Heart & lung : the journal of critical care
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The purposes of this study were to investigate the hemodynamic changes induced by intermittent manual lung hyperinflation (MHI) and to assess if these changes are adverse enough to warrant prohibition of MHI as a routine procedure in the care of patients with septic shock. ⋯ The hemodynamic effects of intermittent MHI in patients with septic shock are relatively small and insignificant and seem to be related to the cardiovascular state before the procedure. The risk of inducing hemodynamic changes with MHI should not be considered as a contraindication in patients with septic shock who are mechanically ventilated.
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The purpose of this study was to determine the degree of agreement between clinically observed muscle movement(s) and train-of-four scores obtained by peripheral nerve stimulation during a neuromuscular blocking agent infusion and after it was discontinued. ⋯ Until additional research is available, nurses must titrate the neuromuscular blocking agent infusion on the basis of the clinical endpoints for paralysis in combination with an assessment of the child's movements and response to peripheral nerve stimulation to prevent overdose and prolonged muscle paralysis.