American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Although many patients with chronic obstructive pulmonary disease (COPD) require a prolonged length of stay (PLOS) following coronary artery bypass grafting (CABG), the impact of PLOS on long-term survival has not been examined in this population. ⋯ COPD and PLOS are 2 of many factors that affect long-term mortality in postoperative CABG patients. Aggressive treatment strategies aimed at early weaning off of mechanical ventilation and prevention of reintubation among COPD patients must be considered carefully as a means to reduce length of stay after CABG. Our results also have important implications for the long-term management of these patients and strategies for containing costs over the life course of the patient.
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Observational Study
Stimulation of Critically Ill Patients: Relationship to Sedation.
To describe the number and type of stimulation events and the relationship of stimulation to sedation level in patients receiving mechanical ventilation. ⋯ Critically ill patients receiving mechanical ventilation are subjected to various forms of auditory and tactile stimulation frequently throughout the day. All types of stimuli increased arousal in patients who were more deeply sedated. The effect of stimulation in patients who were not deeply sedated was minimal and inconsistent.
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More than 55 000 children die annually in the United States, most in neonatal and pediatric intensive care units. Because of the stress and emotional turmoil of the deaths, the children's parents have difficulty comprehending information. ⋯ Death of a child is a time of high stress when parents' concentration, hearing, and information processing are diminished. Many parents have misconceptions about the cause of the death 1 month after the death.
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Measurement of oxygen consumption (Vȯ2) is difficult in children but is essential to calculate cardiac index and systemic vascular resistance. ⋯ Measurements of Vȯ2 did not differ between mass spectrometry and the breath-by-breath method. Use of the breath-by-breath method may facilitate calculation of cardiac index and systemic vascular resistance in critically ill children.