Heart & lung : the journal of critical care
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One of the barriers to effective pain management in critical care is the lack of systematic, comprehensive methods for assessing and treating pain. Use of a printed, standardized pain assessment and intervention tool can stimulate critical thinking and provide a framework for organizing pain assessment and management data. ⋯ The assessment and treatment of pain in critically ill patients are highly complex processes. This study identified many advantages of the use of a standardized, systematic approach to pain assessment and treatment by health professionals.
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The purpose of this study was to examine the association between intensive care unit nurse (ICU) staffing and the likelihood of complications for patients undergoing abdominal aortic surgery. ⋯ Within the range of ICU nurse staffing levels present in Maryland hospitals, decreased nurse staffing was significantly associated with an increased risk of complications in patients undergoing abdominal aortic surgery.
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Case Reports
Management of respiratory failure with noninvasive positive pressure ventilation and heliox adjunct.
Exhausted by persistent coughing and dyspnea, a 63-year-old man with chronic obstructive pulmonary disease was admitted to the emergency department. Initial treatment included oxygen and pharmacologic and noninvasive positive pressure ventilation (NPPV) therapy with minimal clinical improvement. In view of this situation, a gas mixture of helium-oxygen (heliox) 70%:30% was introduced into the nasal mask as an adjunct. ⋯ The patient expressed in a high-pitched voice that he was "breathing easier." He remained on NPPV-heliox adjunct for 80 minutes. At the end of this period, the patient was placed on a 50% Venturi oxygen mask. He was transferred to the intensive care unit, and 6 days later he was discharged from the hospital without incident.
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Comparative Study
A pilot study to investigate any relationship between sustained maximal inspiratory pressure and extubation outcome.
To establish whether any relationship exists between extubation outcome and sustained maximal inspiratory pressures (SMIP). ⋯ In this study, peak MIP was not specific enough to be clinically useful as a predictor of extubation outcome. SMIP was associated with extubation outcome with equally high sensitivity and specificity and may therefore have a role in outcome prediction.
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Comparative Study
Long-term effects of pediatric intensive care unit hospitalization on families with young children.
The purpose of this study was to prospectively examine the long-term effects of the pediatric intensive care unit experience on parents and on family adaptation. ⋯ Despite the smaller than expected sample sizes over time, results suggest that parents are still having stress-related symptoms and difficulties with family functioning as long as 6 months after a child's illness event.