American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Clinical Trial
Effects of a closed tracheal suction system on ventilatory and cardiovascular parameters.
To determine whether patients ventilated in the assist-control mode experienced a change in oxygenation, respiratory rate, inspiratory:expiratory ratio, heart rate, blood pressure or acid-base balance when suctioned with a closed tracheal suction system. ⋯ Subjects ventilated in the assist-control mode and suctioned with a closed tracheal suction system did not experience significant changes in cardiovascular or acid-base parameters when suctioned without hyperoxygenation. Although most subjects did not become desaturated, four subjects experienced desaturation at one or more intervals. To prevent desaturation, hyperoxygenation should be used before and after suctioning with a closed tracheal suction system.
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Decisions to withdraw life-sustaining therapy are being made more often as patients and healthcare providers increase their awareness of patient rights. The process of withdrawal of mechanical ventilation must be conducted in a humane fashion. An understanding of the ethical, legal and practical considerations for patient management during this type of intervention will enhance the ability of the healthcare provider to participate.
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To explore the relationships between parents' reactions to the pediatric intensive care unit admission of a child and characteristics of the child's illness. ⋯ Parents' reactions to their child's critical illness and admission to the pediatric intensive care unit were not related to characteristics of the child's condition in this small sample. Future research needs are suggested.
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To help the clinician bridge the gap between research and practice in determining ways to minimize side effects of endotracheal suctioning. ⋯ An algorithm to guide clinical decision making is presented based on the conclusions of this review of the research.
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Comparative Study Clinical Trial
Comparison of PT and aPTT values drawn by venipuncture and arterial line using three discard volumes.
Blood samples obtained through heparinized arterial catheters are used routinely for a variety of laboratory tests. Accuracy of coagulation studies performed from samples obtained in this fashion continues to be questioned, particularly in regard to the minimum discard volume necessary to clear the catheter of heparinized solution. ⋯ We recommend that when drawing prothrombin time and activated partial thromboplastin time samples from an arterial line, a 5.3-mL discard volume be used.