American journal of critical care : an official publication, American Association of Critical-Care Nurses
-
Weaning from mechanical ventilation is influenced by patient, clinician, and organizational factors. ⋯ Important issues identified were perceived importance of interprofessional collaboration and communication, need to combine subjective knowledge of the patient with objective clinical data, balancing of weaning systematization with individual needs, and appreciation of the physical and psychological work of weaning.
-
Randomized Controlled Trial
Cleanliness of Disposable vs Nondisposable Electrocardiography Lead Wires in Children.
Mediastinitis costs hospitals thousands of dollars a year and increases the incidence of patient morbidity and mortality. No studies have been done to evaluate adenosine triphosphate (ATP) counts on disposable and nondisposable electrocardiography (ECG) lead wires in pediatric patients. ⋯ Results of this study support the use of disposable ECG lead wires in postoperative pediatric cardiac surgery patients for at least the first 48 hours as a direct strategy to reduce the ATP counts on ECG lead wires.
-
Observational Study
Depressive symptoms and the relationship of inflammation to physical signs and symptoms in heart failure patients.
Depressive symptoms in patients with heart failure can affect the relationship between physical signs and symptoms and inflammation. ⋯ Both depressive symptoms and inflammation should be considered along with physical signs and symptoms in patients with heart failure. Further studies are needed to determine the effects of improvement in inflammation on improvement in physical signs and symptoms, with consideration given to the effects of depressive symptoms.
-
Agitation in critically ill adults is a frequent complication of hospitalization and results in multiple adverse outcomes. Potential causes of agitation are numerous; however, data on factors predictive of agitation are limited. ⋯ Predictors of agitation on admission and within 24 hours before the onset of agitation were primarily clinical variables.
-
Early enteral nutrition is recommended for patients in intensive care units, but nutrition provision is often hindered by a variety of unit-specific problems. ⋯ Implementing an enteral nutrition support protocol shortened the time to reach feeding goals. Jejunal feeding tubes were necessary in more than half of the patients, and with a jejunal feeding tube in place, feeding goals were reached rapidly.