Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2015
ReviewHemodynamics of Acute Right Heart Failure in Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome.
In critically ill patients with circulatory shock, the role of the left ventricle has long been appreciated and the object of measurement and therapeutic targeting. The right ventricle is often under appreciated and dysfunction may be overlooked. ⋯ Traditional right heart filling indices may increase because of decreasing compliance, further complicating the picture. The pathophysiology of pulmonary vascular dysfunction in acute respiratory distress syndrome combined with the effects of a mean airway pressure strategy may create an acute cor pulmonale.
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The number of patients with heart failure is growing; the associated morbidity and mortality remains dismal. Advance care planning, end-of-life conversations, and palliative care referrals are appropriate, but do not occur regularly. ⋯ Nurses are well-positioned to provide basic. Nurses are also instrumental in initiating referrals to the specialized palliative care team as the patient's needs become too complex or the disease progresses and the patient approaches the end of life.
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Crit Care Nurs Clin North Am · Dec 2015
ReviewCardiac Transplantation: Considerations for the Intensive Care Unit Nurse.
Heart transplantation is a recommended and curative treatment option for patients with advanced heart failure symptoms despite receiving optimal medical and device therapy. The availability of donor organs limits the number of patients able to receive a heart transplant. ⋯ Understanding the specific interventions and therapies unique to this patient population is critical to their care. This article reviews considerations for the intensive care unit clinician in the management of heart transplant patients in this setting.
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Crit Care Nurs Clin North Am · Dec 2015
ReviewHigh-Output Heart Failure Caused by Thyrotoxicosis and Beriberi.
High-output heart failure is not seen as commonly as low-output heart failure and some of the typical guideline recommendations may not benefit patients with high-output failure. High-output failure is caused by several diseases, including thyrotoxicosis and beriberi, highlighted in this article. ⋯ Prompt recognition of these infrequently seen syndromes is essential. This article outlines the medical treatment and nursing care needed to return these patients to a normal state.