Heart & lung : the journal of critical care
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Comparative Study Clinical Trial
Comparison of two endotracheal tube securement techniques on unplanned extubation, oral mucosa, and facial skin integrity.
To determine the effect of 2 standard methods (i.e., twill tape versus adhesive tape) of securement on unplanned extubation, oral mucosa, and facial skin integrity of the orally intubated patient. ⋯ The findings of this pilot study demonstrated both methods of endotracheal tube securement to be comparable in preventing unplanned extubation and in maintaining oral mucosa status and facial skin integrity.
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The purposes of the study were to: (1) describe the aggregate strength of the relationship of arterial oxygen saturation as measured by pulse oximetry with the standard of arterial blood gas analysis as measured by co-oximetry, (2) examine how various factors affect this relationship, and (3) describe an aggregate estimate of the bias and precision between oxygen saturation as measured by pulse oximetry and the standard in vitro measures. ⋯ Pulse oximeters were found to be accurate within 2% (+/- 1 SD) or 5% (+/- 2 SD) of in vitro oximetry in the range of 70% to 100% Sao2. In comparing ear and finger probes, readings from finger probes were more accurate. Pulse oximeters may fail to record accurately the true Sao2 during severe or rapid desaturation, hypotension, hypothermia, dyshemoglobinemia, and low perfusion states.
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Review Case Reports
Pulmonary thromboendarterectomy: an advance in the treatment of chronic thromboembolic pulmonary hypertension.
A new surgical procedure, pulmonary thromboendarterectomy, provides innovation in the surgical management of chronic thromboembolic pulmonary hypertension. This article will provide an overview of the surgical procedure itself as well as preindications for surgery and postoperative management. A clinical case study of a patient who has experienced the surgical procedure will be shared to apply the care management techniques outlined in the article.
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Comparative Study
Factors influencing intensive care unit survival for critically ill elderly patients.
To examine factors influencing intensive care unit (ICU) survival for critically ill elderly patients and to compare survivors and nonsurvivors of ICU on demographic and illness-related variables. ⋯ The findings of this study demonstrated that severity of illness was a predictor of ICU outcome; age was not. Additionally, age was not related to ICU treatments received.
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Comparative Study
Measurement of glucose in tracheobronchial secretions to detect aspiration of enteral feedings.
To determine (1) the relationship between results from 2 methods to measure glucose in tracheobronchial aspirates, (2) the effect of blood glucose levels on tracheobronchial glucose levels, and (3) the relationship between results from 2 methods to measure glucose in selected enteral formulas. ⋯ It appears appropriate to use glucose oxidase reagent strips to estimate glucose concentrations in tracheobronchial fluid. Elevated blood glucose levels apparently do not have a major effect on the glucose content in tracheobronchial fluid. Although mean glucose concentrations in the 22 formulas were higher with the laboratory assay, the readings were sufficiently similar to allow using glucose oxidase reagent strips to give a good estimation of the formulas' glucose content.