Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses
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Early studies using high doses of steroids in septic shock resulted in increased mortality. More recently, work by Annane et al. using lower doses closer to those that might constitute a stress dose of hydrocortisone have shown encouraging results with a 30% decrease in mortality in septic shock. Although this result is more impressive than the reduction in mortality resulting from the use of activated protein C in septic shock, the numbers of patients involved in the steroid study are low and the results remain unpublished in a peer-reviewed journal.
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Intensive Crit Care Nurs · Aug 2001
Caregivers of ICU patients discharged home: what burden do they face?
Reforms in healthcare aimed at cost-cutting have led to early hospital discharge for many patients, including those who have sustained critical illness or injury requiring admission to an intensive care unit (ICU). Many former ICU patients experience ongoing health-related problems following discharge from hospital, and need ongoing support and care from their family once discharged. However, family members who take on a caregiving role often experience an enormous burden. ⋯ Although only a small number of studies specifically focus on caregivers of former ICU patients, findings suggest that these caregivers experience a substantial burden which is associated with the complexity of the patient's physical and psychological impairment, and complex technology. To enable nurses to incorporate planning strategies and interventions aimed at minimizing the impact on the caregiver, further research is needed to more fully explore, examine and measure the factors involved in caring for ICU patients post-discharge. Furthermore, ongoing research and evaluation of interventions will build an evidence-base to inform future practice.
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A recent large trial has shown that recombinant activated protein C reduced mortality in severe sepsis. This is the first real advance in the pharmacotherapy of sepsis since the introduction of antibiotics in the last century.
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Intensive Crit Care Nurs · Jun 2001
ReviewNurse-led weaning from mechanical ventilation: where's the evidence?
Several authors have suggested clinical protocols as a means of shortening ventilation time and the important role of the nurse in reducing ventilation time has also been highlighted. Despite the many references in the literature to reducing weaning times using clinical protocols, it is not clear whether nurse-led weaning strategies hasten weaning from mechanical ventilation compared with physician-led care. ⋯ There is limited evidence suggesting that nurse-led weaning may reduce ventilation time; however, it is not clear whether it was the nurse-led aspect or the clinical protocol that produced the effect.
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Intensive Crit Care Nurs · Jun 2001
The influence of focus group-oriented supervision on intensive care nurses' reflections on family members' needs.
The aim of this study was to explore intensive care nurses' experiences of focus group-oriented supervision with particular reference to family members' needs. In addition, the aim was to focus on the intensive care nurses' perceived change in their insight into caring for patients and family members in an intensive care unit. ⋯ In conclusion, focus group-oriented supervision increased the intensive care nurses' understanding of their role. This has consequences not only for the family members but also for the teamwork in the intensive care unit, where this type of work is common.