REM sleep.
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Randomized Controlled Trial Clinical Trial
Spotlight article: pulse oximetry in the postoperative care of cardiac surgical patients: a randomized clinical trial. (Bierman MI, Stein KL, Snyder JV. Chest 1992; 102: 1367-70.).
Despite the limitations noted in this critique, the study provides information regarding the usefulness of pulse oximetry in care of postoperative cardiac surgery patients. Similar studies could be done with other groups of critically ill patients. Evaluation of technology in the critical care setting is essential so that care can be rendered in the safest and most efficient, cost-effective, manner.
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Inappropriate intubation of the tracheobronchial tree by a fine-bore nasogastric tube with a metal stylet is a well-known hazard. We report a pulmonary perforation and hydropneumothorax caused by a polyvinylchloride nasogastric tube without a stylet in a child of 13 months. ⋯ It would appear that the auscultatory method is inadequate in checking the correct placement of a nasogastric tube in young children. An ordinary nasogastric tube can cause pulmonary perforation.