Nursing in critical care
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Nursing in critical care · Nov 2006
Retrospective analysis of renal transplantation outcomes in children admitted to a paediatric intensive care unit in Brazil.
Renal transplantation has been described as the main treatment for children with end-stage renal disease. Traditionally, infants and small children represented a high-risk group with poor allograft survival. However, studies conducted mainly in developed countries have been demonstrated improvements in allograft survival rates. ⋯ The occurrence of four or more complications was significantly associated with acute rejection (p= 0.009). In conclusion, the main outcomes of this study were similar to those observed in developed countries, in terms of acute rejections (52.3%), dialysis resumption (31.8%), graft loss (29.5%), chronic rejections (9.1%) and death (4.5%). Complications during PICU stay were significantly linked to the occurrence of acute rejection.
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Advances in medicine and changes in health care provision have resulted in increasingly innovative methods of delivering health care, such as the development of critical care outreach teams (CCOTs). These teams aim to respond to the needs of the critically ill patient, regardless of the patient's location within the acute hospital. The aim of this audit was to assess one aspect of the effectiveness of the Outreach team by examining the attitudes and opinions of the hospital clinical staff towards the outreach service provided. ⋯ In response to the findings, the number of hours per day in which the team operates has been increased. The findings demonstrated a belief by staff that the CCOT was instrumental in enhancing clinical care within the institution. While the findings of this audit are an informative addition to routine activity data, further studies are required to assess the acceptability of the service to patients and the impact of the service on patient outcomes.
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Nursing in critical care · Sep 2006
ReviewCorrecting arterial blood gases for temperature: (when) is it clinically significant?
Interpreting arterial blood gases (ABGs) is a common practice in intensive care units. The use of the temperature correction facility, however, is not standardized, and the effects of temperature correction on the ABG result may affect the overall management of the patient. ⋯ The alpha-stat and pH-stat methods of blood gas analysis are presented, with arguments for and against using the temperature correction facility for blood gas analysis. The study concludes with recommendations for practice.
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Nursing in critical care · Sep 2006
Review Case ReportsReflection on a patient's airway management during a ward-based resuscitation.
The bag-valve-mask (BVM) system is a common adjunct used during adult resuscitation to ventilate the lungs and deliver oxygen to patients in cardiopulmonary arrest. Gastric inflation, regurgitation and aspiration are well-documented complications of BVM ventilation, which can have serious consequences for patients. ⋯ Although the evidence, as presented, for a reduction in bag size is convincing, there appears to be a problem that less regular users do not appear to be able to produce effective tidal volumes when using a smaller bag. If a reduced bag size is standardized, further research using a diverse group of health care workers with the BVM is required before a clear policy can be achieved. It is likely that training and practice will be shown to be important for nursing staff expected to use the smaller BVM.
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Nursing in critical care · Sep 2006
Randomized Controlled TrialThe effect of music listening on older adults undergoing cardiovascular surgery.
The purpose of this study was to determine the effect of music listening on postoperative anxiety and intubation time in patients undergoing cardiovascular surgery. Coronary artery disease and valvular heart disease affect approximately 15 million Americans and 5 million persons in the U. K. annually, with the majority of these patients being older adults. ⋯ Differences in mean intubation time were measured in both groups. Older adults who listened to music had lower scores on the state anxiety test (F = 5.57, p = .022) and had significantly fewer minutes of postoperative intubation (F = 5.45, p = .031) after cardiovascular surgery. Older adults undergoing cardiovascular surgery who listen to music had less anxiety and reduced intubation time than those who did not.