Heart & lung : the journal of critical care
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Fentanyl-induced chest wall rigidity occurred in an 8-week-old infant girl recovering from surgical repair of coarctation of the aorta. The neonate received 30 minutes of a moderate dose continuous infusion of fentanyl before chest wall rigidity developed. Association of the chest wall rigidity with the fentanyl infusion resulted in the appropriate intervention of narcotic reversal and prevented irreversible hypoxic sequelae. Patients receiving fentanyl, even at moderate doses, are at risk for the development of chest wall rigidity.
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Comparative Study
The use of analgesics and sedatives in critically ill patients: physicians' orders versus medications administered.
To examine the difference between the prescribed and actually administered dose of analgesic and sedative drugs in critically ill patients. ⋯ Physicians tended to write fairly nonspecific orders that were used by the nursing staff as very broad guidelines. A need exists to educate physicians as to what patients actually receive for sedation and analgesia and at the same time improve the dialogue between nurses and physicians as to what patients actually require.
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To determine whether the frequency of pneumothorax is increased after thoracentesis in chronic obstructive pulmonary disease patients. ⋯ Pneumothorax may frequently occur in patients with chronic obstructive pulmonary disease undergoing thoracentesis. The reason may be related to the altered architecture of the lung parenchyma and the change in mechanical forces in chronic obstructive pulmonary disease. Sonography-guided thoracentesis may offer a safer means of performing thoracentesis in patients with chronic obstructive pulmonary disease.
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To compare four methods (Lillihei harness, Comfit, Dale, and SecureEasy) of securing endotracheal tubes in orally intubated adult patients in the intensive care unit. ⋯ Results of this study suggest that the SecureEasy holder is the preferred alternative method for securing endotracheal tubes when the standard method with tape is not desirable. These results are similar to those reported in a previous investigation in which the adequacy of the SecureEasy holder was assessed.
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Randomized Controlled Trial Clinical Trial
The effects of music and muscle relaxation on patient anxiety in a coronary care unit.
To test the efficacy of music and muscle relaxation techniques in reducing the anxiety of patients admitted to a coronary care unit with ischemic heart disease. ⋯ These results differ from those of similar studies but may be related to the high probability of a type II error. Further investigation with longer intervention sessions and larger sample sizes is indicated. Similar studies should incorporate power analysis when reporting their results.