Articles: critical-illness.
-
We analyzed the adequacy of pain control for 17 trauma patients during the initial part of their stay in the intensive care unit, and assessed reasons for inadequate analgesia, if it occurred. Patients, and physicians, and nurses were interviewed. A verbal pain intensity scale was used to determine whether patients received adequate analgesia. ⋯ Nurses administered less than the maximum amount ordered 58% of the time. The mean dosing interval was 2.3 hours. Barriers to adequate pain management were disparity in the perception of pain between patients and caregivers; patients not requesting more analgesia despite despite the presence of moderate to severe pain; and physician and nurse concerns about patients' adverse physiologic response to increased dosages.
-
Critical care medicine · Aug 1995
Randomized Controlled Trial Clinical TrialEffect of erythromycin on gastric motility in mechanically ventilated critically ill patients: a double-blind, randomized, placebo-controlled study.
To document the action of erythromycin on gastric emptying and motility in mechanically ventilated patients. ⋯ In mechanically ventilated patients, intravenous erythromycin (200 mg over 30 mins) increases indices of antral motility and accelerates gastric emptying as assessed by the kinetics of acetaminophen absorption.
-
Minerva anestesiologica · Jul 1995
Comparative Study[Comparison of bench central and mixed pulmonary venous oxygen saturation in critically ill postsurgical patients].
To investigate if there were differences between bench central oxygen saturation (ScvO2) and mixed venous oxygen saturation (SvO2) in a group of acutely ill postsurgical patients. ⋯ SvO2 cannot be predicted well from bench ScvO2, nor changes in ScO2 can be predicted wel from changes in bench ScvO2. Therefore, in this category of patients, the clinical usefulness of monitoring bench ScvO2 is strongly limited and we must still rely on the SvO2.
-
This study was undertaken to assess any salivary aspiration in seriously ill patients with tracheostomies in an Intensive Care Unit setting. The alpha-amylase activity in the tracheostomies in an Intensive Care Unit setting. The alpha-amylase activity in the tracheobronchial secretions of 15 such patients were analysed to evaluate the incidence of salivary aspiration. ⋯ The other nine patients showed a low level of amylase activity in their secretions. Two patients in the latter group developed severe pulmonary disease. This study demonstrates that a high level of alpha-amylase activity in the tracheobronchial secretions of tracheotomized, ventilated patients indicates that salivary aspiration may be taking place, and further suggests that progressively increasing levels may indicate the likelihood of a major pulmonary complication developing.