American journal of critical care : an official publication, American Association of Critical-Care Nurses
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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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Nurse-led rounding checklists are a common strategy for facilitating evidence-based practice in the intensive care unit (ICU). To streamline checklist workflow, some ICUs have the nurse or another individual listen to the conversation and customize the checklist for each patient. Such customizations assume that individuals can reliably assess whether checklist items have been addressed. ⋯ Using a paper-based assessment tool, a single trained critical care nurse can reliably assess the discussion of elements of the ABCDEF bundle during multidisciplinary rounds.
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Up to 80% of pediatric intensive care unit (PICU) patients experience new morbidities upon discharge. Patients and families rely on clear communication to prepare for post-PICU morbidities. ⋯ Most parents and physicians reported having prognostic conversations, primarily about post-PICU physical morbidities. More than half of parents wanted more information about potential post-PICU morbidities. More research is needed to understand how and when medical professionals should have prognostic conversations with parents.
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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.