American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study Clinical Trial Controlled Clinical Trial
ST segment monitoring with a derived 12-lead electrocardiogram is superior to routine cardiac care unit monitoring.
Prior studies have shown that a derived 12-lead electrocardiogram with a simple electrode configuration is comparable with the standard electrocardiogram for arrhythmia analysis. ⋯ The findings show that derived 12-lead ST monitoring is superior to routine monitoring of leads V1 and II for detecting transient myocardial ischemia. ST monitoring of the derived 12-lead electrocardiogram may identify high-risk patients with unstable angina and provide prognostic information that would not be otherwise available from the usual clinical measures.
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Comparative Study
Endotracheal suctioning: ventilator vs manual delivery of hyperoxygenation breaths.
Despite a large number of studies on endotracheal suctioning, there is little data on the impact of clinically practical hyperoxygenation techniques on physiologic parameters in critically ill patients. ⋯ Using techniques currently employed in clinical practice, these findings support the use of the patient's ventilator for hyperoxygenation during suctioning.
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Randomized Controlled Trial Clinical Trial
Effects of interpleural bupivacaine on pleural chest tube removal pain: a randomized controlled trial.
Moderate to severe pain associated with the removal of pleural chest tubes is poorly controlled with opioids. New methods are needed to manage the pain associated with this procedure. ⋯ These data demonstrate that chest tube removal pain is of moderate to severe intensity and that pleural chest tube injections of bupivacaine were not effective in decreasing chest tube removal pain. However, the decrease in pain associated with the administration of ketorolac warrants future study.
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Randomized Controlled Trial Clinical Trial
Effect of lateral position on arterial and venous blood gases in postoperative cardiac surgery patients.
Investigators have suggested that lateral position may have clinically significant effects on oxygenation in cardiac surgery patients. Presence of lung disease and type of cardiac surgery may be important considerations. ⋯ The results of this study support those of previous research, which reported lower PaO2 in postoperative coronary artery bypass graft patients in the left lateral position. Mean differences in PaO2 were small, suggesting that the known benefits of lateral positioning in the early postoperative period outweigh the potential risks.
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A range of neuro-cognitive sequelae, from mild intellectual impairments to brain death, have been reported in survivors of aborted sudden cardiac death. ⋯ Our results suggest that half of the long-term survivors of aborted sudden cardiac death are cognitively intact 6 months after resuscitation but that 25% have moderate to severe impairment in memory, which could hamper and/or preclude the resumption of prearrest roles.