Heart & lung : the journal of critical care
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Randomized Controlled Trial Clinical Trial
Endotracheal suctioning in adults with head injury.
The purpose of this study was to determine the method of endotracheal suctioning (ETS) that resulted in the least compromise to the cerebrovascular status of adult patients with severe head injuries. A two-group (two vs three ETS), two-protocol (100% tidal volume [VT] vs 135% VT) design was used. The dependent variables were mean intracranial pressure (MICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), heart rate (HR), and oxygen saturation (SaO2). ⋯ No significant difference was found for SaO2 for either of the protocols regardless of number of suction passes. No significant differences were found between two- and three-ETS groups for any of the dependent variables. All groups, however, regardless of number of suction passes, demonstrated a cumulative increase in MICP, MAP, and CPP with each consecutive suction sequence.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Effect of lung hyperinflation and endotracheal suctioning on heart rate and rhythm in patients after coronary artery bypass graft surgery.
We examined the effect of lung hyperinflation and suction on PaO2, heart rate, and rhythm in patients after coronary artery bypass graft surgery (N = 26). Three lung hyperinflation breaths, at one of five randomly ordered volumes (tidal volume, 12 cc/kg, 14 cc/kg, 16 cc/kg, or 18 cc/kg of lean body weight) were delivered, by a ventilator (fraction of inspired oxygen 1.0), followed by 10 seconds of continuous suction. Lung hyperinflation and suctioning were repeated three times. ⋯ The majority of rhythm changes for lung hyperinflation and suctioning were from normal sinus rhythm to sinus tachycardia. Suction was associated with a greater incidence of rhythm (53.9%) and arrhythmia (80.8%) changes. The most frequent arrhythmia was premature atrial contraction.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of normal saline and heparin solutions for maintenance of arterial catheter patency.
A double-blind, randomized study was conducted in 30 adult medical intensive care unit patients to determine if the presence of heparin in continuous-flush solutions prolongs the functional life span of radial arterial catheters compared with catheters flushed with solutions not containing heparin. Patients were consecutively entered into the study and randomly assigned to receive arterial line flush solutions containing 0.9% sodium chloride (NSS) or heparin 4 U/ml in 0.9% sodium chloride. ⋯ In addition, the heparin-flushed catheters required significantly less manipulation to prevent catheter occlusion and arterial pressure-wave dampening (p less than 0.01). The use of NSS as a continuous flush for radial artery catheters is associated with an increased frequency of catheter occlusion and malfunctions compared with solution containing heparin, and thus is not recommended in patients with normal coagulation status and platelet count.
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Randomized Controlled Trial Clinical Trial
Electrode site preparation techniques: a follow-up study.
A posttest-only control group design was used to study the effect of electrode site preparation techniques on reducing electrical potential across a pair of disposable skin electrodes. One hundred twenty healthy volunteers were randomly assigned into one control and three treatment groups of 30 subjects each. The three treatments were One Step Skin Prep used once, ECG Prep Pad used five times, and ECG Prep Pad used once. ⋯ Skin preparation done by using One Step Skin Prep or the ECG Prep Pads used once significantly decreased skin potentials by 2.3 mV and 3.3 mV respectively. There was no significant difference in the control group and the group in which ECG Prep Pads were used five times. These findings extend the knowledge of techniques available to reduce the amount of noise (electrical potential) in physiologic measurement using skin electrodes.
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Randomized Controlled Trial Clinical Trial
Improving family functioning after cardiac surgery: a randomized trial.
As part of a randomized clinical trial of in-hospital and postdischarge nursing interventions designed to facilitate the individual patient's recovery and improve the family's functioning after cardiac surgery, we followed 67 patient-spouse pairs for 6 months after surgery. Family health was appraised by using three pencil and paper measurements: the Family APGAR, the Locke-Wallace Marital Adjustment Scale, and the Family Inventory of Resources for Management. Mixed-effects analysis of variance did not detect differences for the main effect of intervention group; however, the main effect of time was significant for both patients' and spouses' APGAR scores and for patients' Marital Adjustment Scale scores, suggesting a pattern of response during recovery from cardiac surgery.