American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Randomized Controlled Trial Clinical Trial
The effect of earplugs on sleep measures during exposure to simulated intensive care unit noise.
Sleep deprivation may contribute to impaired immune function, ventilatory compromise, disrupted thermoregulation, and delirium. Noise levels in intensive care units may be related to disturbed sleep patterns, but noise reduction has not been tested in this setting. ⋯ The results provide a reasonable basis for testing the effects of earplugs on the sleep of critically ill subjects.
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Review Randomized Controlled Trial Comparative Study Clinical Trial
Effects of injectate volume on thermodilution measurements of cardiac output in patients with low ventricular ejection fraction.
To determine the effect of 5-mL injectate on cardiac output measurements in critically ill patients with low ventricular ejection fraction (< 35%). ⋯ Cardiac outputs measured with 5- and 10-mL injectates do not differ significantly. The greater variability of measurements obtained with a 5-mL injectate suggests that more measurements, and thus more time, are needed to measure cardiac output accurately. Clinicians must weigh the benefit of minimizing fluid volume used against the potential decreased reliability of cardiac output measurements.
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Randomized Controlled Trial Clinical Trial
Instillation of normal saline before suctioning in patients with pulmonary infections: a prospective randomized controlled trial.
To determine the effect of instillation of normal saline before suctioning on oxygen saturation, heart rate, and blood pressure in patients with pulmonary infections. ⋯ Instillation of normal saline before suctioning has an adverse effect on oxygen saturation and should not be used routinely in patients receiving mechanical ventilation who have pulmonary infection.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of transparent polyurethane and dry gauze dressings for peripheral i.v. catheter sites: rates of phlebitis, infiltration, and dislodgment by patients.
Before a meta-analysis by Hoffman et al was published, polyurethane dressings were used at insertion sites for peripheral i.v. catheters at our institution. On the basis of the results of the meta-analysis, we began to use gauze dressings. The change from polyurethane dressings to gauze dressings limited direct observation of the i.v. insertion site, and i.v. catheters were anecdotally reported not to be anchored as securely as before. ⋯ At our institution, given the decreased disruption of the i.v. therapy with the transparent polyurethane dressings and the lack of differences in the rates of phlebitis or infiltration with the two types of dressings, we prefer to use transparent polyurethane rather than gauze dressings at insertion sites for peripheral i.v. catheters.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Psychological factors and survival in the cardiac arrhythmia suppression trial (CAST): a reexamination.
Evaluating the independent effects of psychosocial and physiological factors on survival of cardiac patients is difficult because it requires obtaining extensive physiological and psychosocial data and long-term follow-up of high-risk patients. ⋯ Among patients who had asymptomatic ventricular arrhythmias after myocardial infarction, psychological status during the period after infarction contributed to mortality beyond the effect of physiological status. The results reaffirm the critical interrelationship between mind and body for cardiovascular health.