Critical care nursing quarterly
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Ventricular assist devices (VADs) play an increasingly important role in the care of cardiovascular patients. Developed initially for support of cardiothoracic surgery patients experiencing difficulty in weaning from cardiopulmonary bypass, these devices have been used extensively as a bridge to cardiac transplantation for patients who are failing on medical management. ⋯ Applications for VADs are expanding and advances in technology occurring to support these new applications. This article provides an overview of current and emerging VADs and nursing management of the VAD patient.
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Review Case Reports
Bringing research to the bedside: the role of induced hypothermia in cardiac arrest.
Despite progress in resuscitative practices, there has been little improvement in mortality and neurologic morbidity outcomes after cardiac arrest. Updated resuscitative guidelines were published in 2005, and included changes in resuscitation measures and recommendations in postresuscitation interventions including induced hypothermia. Treatment with induced hypothermia after cardiac arrest for up to 24 hours has been shown to significantly improve the neurologic outcomes and mortality in patients with primary cardiac arrest who remain comatose after return of spontaneous circulation. ⋯ A multidisciplinary team led by a neurointensivist was formed to develop and implement a protocol to support induced hypothermia after cardiac arrest. Twenty-five patients have received induced hypothermia with a 74% survival rate. Of those who survived, 47% went home for a regular discharge, 29% transferred to acute rehabilitation, and 23% transferred to a long-term care facility.