American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Comparative Study
Room-temperature thermodilution cardiac output: proximal injectate lumen vs proximal infusion lumen.
To assess the accuracy of room-temperature thermodilution cardiac output measurements from the venous infusion port. ⋯ Room-temperature thermodilution cardiac output determinations from the venous infusion port can be used in place of central venous port cardiac outputs if the central venous port becomes nonfunctional.
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Case Reports
Case study: heart transplantation--increased incidence of acute rejection in female recipients.
Although the precise link between the increased incidence of allograft rejection in female heart transplant recipients remains uncertain, various gender-specific characteristics may predispose women to earlier rejection episodes. Critical care practitioners must be cognizant of the underlying immunologic factors that indicate higher risk in these recipients. Until the ideal treatment for cardiac rejection is discovered, identifying pertinent immunologic factors, attending to subtle symptoms, obtaining serial endomyocardial biopsies and initiating prompt, additional aggressive immunosuppressive protocols remain paramount in rendering quality patient care. Research must continue to elicit more specific tissue-typing antigens and more selective immunosuppressive agents that will ultimately result in prolonged survival of all heart transplant recipients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of patient-controlled analgesia on postoperative anxiety in elderly men.
To determine whether the use of patient-controlled analgesia vs intramuscular injections improves postoperative psychological parameters, particularly anxiety. ⋯ The use of patient-controlled analgesia does not significantly alter the measured psychological parameters, compared with intramuscular injections. Improved analgesia is the result of pharmacologic effects, independent of psychological factors.
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Comparative Study
Pilot study: validating staff nurses' observations of sleep and wake states among critically ill patients, using polysomnography.
Effective management of sleep pattern disturbance begins with accurate assessment of the patient's sleep and wake states. ⋯ There is some basis for using staff nurses as observers of sleep and wake states. Increased credence can be placed on nursing assessments and diagnosis of sleep pattern disturbance, resulting in more timely and effective management of the problem.