Heart & lung : the journal of critical care
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Randomized Controlled Trial Clinical Trial
Duration of action of a single, early oral application of chlorhexidine on oral microbial flora in mechanically ventilated patients: a pilot study.
The purpose of this study was to describe the effect of an early post-intubation oral application of chlorhexidine gluconate on oral microbial flora and ventilator-associated pneumonia. ⋯ Trends in the data suggest that use of chlorhexidine gluconate in the early post-intubation period may mitigate or delay the development of ventilator-associated pneumonia.
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Comparative Study
Descriptors of dyspnea by patients with chronic obstructive pulmonary disease versus congestive heart failure.
The purpose of this study was to determine whether differences existed between reports of dyspnea in stable chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) subjects. ⋯ Stable COPD and CHF patients use and recognize a variety of terms that describe their breathing distress. There was, however, only 1 unique term among the endorsed and volunteered terms, and that was among the COPD subjects. COPD and CHF subjects shared many common terms and also experienced dyspnea with similar frequency. The uniqueness of terms among the COPD group was less clear. The study highlights the variability of the dyspnea experience among COPD and CHF patients and the potential difficulty identifying unique dyspnea terms in these subjects.
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The purpose of this study was to investigate patients' perceptions of the effectiveness of a pain management regimen, which consisted of intermittent prn bolus doses of morphine, in a critical care unit after cardiac surgery. ⋯ Overall, the majority of participants were reasonably satisfied with their pain experience. However, the following areas need improvement: the assessment and management of pain in relation to gender and age differences and the type of graft/s used; the administration of morphine before activity; and the communication of pain experience by patients.
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Case Reports
SAM-systolic anterior motion of the anterior mitral valve leaflet post-surgical mitral valve repair.
Systolic anterior motion (SAM) is a postoperative complication experienced by patients undergoing mitral valve repair. The incidence of SAM after mitral valve repair ranges from 5 to 10%. ⋯ This article's main focus is the detection and management of SAM and the most current treatment modalities. A case study is used to illustrate the complex management necessary for the patient with SAM.