American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Family members of critically ill patients experience indications of post-intensive care syndrome, including anxiety, depression, and posttraumatic stress disorder. Despite increased use of long-term acute care hospitals for critically ill patients, little is known about the impact of long-term hospitalization on patients' family members. ⋯ Family decision makers of patients in long-term acute care hospitals have a significant prevalence of indications of post-intensive care syndrome.
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Comparative Study
Measuring Stroke Volume: Impedance Cardiography vs Phase-Contrast Magnetic Resonance Imaging.
Determination of cardiac output requires measurement of both heart rate and stroke volume. Techniques for measuring heart rate are widespread, and 1 technique for bedside monitoring of stroke volume is electrical impedance cardiography. ⋯ Impedance cardiography had low accuracy and precision in measuring absolute stroke volume and was a poor detector of stroke-volume trends.
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Observational Study
Psychotropic Drug Use in Physically Restrained, Critically Ill Adults Receiving Mechanical Ventilation.
Restraining therapies (physical or pharmacological) are used to promote the safety of both patients and health care workers. Some guidelines recommend nonpharmacological or pharmacological interventions be used before physical restraints in critically ill patients. ⋯ Psychotropic drug interventions (mostly using opioids) were more common after use of physical restraints. Some patients may be physically restrained for anticipated treatment interference without consideration of pharmacological options and without documented agitation.
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Observational Study
Patterns of Instability Associated With Endotracheal Suctioning in Infants With Single-Ventricle Physiology.
In infants with single-ventricle physiology, endotracheal suctioning poses risks because of the instability between pulmonary and systemic blood flow. ⋯ Significant hemodynamic instability and adverse events occur during routine suctioning in infants with single-ventricle physiology after surgical palliation.
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Improving patient care quality in intensive care units is increasingly important as intensive care unit services account for a growing proportion of hospital services. Organizational factors associated with quality of patient care in such units have been identified; however, most were examined in isolation, making it difficult to assess the relative importance of each. Furthermore, though most intensive care units now use a closed model, little research has been done in this specific context. ⋯ Augmenting work resources and/or focusing limited hospital resources on improving patient care coordination may be the most productive ways to improve patient care quality in closed intensive care units.