American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial
Effect of continuous display of cerebral perfusion pressure on outcomes in patients with traumatic brain injury.
Clinical bedside monitoring systems do not provide prominent displays of data on cerebral perfusion pressure (CPP). Immediate visual feedback would allow more rapid intervention to prevent or minimize suboptimal pressures. ⋯ The presence of a highly visible display of CPP was associated with significantly better odds of survival and overall condition at discharge.
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Randomized Controlled Trial Comparative Study
Intensive versus modified conventional control of blood glucose level in medical intensive care patients: a pilot study.
Critically ill postsurgical patients fare better with intensive control of blood glucose level. The link between glucose control and outcome is less well studied for medical intensive care patients. Whether intensive glucose control requires additional staffing is unclear. ⋯ Target levels for blood glucose were achieved with both protocols. Severe hypoglycemia was rare and uncomplicated regardless of type of glucose control. Additional staffing may be needed for intensive glucose control.
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Randomized Controlled Trial Clinical Trial
Randomized trial of an intensive care unit-based early discharge planning intervention for critically ill elderly patients.
Few investigators have targeted elderly patients and monitored outcomes of care in studies on discharge planning interventions after critical illness. ⋯ Intensive care unit-based early discharge planning can affect elderly patients' preparation for discharge.
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Randomized Controlled Trial Clinical Trial
Appropriately timed analgesics control pain due to chest tube removal.
Pain during chest tube removal can be moderately to severely intense and distressful to patients. Little evidence-based research has guided clinicians in attempts to alleviate such pain. ⋯ If used correctly, either an opioid (morphine) or a nonsteroidal anti-inflammatory (ketorolac) can substantially reduce pain during chest tube removal without causing adverse sedative effects. Thus, clinicians may choose among several safe and effective analgesic interventions during chest tube removal.
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Randomized Controlled Trial Clinical Trial
Endotracheal suctioning with or without instillation of isotonic sodium chloride solution in critically ill children.
Instillation of isotonic sodium chloride solution for endotracheal tube suctioning is controversial. Research has focused on the effect of such instillation in adults; no studies in children have been published. ⋯ Results of this study support a growing body of evidence that instillation of isotonic sodium chloride solution during endotracheal tube suctioning may not be beneficial and actually may be harmful.