Heart & lung : the journal of critical care
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Knowing what parents find stressful about having a child in a pediatric intensive care unit and how they cope is essential before professionals can bolster their coping and provide support. In a semistructured interview we asked parents to discuss the aspects of the situation that they found stressful and to identify their predominant stressor. Then, using the Ways of Coping Questionnaire, we asked them to identify what coping strategies they used to cope with that predominant stressor. ⋯ Seeking social support and positive reappraisal were the two most often used strategies by all parents regardless of the classification of stressors. No significant associations were found between stress or coping and any of the demographic variables. Research such as this can be useful to practicing clinicians who plan strategies that offer assistance and emotional support to parents of children hospitalized in the pediatric intensive care unit.
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In patients receiving mechanical ventilation there occasionally occurs an unintentional positive end-expiratory pressure, known as auto-PEEP, a phenomenon that can easily go undetected. Potential adverse effects of auto-PEEP include misleading hemodynamic information, cardiopulmonary morbidity, or both. Our study was designed to evaluate the incidence of auto-PEEP, its magnitude, and factors influencing it in a university hospital. ⋯ Therefore, auto-PEEP is the result of several ventilator-related factors. Because auto-PEEP occurred in 47% of the patients in the study, routine monitoring for auto-PEEP in patients receiving controlled ventilation is recommended. Further studies of auto-PEEP and its clinical impact are warranted.
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This descriptive study was a pilot effort to determine the effect of specific sensory input on the cortical activity of a selected population of young adults with a closed head injury. The specific research questions were (1) Does the comatose patient demonstrate a response on an electroencephalogram (EEG) to a specific auditory stimulus? (2) Does the comatose patient demonstrate other types of responses to a specific auditory stimulus? The subjects were three male and two female young adults 15 to 29 years of age who had a closed head injury as the result of an automobile accident. A similarity in depth of coma was established by using the Glasgow Coma Scale. ⋯ Two patients demonstrated a response on EEG and the other responded by eye opening or extremity movement. The EEG alone does not appear to be useful as a measure of response to auditory stimulus. Further work needs to be done to determine what other methods measure the response of comatose patients to auditory stimulation.
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The level of dyspnea reported by the patient with chronic obstructive pulmonary disease is related to both the physiologic and psychologic state of the person at the time. The purpose of this pilot study was to explore, from a psychophysiologic perspective, the differences in anxiety, depression, and somatization during times of high and low levels of dyspnea. Six male subjects with chronic obstructive pulmonary disease, with a mean age of 64 years and a mean forced expiratory volume in 1 second that was 44% of predicted, completed the study. ⋯ Subjects receiving oral prednisone had high depression levels that increased during times of severe dyspnea. Somatization, PO2, respiratory rate, depth of respiration, and other clinical signs did not change with dyspnea level. These results indicate that dyspnea is accompanied by both psychologic and physiologic changes that can be targeted to assist in alleviating this distressing symptom.