Articles: critical-care.
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Caring for the cardiac surgery patient includes intervening with the patient's family members. It is important for the nurse to acquire the knowledge base to implement appropriate interventions with family members. ⋯ A visiting intervention checklist was given to each nurse to initiate for each family member at all visits. Family members who received the intervention program reported higher satisfaction of needs and lower anxiety levels than those family members who did not receive the program.
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Helvetica chirurgica acta · Oct 1990
[Serial rib fractures: a differentiated treatment concept, illustrated by 59 severely injured intensive care patients].
In a group of 59 consecutive ICU trauma patients with blunt chest injury and considerable injury severity (ISS = 29) a three-staged therapeutic approach was followed, depending seriousness of chest injury, overall injury severity and age. Stage 1: i.v. analgesia and conventional respiratory therapy. ⋯ Only 44% of the patients needed intubation, and none died. The authors recommend this three-step approach towards blunt chest injury and serial rib fractures.
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In patients with multiple injuries, the development of permeability edema can be assumed. However, no uniform shape of this fluid accumulation can be found even in the presence of severe injuries. Based on the first clinical observations, our aim was to search for correlations between the development of extravascular lung water (EVLW) and the individual injury pattern in severely traumatized ICU patients. ⋯ Increase of EVLW at a later time (day 7), as observed in groups B and C, is possibly the expression of a mediator and activator-induced "septiformal" injury of the microvascular endothelium. This may be caused by the underlying massive peripheral soft-tissue trauma. Specific elevations of EVLW subsequent to the individual injury pattern can indicate that that process has begun and is responsible for the origin of the microvascular injuries.