American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Review Randomized Controlled Trial Comparative Study Clinical Trial
Effects of injectate volume on thermodilution measurements of cardiac output in patients with low ventricular ejection fraction.
To determine the effect of 5-mL injectate on cardiac output measurements in critically ill patients with low ventricular ejection fraction (< 35%). ⋯ Cardiac outputs measured with 5- and 10-mL injectates do not differ significantly. The greater variability of measurements obtained with a 5-mL injectate suggests that more measurements, and thus more time, are needed to measure cardiac output accurately. Clinicians must weigh the benefit of minimizing fluid volume used against the potential decreased reliability of cardiac output measurements.
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Multicenter Study
Pain assessment and management in critically ill postoperative and trauma patients: a multisite study.
Pain in critically ill patients is undertreated. ⋯ Despite moderate to severe pain, patients are generally satisfied with their pain relief. Measuring patients' satisfaction alone is not a reliable outcome for determining the effectiveness of pain management. Realistic expectations of patients about their pain may enhance coping, increase satisfaction, and decrease pain intensity after surgery.
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Clinical Trial Controlled Clinical Trial
Stress during mechanical ventilation: benefit of having concrete objective information before cardiac surgery.
Negative emotional reactions and difficulty in communicating are common in patients receiving mechanical ventilation and may adversely affect recovery from cardiac surgery. ⋯ Nursing interventions that include concrete objective information help cardiac patients cope with the stresses associated with surgery and mechanical ventilation.
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Few data exist about buildup of secretions within endotracheal tubes of patients treated with closed-system suctioning in the intensive care unit. ⋯ Endotracheal tubes are markedly narrowed by the buildup of secretions after closed-system suctioning. Duration of intubation, but not endotracheal tube size or amount of secretions, was associated with the degree of narrowing.