Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2005
ReviewSafety in the pediatric ICU: the key to quality outcomes.
Patient safety is a major concern in the pediatric ICU. The acuity has never been higher, patient needs are extremely complex, and the margin for error is small. ⋯ This article discusses communication, patient identification, catheter-related bloodstream infections, unplanned extubations, restraints and medication administration. The health care system of the future must be transparent, making safety information to insurers, patients and health care providers easily available.
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Crit Care Nurs Clin North Am · Dec 2005
ReviewLow cardiac output syndrome: identification and management.
Low cardiac output syndrome (LCOS) is a clinical condition that is caused by a transient decrease in systemic perfusion secondary to myocardial dysfunction. The outcome is an imbalance between oxygen delivery and oxygen consumption at the cellular level which leads to metabolic acidosis. Although LCOS is observed most commonly in patients after cardiac surgery, it may present in various disease processes resulting in cardiac dysfunction. This article provides an overview of the determinants involved in oxygen transport, the physiologic factors influencing cardiovascular function, the assessment of hemodynamic variables, the etiology of LCOS, and management strategies, including a brief review of some pharmacologic agents that are used in the treatment of low cardiac output.
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Crit Care Nurs Clin North Am · Dec 2005
ReviewManagement of the pediatric postoperative cardiac surgery patient.
Optimal management of the postoperative pediatric cardiac surgical patient requires a thorough understanding of patient anatomy, physiology, surgical repair or palliation, and clinical condition. This necessitates a dedicated team of clinicians including skilled nurses, physicians, and respiratory therapists specialized in the care of patients who have complex congenital heart disease. ⋯ An evaluation of cardiac hemodynamics and a review of major organ systems are included. Essential assessment information and interventional strategies for managing the pediatric postoperative cardiac surgery patient are detailed.
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A significant percentage of pediatric patients admitted to an ICU have an infectious disease process. Many infants and children go on to develop sepsis, a major cause of death in the intensive care unit. Caring for these children presents a collaborative challenge because of the multifactorial etiology and the complicated pathophysiology. This article focuses on the specific implications of sepsis for infants and children.
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Crit Care Nurs Clin North Am · Dec 2005
ReviewAcute lung injury and acute respiratory distress syndrome in the pediatric patient.
When the lung becomes injured by direct or indirect assault, the body unleashes a massive immune-modulated initiative. The pediatric patient who experiences acute lung injury is at considerable risk for developing life-threatening respiratory compromise. By understanding the mechanisms of illness in these complex patients, the critical care nurse can connect the science of therapy with the art of providing care that minimizes oxygen expenditure and maximizes oxygen delivery.