Heart & lung : the journal of critical care
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Randomized Controlled Trial Comparative Study Clinical Trial
A pilot study of pain, analgesia use, and pulmonary function after colectomy with or without a preoperative bolus of epidural morphine.
To determine whether patients who received a preoperative bolus of epidural morphine plus postoperative parenteral analgesia had less pain and better pulmonary function over the first 2 days after a colectomy than patients who received postoperative parenteral analgesia alone. ⋯ Results should be confirmed through study of a larger sample with the hypothesis that pain relief, selected aspects of pulmonary function, and peripheral oxygenation may be superior for patients who receive a preoperative bolus of epidural analgesia for abdominal surgery.
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Critically ill patients have greater than normal oxygen demands because of enhanced energy requirements placed on them by the stress of acute illness, blood and fluid loss, surgery, wound healing, and hospitalization. Early recognition of major alterations in oxygen transport variables, oxygen delivery, oxygen consumption, and the oxygen extraction ratio, by the critical care team assists in the prevention and treatment of tissue hypoxia in seriously ill and injured patients. ⋯ When deviations from supranormal values of oxygen transport variables in these patients are identified, specific interventions that improve oxygen delivery to peripheral tissues should be implemented and evaluated for their effectiveness in normalizing the oxygen extraction ratio. When serial measurements of oxygen delivery, oxygen consumption, and the oxygen extraction ratio follow each therapeutic intervention that is directed at increasing oxygen delivery, the survival rate of critically ill patients is significantly improved.
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To identify which behaviors performed by emergency department nurses were perceived by patients as important indicators of caring. ⋯ Patients experience nurse caring behavior most consistently from the technical aspects of nursing care.