American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Lactate Level and Clearance as Predictors of Neurologic Outcome After Cardiopulmonary Resuscitation.
Cardiac arrest with subsequent cardiopulmonary resuscitation is common in emergency medicine and is often associated with an unfavorable neurologic outcome. Lactate level corresponds to the severity of tissue hypoxia and damage and thus could be useful in predicting neurologic outcome. ⋯ These results suggest that lactate and its clearance have an impact on neurologic outcome and can be used as prognostic biomarkers and in treatment decision-making in patients with cardiac arrest and successful resuscitation.
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Randomized Controlled Trial
Receptive Music Therapy for Patients Receiving Mechanical Ventilation in the Intensive Care Unit.
Live music therapy provided by a board-certified music therapist reduces anxiety, decreases pain, and improves the physiological response of patients in the intensive care unit (ICU). ⋯ Live music therapy significantly reduced agitation and heart rate in adult patients receiving mechanical ventilation in the ICU. These findings provide further evidence for the benefits of music therapy in the ICU, including in intubated patients.
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The COVID-19 pandemic has substantially affected health care professionals. Health care professionals have noted increased distress, psychiatric symptoms, and feelings of burnout during this time. Implementation of brief, easy-to-access psychosocial interventions might help health care professionals process stressful events, thus bolstering mental health. One such approach is the narrative expressive writing program, a 5-session cognitive behavioral writing intervention. ⋯ Preliminary data show that narrative expressive writing is an easy-to-access intervention that has the potential to decrease stress and depressive symptoms. Additional research on tailoring or augmenting the narrative expressive writing program may facilitate health care professionals' engagement and address other mental health domains (eg, burnout).
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Current guidelines recommend extubation only if a patient is not receiving vasopressor therapy or is receiving minimal doses of vasopressors. However, recent data indicate that extubation of patients receiving higher vasopressor doses may be safe. This study was undertaken to examine practices regarding extubation of patients receiving vasopressor therapy reported by clinician respondents to a survey by the Michigan Health and Hospital Association Keystone Center. ⋯ Practices regarding extubation of patients receiving vasopressor therapy differed significantly by unit type and by role as a direct care provider. These data indicate that patient and clinician factors may drive practice patterns. Additional research to inform guidelines and local protocols is warranted.