Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 1999
Review Case ReportsClinical application. Using oxygenation profiles to manage patients.
Cellular oxygenation is dependent on both tissue oxygenation and pulmonary oxygenation. The use of profiles can help to make the assessment of tissue and pulmonary oxygenation more thorough. ⋯ Oxygenation profiles enable the nurse to trend a patient's progress and response to nursing and medical interventions. A sophisticated assessment relies not merely on physical assessment alone but incorporates continuous mixed venous oxygenation and oxygenation profiles to assess a patient's tissue and pulmonary oxygenation status.
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Crit Care Nurs Clin North Am · Dec 1999
ReviewNew strategies for mechanical ventilation. Lung protective ventilation.
Although research is ongoing, and there are no definitive data to mandate the final answer to the question of which ventilation strategies result in the most optimal outcomes, the consensus of clinicians today suggests that we limit FIO2 to nontoxic levels, limit ventilating pressures and volumes, and use PEEP levels adequate to recruit alveoli and prevent tidal collapse. The critical care nurse must remain vigilant in his or her review of current literature to maintain knowledge of the current recommendations for optimal MV strategies.
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Crit Care Nurs Clin North Am · Dec 1999
ReviewVentilatory strategies for the critically ill infant and child.
As newer modes of mechanical ventilation and adjuncts to ventilation continue to be developed and studied, pediatric critical care practitioners are going to have many exciting options for the treatment of the critically ill infant and child. All who provide care to these critically ill patients must continue to evaluate these varied ventilatory strategies.
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Crit Care Nurs Clin North Am · Jun 1999
ReviewManagement of patients with acute respiratory distress syndrome.
Acute respiratory distress syndrome is a complex clinical syndrome of respiratory failure that presents a challenge to every critical care team. Since the first clear description by Ashbaugh et al more than 30 years ago, much has been learned about the pathophysiologic process that occurs within the lungs after they suffer either a direct or indirect injury. Unfortunately, little success has been achieved in improving outcomes; however, hope is on the horizon. Current research evaluating optimal ventilator management, ECMO, the use of inhaled nitric oxide, and other experimental management strategies will hopefully combine to produce improved outcomes.
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Crit Care Nurs Clin North Am · Jun 1999
ReviewManagement strategies for improving outcome following severe head injury.
Severe head injury is a major cause of disability, death, and economic cost. Significant reductions in mortality and morbidity can be achieved in patients with severe head injury through the use of evidence-based protocols and guidelines. Although no set standard is available for the management of patients with severe head injury, improved outcomes following severe head injury are seen with complete and rapid physiologic resuscitation and specific strategies that decrease ICP.