American journal of critical care : an official publication, American Association of Critical-Care Nurses
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To test an alternative flexible approach to traditional fixed intermediate and intensive care to minimize transfers of patients. ⋯ In a community teaching hospital, flexible care policies decreased the number of in-hospital transfers of patients treated with mechanical ventilation.
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The most frequently recommended methods to assess for pulmonary aspiration of enteral formula in intubated, tube-fed patients are (1) adding dye to enteral formulas and observing for dye-stained tracheal secretions and (2) testing tracheal secretions with glucose oxidase reagent strips to detect the presence of glucose-rich formula. Reportedly, the glucose method is more sensitive than the dye method, and the dye method may have greater potential for harm. It is not known if this information has resulted in wider use of the glucose method in practice settings. ⋯ The dye method is used far more often than is the glucose method. Two probable reasons are that the dye method is easier to implement, and it is recommended in commonly used basic nursing textbooks.
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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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Clinical Trial Controlled Clinical Trial
Stress during mechanical ventilation: benefit of having concrete objective information before cardiac surgery.
Negative emotional reactions and difficulty in communicating are common in patients receiving mechanical ventilation and may adversely affect recovery from cardiac surgery. ⋯ Nursing interventions that include concrete objective information help cardiac patients cope with the stresses associated with surgery and mechanical ventilation.