Nursing research
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Randomized Controlled Trial Clinical Trial
The effect of lung hyperinflation and endotracheal suctioning on cardiopulmonary hemodynamics.
The purpose of this study was to examine the effect of sequential lung hyperinflation breaths followed by suction on mean arterial pressure (MAP), cardiac output (CO), pulmonary artery pressure (PAP), and pulmonary airway pressure (Paw) to elucidate the mechanism for the increase in MAP seen with lung hyperinflation and suction. Thirty-four postoperative coronary artery bypass graft patients were randomly exposed to three lung hyperinflation breaths at one of five volumes (tidal volume, 12cc/kg, 14cc/kg, 16cc/kg, and 18cc/kg of lean body weight) using a ventilator followed by 10 s of suctioning repeated for a total of three times. There was a mean increase in MAP (13.71 torr), CO (12.2%), PAP (4 torr), and Paw (23.5 torr) above baseline over the three sequences. The mechanism for the increase in MAP with lung hyperinflation may be attributed to transient increases in intrathoracic pressure, resulting in increased left ventricular preload and CO.
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The primary research literature on cocaine abuse in pregnancy from 1982 to 1989 was reviewed. This article is a synthesis of current knowledge regarding the effects of maternal cocaine use during pregnancy on obstetrical, neonatal, and infant health and developmental outcomes. Consistencies and inconsistencies in the findings, a critique of key methodological issues, and suggestions for future research are provided.
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Comparative Study
Comparison of tympanic and oral temperatures in surgical patients.
The purpose of this study was to compare tympanic and oral temperatures at four times during the perioperative period in 60 adults having major abdominal surgery. Tympanic temperature was measured with an infrared thermometer and oral temperature with a predictive thermistor thermometer. Measurements at the two sites were similar in pattern and moderately well correlated. ⋯ The tympanic-oral temperature offset was relatively stable over time, with tympanic readings having a smaller range of values at each measurement. Tympanic temperature measurement variation was fairly small, with 92% of readings reproducible within 0.5 degree F (0.3 degree C); comparable oral data were not available. The findings suggest that the tympanic site offers some advantage, but that either tympanic or oral readings would be satisfactory for routine intermittent monitoring of body temperature during the perioperative period.