Heart & lung : the journal of critical care
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Randomized Controlled Trial Multicenter Study Comparative Study
Nurse and patient characteristics associated with duration of nurse talk during patient encounters in ICU.
Communication interactions between nurses and mechanically ventilated patients in the intensive care unit (ICU) are typically brief. Factors associated with length of nurses' communication have not been explored. ⋯ Length of time the patient is intubated, and the patient's level of consciousness may influence duration of nurse communication in ICU.
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Comparative Study
A local risk prediction model for prolonged ventilation after adult heart valve surgery in a Chinese single center.
The aim of this study was to develop a logistic risk prediction model for prolonged ventilation after adult heart valve surgery. ⋯ We developed and validated a local risk prediction model for prolonged ventilation after adult heart valve surgery. This model can be used to calculate patient-specific risk by the logistic equation with an equivalent predicted risk at our center in future clinical practice.
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Case Reports
Phrenic nerve injury and diaphragmatic paralysis following pacemaker pulse generator replacement.
Diaphragmatic paralysis (DP) is a common condition. It can be unilateral or bilateral and the diagnosis is usually based on a clinical and radiological findings. ⋯ DP can be the result of various chest conditions that affect the phrenic nerve such as tumors, vascular abnormalities or traumatic incidents during surgery as well as blunt or penetrating chest or neck injuries. We report a unique case of phrenic nerve injury and unilateral diaphragmatic paralysis secondary to pacemaker pulse generator replacement that was successfully treated with diaphragmatic plication.
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Pressure ulcers and ventilator-associated pneumonia (VAP) are both common in acute and critical care settings and are considerable sources of morbidity, mortality, and health care costs. To prevent pressure ulcers, guidelines limit bed backrest elevation to less than 30 degrees, whereas recommendations to reduce VAP include use of backrest elevations of 30 degrees or more. Although a variety of risk factors beyond patient position have been identified for both pressure ulcers and VAP, this article will focus on summarizing the major evidence for each of these apparently conflicting positioning strategies and discuss implications for practice in managing mechanically ventilated patients with risk factors for both pressure ulcers and VAP.
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Comparative Study
Testing the prognostic value of the rapid shallow breathing index in predicting successful weaning in patients requiring prolonged mechanical ventilation.
The study objective was to assess the prognostic value of the rapid shallow breathing index (RSBI) in predicting successful weaning of patients from prolonged mechanical ventilation (PMV) in long-term acute care (LTAC) facilities. The RSBI predicts successful ventilator weaning in acutely ill patients. However, its value in PMV is unclear. ⋯ Although isolated RSBI measurements do not predict successful weaning from PMV, RSBI trends may have prognostic value.