Heart & lung : the journal of critical care
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A 24-year-old man developed systolic hypertension as a result of renal contusion, perinephric fluid collection, and renal compression (Page kidney) after blunt renal trauma. The patient was treated with an angiotensin-converting enzyme inhibitor for 30 days, after which his blood pressure normalized and the medications were discontinued. ⋯ Transient hypertension may develop in patients after blunt renal injury as a result of Page phenomenon. Appropriate medical therapy is warranted and may be successful because spontaneous resolution may be delayed or not occur at all.
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There are several species of coagulase-negative Staphylococci (CoNS) that are part of the normal skin flora and are relatively noninvasive/low virulence organisms. CoNS are important pathogens in patients with prosthetic devices and are the most common pathogen associated with prosthetic valve endocarditis. ⋯ There has been only one reported case of non-mitral valve IE due to CoNS in a patient with hypertrophic obstructive cardiomyopathy. To the best of our knowledge, we report the first case of Staphylococcal hominis mitral valve endocarditis in a patient with hypertrophic obstructive cardiomyopathy.
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The study assessed attitudes of intensive care unit (ICU) staff members toward practice guidelines in general and toward a specific guideline, The Centers for Disease Control and Prevention's Guideline for Hand Hygiene in Healthcare Settings; correlated these attitudes with staff and hospital characteristics; and examined the impact of staff attitudes toward the Hand Hygiene Guideline on self-reported implementation of the Guideline. ⋯ The majority of staff members were familiar with the Centers for Disease Control and Prevention Hand Hygiene Guideline. Staff attitudes toward practice guidelines varied by type of ICU and by profession, and more positive attitudes were associated with significantly better self-reported guideline implementation. Because differences in staff attitudes might hinder or facilitate their acceptance and adoption of evidence-based practice guidelines, these results may have important implications for the education and/or socialization of ICU staff.
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Unplanned endotracheal extubation (UE) is recognized as the most common airway adverse event in the intensive care unit (ICU). ⋯ This study does not confirm the highest rates of UE previously reported in orally intubated medical patients in the ICU or the association with mortality in this scenario. However, UE increased the need for MV and ICU care. We found a moderate to high prevalence of potentially modifiable risk factors for UE, suggesting unsatisfactory ICU practices.
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Comparative Study
Caregiver burden and outcomes of caregiving of spouses of patients who undergo coronary artery bypass graft surgery.
Patients who undergo coronary artery bypass graft surgery often rely on spouses for care during recovery. Although often meaningful, caregiving may be stressful and affect spouses' ability to provide care to the patient. ⋯ Longitudinal investigations are needed to understand burden and caregiving outcomes over time and the impact of burden on spousal and patient recovery outcomes.