American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Shivering following cardiac surgery: predictive factors, consequences, and characteristics.
Shivering is common after cardiac surgery and may evoke harmful hemodynamic changes. Neither those changes nor factors increasing probability of shivering are well defined. ⋯ These results suggest that true shivering occurs after cardiac surgery. Skin, but not core, temperature and elevated heart rate predict shivering. Shivering may be more likely in hemodynamically unstable patients.
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Comparative Study
Perceptions of collaborative practice between Navy nurses and physicians in the ICU setting.
Despite strong evidence for the benefits of collaborative practice between nurses and physicians, this model remains the exception rather than the rule. ⋯ Navy ICU nurses and physicians perceived that they were involved in collaborative practice behavior at a moderate level. Physicians, however, reported perceiving collaborative practice to a greater extent than did nurses. Further research, in different populations, is required to test the theorized constructs of the instruments used to measure perceptions of collaborative practice behavior in this study.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of position on selected hemodynamic parameters in postoperative cardiac surgery patients.
Indirect/noninvasive blood pressure, heart rate and central venous pressure are frequently monitored hemodynamic parameters in postoperative cardiac surgery patients. No previous studies have explored the effect of lateral position on these variables in this population. ⋯ Lateral positioning of postoperative cardiac surgery patients appears to cause no detrimental effects on indirect/noninvasive blood pressure or heart rate measurements. However, significant differences in central venous pressure may occur and supine positioning for determination of central venous pressure is recommended.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of two dosing regimens of intravenous ranitidine on gastric pH in critically ill children.
Gastric bleeding in children is associated with critical illness, shock, and physical trauma. Histamine-2 receptor antagonist therapy is used prophylactically to treat gastric bleeding, but it is not known whether bolus dosing or continuous infusion dosing is more effective. ⋯ Both bolus dosing and continuous infusion dosing of 4 mg/kg per day of intravenous ranitidine were effective at raising and maintaining gastric pH in critically ill children.
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Clinical Trial
Differences in end-tidal carbon dioxide and breathing patterns in ventilator-dependent patients using pressure support ventilation.
Although several investigators have assessed the effects of pressure support ventilation on tidal volume and breathing patterns, none have investigated the combination of breathing patterns and end-tidal carbon dioxide in ventilator-dependent patients. ⋯ Pressure support ventilation prevents asynchronous chest and abdominal movement and lowers the level of end-tidal carbon dioxide. Pressure support ventilation offers clinicians a way to lower the elevated carbon dioxide level that often occurs in critically ill patients. Increasing tidal volume and reducing the work of breathing by using pressure support ventilation may reduce diaphragm fatigue in ventilator-dependent patients.