Heart & lung : the journal of critical care
-
Review Case Reports
Treatment strategies in shock: use of oxygen transport measurements.
Shock has traditionally been categorized according to its cause. Shock can result from hemorrhage, primary cardiac failure, central nervous system failure, trauma, or sepsis. Therapeutic principles have been developed for each etiologic type. ⋯ These variables are easily calculated by using data obtained from pulmonary artery catheter and laboratory measurements. The physician or nurse caring for critical ill patients should have a thorough understanding of the rationale for the use of oxygen transport calculations and the methods of manipulating oxygen delivery. A simple explanation of these principles including the importance of hemoglobin, cardiac index, and percent saturation of hemoglobin and suggested treatment strategies are presented.
-
Comparative Study
Incidence of pulmonary aspiration in intubated patients receiving enteral nutrition through wide- and narrow-bore nasogastric feeding tubes.
A descriptive study was performed to compare the incidence of pulmonary aspiration in 25 critically ill patients who had endotracheal tubes in place and were receiving enteral nutrition through a narrow-bore nasogastric tube (n = 10) or a wide-bore nasogastric tube (n = 15). Results of chi-square analysis of this comparison were not significant, p less than 0.05. Aspiration occurred in one subject. ⋯ The number of checks for residual feeding was found to be significantly greater in the wide-bore tube group. A comparison of the assessment of nasogastric tube placement on x-ray examination showed that tube placement was reported on x-ray results with more frequency in the wide-bore group. Questions are raised by these observations regarding the use of narrow-bore tubes in the critically ill population with endotracheal tubes in place.
-
Randomized Controlled Trial Clinical Trial
Improving family functioning after cardiac surgery: a randomized trial.
As part of a randomized clinical trial of in-hospital and postdischarge nursing interventions designed to facilitate the individual patient's recovery and improve the family's functioning after cardiac surgery, we followed 67 patient-spouse pairs for 6 months after surgery. Family health was appraised by using three pencil and paper measurements: the Family APGAR, the Locke-Wallace Marital Adjustment Scale, and the Family Inventory of Resources for Management. Mixed-effects analysis of variance did not detect differences for the main effect of intervention group; however, the main effect of time was significant for both patients' and spouses' APGAR scores and for patients' Marital Adjustment Scale scores, suggesting a pattern of response during recovery from cardiac surgery.