Heart & lung : the journal of critical care
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In this time series design study we investigated the effects of conversation on intracranial pressure (ICP). Two conversation types were used, and continuous measurements of ICP were recorded. Type 1 conversation was an emotionally referenced conversation that reflected an actual nursing report on the patient's current condition. ⋯ There was, however, a statistically significant decrease in ICP when minimum ICP measurements before type 2 conversations were compared with measurements recorded during type 2 conversation. The data also demonstrated a wide variation of individual patient responses. The results of the current study suggest that the direction of influence from conversation on the ICP is individual and may be influenced greatly by the patient's level of consciousness.
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This within-subject study compared the effects of hyperinflations with 20% above maintenance oxygen (O2) level and 100% O2 hyperinflations before and after endotracheal suction in 11 acutely ill patients with chronic obstructive pulmonary disease. Four hyperinflations were delivered at 1.5 times the calculated tidal volume (10 ml/kg) with 100% O2 or 20% above maintenance O2 level via resuscitator bag, followed by 10 seconds of continuous endotracheal suctioning. This sequence was repeated three times. ⋯ There was no change in heart rhythm for any of the subjects. The results of this study suggest that hyperinflation with 20% above maintenance O2 level can be used for oxygenation in patients with chronic obstructive pulmonary disease before and after endotracheal suctioning. Replication is needed before clinical implementation.
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The pediatric intensive care unit (PICU) hospitalization of a child is stressful for parents. Helping parents to decrease their stress is warranted so that they can function in the vital role that is therapeutic to them and their critically ill child. Many parent-supportive nursing interventions have been recommended but none has been tested in the clinical setting. ⋯ The experimental group participated in the NMPMC, designed to be supportive to and guided by the perceived individual needs of each parent. The dependent measure was the Parental Stressor Scale: Pediatric Intensive Care Unit administered within 24 to 48 hours of PICU admission, every 48 hours thereafter, and 24 hours after PICU discharge. The results indicate that the NMPMC is helpful in alleviating parental stress, specifically the stress related to interruption in the parent-child relationship, in the PICU setting.
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Heparinized arterial catheters are commonly used in critically ill patients to monitor pressures and to collect blood for laboratory analysis. To remove the heparinized fluid used to keep these lines patent large volumes of blood are often withdrawn and discarded or calculations of tube volume must be made. Repeated violation of stopcocks may lead to contamination and infection of arterial lines. ⋯ The average arterial PT was 0.12 seconds less than venous control and the average arterial aPTT was 0.49 seconds greater than control. Neither of these differences was significant. We conclude that this type of high-pressure tubing allows accurate blood samples to be obtained from arterial lines without the necessity of precise calculations or blood wastage.