Articles: intensive-care-units.
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Because ICU ventilators incorporate flow velocity measurement, cough peak expiratory flow (CPF) can be assessed without disconnecting the patient from the ICU ventilator. Our goal was to estimate the correlation between CPF obtained with the built-in ventilator flow meter (ventilator CPF) and CPF obtained with an electronic portable handheld peak flow meter connected to the endotracheal tube. ⋯ CPF measurements using a built-in ventilator flow meter were feasible in routine practice with cooperative ICU subjects who were intubated and correlated with CPF assessed by an electronic portable peak flow meter.
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Postgraduate medicine · Apr 2023
Randomized Controlled TrialPredictive value of arterial blood lactate to serum albumin ratio for in-hospital mortality of patients with community-acquired pneumonia admitted to the Intensive Care Unit.
To investigate the predictive value of the arterial blood lactate to serum albumin ratio (LAR) on in-hospital mortality of patients with community-acquired pneumonia (CAP) admitted to the Intensive Care Unit (ICU). ⋯ LAR could predict in-hospital mortality of patients with CAP admitted to ICU independently as a readily accessible biomarker. The nomogram that included LAR with other independent factors performed well in predicting in-hospital mortality.
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J Clin Monit Comput · Apr 2023
Observational StudyComparison of mainstream end tidal carbon dioxide on Y-piece side versus patient side of heat and moisture exchanger filters in critically ill adult patients: a prospective observational study.
The purpose of the study was to investigate the accuracy of mainstream EtCO2 measurements on the Y-piece (filtered) side of the heat and moisture exchanger filter (HMEF) in adult critically ill patients, compared to that on the patient (unfiltered) side of HMEF. We conducted a prospective observational method comparison study between July 2019 and December 2019. Critically ill adult patients receiving mechanical ventilation with HMEF were included. ⋯ In the Bland-Altman analyses, 95% limits of agreement between PaCO2 and EtCO2 were similar on both sides of HMEF (Y-piece side, - 8.67 to + 10.65 mmHg; patient side, - 8.93 to + 10.67 mmHg). The accuracy of mainstream EtCO2 measurements on the Y-piece side of HMEF was noninferior to that on the patient side in critically ill adults. Mechanically ventilated adult patients could be accurately monitored with mainstream EtCO2 on the Y-piece side of the HMEF unless their tidal volume was extremely low.
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Critical care nurse · Apr 2023
Implementing a Unit-Based Alarm Management Bundle for Critical Care Nurses.
Clinical alarms are designed to signal an unsatisfactory patient physiological state and alert staff members to malfunctioning medical equipment. Alarm desensitization and fatigue can occur when clinicians are exposed to an overwhelming number of clinical alarms, particularly nonactionable alarms. ⋯ The Joint Commission's 2022 goal of improving clinical alarm safety remains a top priority nationwide. Implementation of the CEASE alarm management bundle was effective in reducing surgical intensive care unit nurses' alarm fatigue and improving their alarm management practices.