American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Comparison of heparinized and nonheparinized solutions for maintaining patency of arterial and pulmonary artery catheters.
Arterial and pulmonary artery catheters are often used in the management of critically ill patients. If heparin were not necessary to maintain the patency of arterial and pulmonary artery catheters, these patients could avoid exposure to heparin. ⋯ The failure rate of pulmonary artery catheters was not affected by the use of nonheparinized solutions. Arterial catheters failed less often when they were maintained with heparinized solutions. The authors recommend that all arterial catheters be maintained with heparinized solutions, unless use of heparin is contraindicated.
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Randomized Controlled Trial Comparative Study Clinical Trial
Rewarming cardiac surgical patients: warm water vs warm air.
Hypothermia is experienced by 60% to 90% of adult patients after surgery. The detrimental physiological consequences of prolonged hypothermia are a significant risk for cardiac surgical patients. ⋯ The data suggest that rewarming with a circulating-water blanket produces normothermia more rapidly than rewarming with a warm convective-air blanket in adult patients who are hypothermic after cardiac surgery.
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Although sleep is important for physical and psychological health, no research has assessed the sleep of children in a pediatric ICU and the factors that affect sleep. ⋯ Patients in the pediatric ICU sleep significantly less than is normal for children of the same ages, and their patterns of sleep are seriously disturbed. Because noise, light, and contact with caregivers are significant predictors of sleep state, health professionals can use these findings to structure the environment and the care they give to promote the sleep of critically ill children.
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Comparative Study
Comparative study of bedside and laboratory measurements of hemoglobin.
The purpose of this study was to examine the effects of variations in technique on measurements of hemoglobin level done at the bedside and to compare these results with laboratory measurements of hemoglobin. ⋯ Bedside measurement of hemoglobin increases efficiency in patient care, decreases risk of blood-transmitted infection for staff, and decreases cost to the patient. However, the persons who perform the assay must be responsible in adhering to the standard of practice to minimize errors in the measurements.
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Acute pain is a significant problem in critical care patients. Although many barriers to successful assessment and management of pain in critical care patients have been noted, little is known about how critical care nurses make clinical judgments when assessing and managing patients' pain. ⋯ Many nurses' reports showed that they accurately assessed their patients' needs for analgesics. Through testing of and learning from their patients' responses, nurses were able to give amounts of analgesics that diminished patients' postoperative pain. Additionally, nurses had to balance analgesic administration against the patients' hemodynamic and respiratory conditions, medical plan and prescriptions, and the desires of the patients and the patients' families.