Heart & lung : the journal of critical care
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To describe patients' recollections of their experiences during mechanical ventilation and weaning and to extend an evolving nursing theory of weaning. ⋯ Despite good care during the process, mechanical ventilation and weaning are stressful experiences that require active participation by patients. Patients' work needs to be understood and supported by clinicians to facilitate recovery from mechanical ventilation and weaning.
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Fever after a cardiac operation is commonly caused by myocardial infarction, postpericardiotomy syndrome, post-myocardial infarction syndrome (Dressler's syndrome), or postperfusion syndrome resulting from cytomegalovirus infection. Postpericardiotomy syndrome and post-myocardial infarction syndrome are autoimmune disorders characterized by eosinophilia, pleuritic chest pain, and pleural effusions. In contrast, the diagnosis of postperfusion syndrome caused by cytomegalovirus is suggested if the patient has a mild sore throat, no pleural component or chest pain, no eosinophilia, and atypical lymphocytosis. The syndromes of injury after cardiac surgical procedures are diagnoses of exclusion, but the diagnosis of postperfusion syndrome ("40-day postoperative fever") may be made on the basis of elevated cytomegalovirus IgM titers.