The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
-
The aim of this article was to review the current literature in relation to the nursing of intensive care unit (ICU) delirium. In particular, we discuss the definition and frequency, clinical features, risk factors, the adverse effects associated with instruments for assessing delirium, as well as prevention and nursing for delirium patients. ⋯ Routine screening of all patients in the ICU for the presence of delirium is crucial to its successful management. Nurses are on the front line to detect, manage, and even prevent ICU delirium.
-
Controlled Clinical Trial
The effects of open and closed endotracheal suctioning on intracranial pressure and cerebral perfusion pressure: a crossover, single-blind clinical trial.
Although endotracheal suctioning is a routine nursing intervention, this procedure can lead to an increase in intracranial pressure (ICP). This study was planned to determine the appropriate suctioning technique (open system suctioning [OS] and closed system suctioning [CS]) to minimize variability of ICP and cerebral perfusion pressure (CPP) in neurologically impaired patients. The study, which was designed as a crossover, single-blind clinical trial, consisted of 32 neurosurgical patients who underwent ICP monitoring, intra-arterial blood pressure monitoring, and endotracheal intubation in the intensive care unit. ⋯ It was observed that both suctioning techniques significantly increased ICP, mean arterial blood pressure, CPP, and HR; ICP was found to be significantly higher in OS compared with CS, whereas there were no significant differences in CPP and HR between the two techniques. The patients suctioned using OS had significantly lower mean PaO(2) than those suctioned using CS; however, the comparison of the two techniques revealed no significant differences in PaCO(2). The data obtained indicate that CS, compared with OS, can be used safely on this patient group.