American journal of critical care : an official publication, American Association of Critical-Care Nurses
-
Case Reports
Pressure-controlled inverse-ratio ventilation in children with acute respiratory failure.
We report the use of pressure-controlled inverse-ratio ventilation in two children with acute respiratory failure who were failing conventional mechanical ventilation. The children had subsequent improvement in oxygenation and ventilation without hemodynamic compromise. Pressure-controlled inverse-ratio ventilation was well tolerated by one patient who had increased intracranial pressure secondary to head injury. We were able to successfully hyperventilate, improve oxygenation and control intracranial pressure in this patient while using pressure-controlled inverse-ratio ventilation, which may prove to be an alternative method of ventilation for children with severe lung disease.
-
In the last 10 years, the American Association of Critical-Care Nurses has twice ranked pain management as a priority issue for research and practice. Recent research findings suggest that undermedication of patients continues both in and out of critical care. Postoperative cardiac surgery patients have reported detailed recollections of pain experiences while in critical care, yet little is known about management of postoperative cardiac surgery pain. ⋯ The finding of small and infrequent analgesic doses is consistent with other studies conducted in and out of critical care. Important inconsistencies, or variations in practice, exist in both the prescription and administration of analgesics for postoperative cardiac surgery patients in the critical care setting.