Articles: critical-illness.
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Elderly patients who enter the critical care setting have special nursing care needs based on the physiologic changes of aging. An overview of the changes of aging associated with the immunologic, cardiovascular, integumentary, musculoskeletal, and renal systems provides the basis for care planning to meet the needs of older adults in the intensive care unit.
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AACN Clin Issues Crit Care Nurs · Feb 1992
Adverse psychologic responses of the elderly to critical illness.
Afflicting as many as 80% of critically ill elderly (older than 65 years) patients, adverse psychologic reactions (e.g., acute confusional states) to critical illness and its treatment present a unique challenge to medical and nursing intensive care practitioners. Additionally, the consequences of these adverse psychologic reactions financially strain health-care organizations, placing additional constraints on the delivery of health-care services. This article presents information regarding the origins of these adverse psychologic reactions and nursing strategies for the prevention, identification, and management of these clinical states. With such information, nurses who work in critical care units may be better equipped to identify and care for patients at risk of or experiencing an adverse psychologic reaction to critical illness.
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To provide up-to-date practical information, relevant to Australian conditions and practice, on stabilising the condition of critically ill children who need transport to a paediatric hospital. ⋯ A recent study found that 47% of 100 children who needed emergency interhospital transfer experienced problems which should have been preventable by greater availability to referring doctors of information on pretransport stabilisation of critically ill children. Hypoventilation, hypoxaemia and hypotension are commonly found in critically ill children before transport, as are difficulties with endotracheal tube care, sedation and analgesia. Mild physiological disturbances are likely to become severe and life-threatening during transfer unless they are corrected before departure. Early discussion of the child's problems and the transfer plan with senior staff at the nearest paediatric intensive care unit may be helpful in planning the pre-transfer resuscitation.
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Intensive care medicine · Jan 1992
Tidal volume, breathing frequency, and oxygen consumption at different pressure support levels in the early stage of weaning in patients without chronic obstructive pulmonary disease.
The objective of this study was to evaluate the influence of different PSV levels on VT, F, VO2 in the early weaning phase of patients without chronic obstructive pulmonary disease. These parameters were tested for the predictive power for the success of the weaning. Patients on SIMV were studied during the first weaning attempt with PSV. ⋯ Responders and nonresponders could be separated by the response of VO2, VT and F to a change in PS 10 to PS 20 cmH2O. Patients who significantly increased VT and significantly decreased F did not fulfil our weaning criteria. Our responders did not show a significant change in these two parameters, but a significant increase in VO2 at PS 20 cmH2O could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Intensive care medicine · Jan 1992
Randomized Controlled Trial Clinical TrialPrevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract. A randomized, double blind, placebo-controlled study.
To evaluate the effect of a method of Selective Decontamination of the Digestive Tract (SDD) on colonization, nosocomial infection (NI), bacterial resistance, mortality and economic costs. ⋯ colonization by gram-negative bacilli, NI and the mortality related to it can be modified by SDD. Continuous bacteriological surveillance is necessary.