Heart & lung : the journal of critical care
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Randomized Controlled Trial Multicenter Study Comparative Study
Nurse and patient characteristics associated with duration of nurse talk during patient encounters in ICU.
Communication interactions between nurses and mechanically ventilated patients in the intensive care unit (ICU) are typically brief. Factors associated with length of nurses' communication have not been explored. ⋯ Length of time the patient is intubated, and the patient's level of consciousness may influence duration of nurse communication in ICU.
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Case Reports
Phrenic nerve injury and diaphragmatic paralysis following pacemaker pulse generator replacement.
Diaphragmatic paralysis (DP) is a common condition. It can be unilateral or bilateral and the diagnosis is usually based on a clinical and radiological findings. ⋯ DP can be the result of various chest conditions that affect the phrenic nerve such as tumors, vascular abnormalities or traumatic incidents during surgery as well as blunt or penetrating chest or neck injuries. We report a unique case of phrenic nerve injury and unilateral diaphragmatic paralysis secondary to pacemaker pulse generator replacement that was successfully treated with diaphragmatic plication.
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Comparative Study
A local risk prediction model for prolonged ventilation after adult heart valve surgery in a Chinese single center.
The aim of this study was to develop a logistic risk prediction model for prolonged ventilation after adult heart valve surgery. ⋯ We developed and validated a local risk prediction model for prolonged ventilation after adult heart valve surgery. This model can be used to calculate patient-specific risk by the logistic equation with an equivalent predicted risk at our center in future clinical practice.
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Comparative Study
Nurses' strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients: an in-depth look.
Despite an increasing body of knowledge on self-care in heart failure patients, the need for effective interventions remains. We sought to deepen the understanding of interventions that heart failure nurses use in clinical practice to improve patient adherence to medication and symptom monitoring. ⋯ Despite a strong focus on educational strategies, nurses also reported other strategies to increase patient adherence. Nurses use several strategies to improve patient adherence that are not incorporated into guidelines. These interventions need to be evaluated for further applications in improving heart failure management.
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Pressure ulcers and ventilator-associated pneumonia (VAP) are both common in acute and critical care settings and are considerable sources of morbidity, mortality, and health care costs. To prevent pressure ulcers, guidelines limit bed backrest elevation to less than 30 degrees, whereas recommendations to reduce VAP include use of backrest elevations of 30 degrees or more. Although a variety of risk factors beyond patient position have been identified for both pressure ulcers and VAP, this article will focus on summarizing the major evidence for each of these apparently conflicting positioning strategies and discuss implications for practice in managing mechanically ventilated patients with risk factors for both pressure ulcers and VAP.