Articles: critical-care.
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Spinal cord injuries create alterations in ventilatory mechanics that range from complete ventilator dependence in high cervical injuries to the need for an assisted cough to clear secretions in low thoracic injuries. The initial nursing assessment should include the degree of respiratory muscle impairment, the effectiveness of the patient's inspiratory efforts, and the ability to cough. ⋯ Perhaps the greatest challenge for both the nurse and the patient is weaning from mechanical ventilation. Weaning requires a coordinated plan, based on trust between patient and nurse, in order to achieve maximum independence from ventilatory support.
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Wien. Klin. Wochenschr. · Aug 1990
[Percutaneous cannulation of the radial artery in severely ill premature and newborn infants].
Cannulation of the radial artery is an easy and safe alternative to the usual procedure of catheterization of the umbilical artery to secure blood for gas sampling and for monitoring blood pressure in critically ill neonates. The use of a fiberoptic light source further improves the success of percutaneous radial artery cannulation. We performed this procedure in 264 critically ill babies and it was successful in 211 (80%). ⋯ No case of bacterial infection due to cannulation was observed. No neurological disturbance in hand or finger function was found on follow up after one year. In conclusion, this method is safe, easy to handle, has less complications and several advantages over previous methods.