Articles: critical-care.
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Minerva anestesiologica · Dec 1994
[Survival in intensive care of patients with chronic obstructive bronchopneumopathy and acute respiratory failure undergoing mechanical ventilation. Retrospective study].
To collect valuable informations for the evaluation of the patients' clinical evolution and to perform a cost-effectiveness analysis on the utilization of resources in the management of patients with chronic obstructive pulmonary disease (COPD) undergoing mechanical ventilation (MV) for acute respiratory failure (ARF). ⋯ Our results demonstrate that hospital outcome in COPD patients with ARF requiring mechanical ventilation is quite good. Prolonged mechanical ventilation and--severity of underlying chronic respiratory disease do not affect significatively the prognosis. The high costs of the treatment of these patients are counterbalanced by a good efficiency of utilization of resources and appreciable clinical results.
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Ned Tijdschr Geneeskd · Nov 1994
Clinical Trial Controlled Clinical Trial[Results of long-term intensive care in 223 patients].
To determine survival rates of patients treated for more than 30 days in an intensive care unit (ICU). ⋯ Patients who needed more than 30 days ICU treatment had a high ICU mortality; 2 months after discharge 75% were alive.
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Few studies have comprehensively focused on caring as perceived by the critical care family. This study explores and describes positive types of nurses' behaviors and critical care families' perceptions of these nursing behaviors as caring. Grounded theory methodology was used to enter the world of the critical care family and to elicit the meanings of caring behaviors in nurse-family interactions in the critical care waiting room.
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To describe the conflict that occurs during the process of consenting to do-not-resuscitate (DNR) status and the strategies used by critical care nurses to attempt to prevent, minimize, and/or resolve these conflicts. ⋯ Critical care nurses play an active role in assisting patients and families with DNR-status decisions. To better understand the process of consenting to DNR status, additional studies need to focus on the experiences of patients, families, and other health care providers.
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The effect of a do-not-resuscitate order on the standard of care of critically ill patients is of concern to practitioners, patients, and their families. Because "do not resuscitate" may be misconstrued to include more than "no cardiopulmonary resuscitation," it may influence the aggressiveness with which some patients are managed. Nurses play a central role in determining standards of care. Hence, confusion on their part as to the meaning of this term can have a significant impact on patient care. ⋯ Our findings suggest that "do-not-resuscitate" may be misinterpreted to include more than "no cardiopulmonary resuscitation" even if the patient is receiving aggressive medical management. Misinterpretation of orders not to resuscitate may be related to a variety of factors including lack of understanding about hospital policy and ethical and moral values of the staff. We suggest replacing orders such as "Do not resuscitate" with clearly defined resuscitation plans that are jointly determined by the multidisciplinary team, patient, and family.