American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Enrollment challenges for critical care research are common. Contributing factors include short enrollment windows, the crisis nature of critical illness, lack of research staff, unavailable legal proxy, family dynamics, and language barriers. ⋯ Unavailability of a legal proxy within a short enrollment window was the major challenge to enrollment. Various factors influenced consent decisions. Clinical study design requires more conservative estimates.
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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
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.