American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial
A simplified score for transfer of patients requiring mechanical ventilation to a long-term care hospital.
Long-term care hospitals are Medicare providers of postacute care that have a mean length of stay of 25 days or more. Early identification and timely transfer of patients requiring mechanical ventilation to such hospitals may improve the efficiency of inpatient care. ⋯ Efforts to aid discharge decision making and optimize hospital resource planning could take advantage of our predictive model and the simplified scoring tool.
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Randomized Controlled Trial
Daily interruption of sedation in patients receiving mechanical ventilation.
Daily interruption of continuous infusion of sedatives has improved outcomes in patients receiving mechanical ventilation in open-label studies. ⋯ The double-blinded design for assessment of sedation interruption in patients receiving mechanical ventilation was safe and effective. Slow recruitment of patients and frequent noncompliance with the protocol suggest that modifications to the protocol are needed.
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Randomized Controlled Trial
Evaluation of an intervention to maintain endotracheal tube cuff pressure within therapeutic range.
Endotracheal tube cuff pressure must be kept within an optimal range that ensures ventilation and prevents aspiration while maintaining tracheal perfusion. ⋯ The intervention was effective in maintaining cuff pressure within an optimal range, and cuff pressure decreased over time without intervention. The effect of the intervention on outcomes such as ventilator-associated pneumonia and tracheal damage requires further study.
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Randomized Controlled Trial
Decrease in frequency of liquid stool in enterally fed critically ill patients given the multispecies probiotic VSL#3: a pilot trial.
Diarrhea has adverse consequences for critically ill patients, health care staff, and health care costs. ⋯ VSL#3 was effective in reducing the frequency of liquid stool in critically ill patients receiving enteral nutrition. Probiotics possibly can minimize diarrhea in critically ill tube-fed patients, but more controlled clinical trials are needed.
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Randomized Controlled Trial Multicenter Study
Clinical predictors of duration of action of cisatracurium and rocuronium administered long-term.
The duration of action of neuromuscular blocking drugs (NBDs) varies between individuals and even within individuals in different settings. ⋯ Duration of NBD treatment is strongly predictive of the duration of action of rocuronium, and body temperature is predictive of the duration of action of cisatracurium. These data may help decrease the incidence of drug-induced muscle weakness in recovery rooms and surgical intensive care units, particularly if neuromuscular transmission monitoring is not available.