Heart & lung : the journal of critical care
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To describe patients' recollections of their experiences during mechanical ventilation and weaning and to extend an evolving nursing theory of weaning. ⋯ Despite good care during the process, mechanical ventilation and weaning are stressful experiences that require active participation by patients. Patients' work needs to be understood and supported by clinicians to facilitate recovery from mechanical ventilation and weaning.
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Fever after a cardiac operation is commonly caused by myocardial infarction, postpericardiotomy syndrome, post-myocardial infarction syndrome (Dressler's syndrome), or postperfusion syndrome resulting from cytomegalovirus infection. Postpericardiotomy syndrome and post-myocardial infarction syndrome are autoimmune disorders characterized by eosinophilia, pleuritic chest pain, and pleural effusions. In contrast, the diagnosis of postperfusion syndrome caused by cytomegalovirus is suggested if the patient has a mild sore throat, no pleural component or chest pain, no eosinophilia, and atypical lymphocytosis. The syndromes of injury after cardiac surgical procedures are diagnoses of exclusion, but the diagnosis of postperfusion syndrome ("40-day postoperative fever") may be made on the basis of elevated cytomegalovirus IgM titers.
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To describe the experiences of families with a relative in the intensive care unit (ICU). ⋯ Families experience a sense of uncertainty that is eventually resolved by seeking information and resources. Health care professionals can minimize the stress associated with hospitalization of relatives in the ICU by anticipating and addressing the family's needs for information and resources.
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To describe the process of family decision making about life support in the critical care setting. ⋯ Little is known about the actual experience of family members as they are involved in life-support decision making. Identification of the needs of family members to work through the decision-making experience cognitively, emotionally, and morally is essential to communicating effectively about the ill relative's condition and to providing understanding and support to families involved in life-support decision making in the critical care unit.
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To determine the incidence and the effect of intraoperative and discharge variables on gastrointestinal (GI) symptoms after cardiac surgery during hospitalization and 2 and 6 weeks after discharge. ⋯ The incidence of GI symptoms after cardiac surgery is significant, but their etiology has yet to be determined.