American journal of critical care : an official publication, American Association of Critical-Care Nurses
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The role of fever in trauma patients remains unclear. Fever occurs as a response to release of cytokines and prostaglandins by white blood cells. Many factors, including trauma, can trigger release of these factors. ⋯ No relationship was found between the presence of fever during the first 48 hours and mortality. Patients with traumatic brain injury did not have a higher incidence of fever than did patients without traumatic brain injury. About 30% of febrile patients had an identifiable source of infection. Further studies are needed to understand the origin and role of fever in trauma patients.
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Randomized Controlled Trial Comparative Study
Hemodynamic changes with manual and automated lateral turning in patients receiving mechanical ventilation.
Lateral turning of critical care patients receiving mechanical ventilation can adversely affect hemodynamic status. ⋯ In medical-surgical critical care patients receiving mechanical ventilation, manual lateral turning was associated with changes in heart rate, mean arterial pressure, and pulse pressure that persisted up to 45 minutes.
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Randomized Controlled Trial
Preoperative education on postoperative delirium, anxiety, and knowledge in pulmonary thromboendarterectomy patients.
Delirium is the most common postoperative psychiatric condition in intensive care settings and can lead to increased complications and costs. ⋯ The patient education appeared to be effective in improving knowledge and reducing days of mechanical ventilation. Hearing impairment was an unexpected predictor of adverse outcomes for patients but may be amenable to nursing intervention.
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Multicenter Study
Computer-Assisted Interventions To Improve QTc Documentation in Patients Receiving QT-Prolonging Drugs.
Many medications commonly used in hospitals can cause prolonged corrected QT interval (QTc), putting patients at risk for torsade de pointes (TdP), a potentially fatal arrhythmia. However, documentation of QTc for hospitalized patients receiving QT-prolonging medications is often not consistent with American Heart Association standards. ⋯ A 3-step system-wide intervention was associated with an increase in QTc documentation for patients at risk for drug-induced TdP, and improvements persisted over time. Further study is needed to assess whether increased QTc documentation decreases occurrence of drug-induced TdP. (American Journal of Critical Care. 2015;24:e6-e15).
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Randomized Controlled Trial
A computer-based education intervention to enhance surrogates' informed consent for genomics research.
Many research studies conducted today in critical care have a genomics component. Patients' surrogates asked to authorize participation in genomics research for a loved one in the intensive care unit may not be prepared to make informed decisions about a patient's participation in the research. ⋯ Computer-based education modules may be an important addition to conventional approaches for obtaining informed consent in the intensive care unit. Preparing patients' family members who may consider serving as surrogate consenters is critical to facilitating genomics research in critical care.