Nursing in critical care
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Nursing in critical care · Sep 2008
ReviewThe LoTrach system: its role in the prevention of ventilator-associated pneumonia.
To discuss the development of the LoTrach system in light of current evidence around the prevention of ventilator-associated pneumonia (VAP) and its practical application in the intensive care setting. ⋯ The LoTrach system has been designed to facilitate the provision of a number of evidence-based interventions that have been shown to reduce VAP. Pulmonary aspiration is ubiquitous with conventional cuffs but prevented by the cuff of the LoTrach system when held at a constant and safe pressure against the tracheal wall with a cuff pressure controller. Other aspects incorporated in the ETT are aimed at clearing the secretions from the subglottic space, preventing tube occlusion and accidental extubation, and avoiding damage to the airway. In this way the LoTrach system employs a multifactorial approach to the prevention of VAP and the cost savings from LoTrach rather than a standard ETT will be considerable because of an average 3 day reduction in ICU length of stay related to this. It thus has the potential to be a very useful tool in the ICU setting in the prevention of VAP.
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Nursing in critical care · Sep 2008
Asymmetry in the intensive care unit: redressing imbalance and meeting the needs of family.
The purpose of this study was to develop a way for nurses to understand how they negotiate and work with families in the intensive care unit (ICU). ⋯ Positive steps to redress asymmetrical relationships can help ensure that family care is better integrated into ICU practice.