American journal of critical care : an official publication, American Association of Critical-Care Nurses
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Adult respiratory distress syndrome, presenting as rapid respiratory decompensation in the setting of preeclampsia at 36 weeks of gestation, was managed by early hemodynamic monitoring with pulmonary artery catheterization. With confirmation of the diagnosis of preeclampsia the patient was delivered promptly; improvement of her respiratory failure was observed within 48 hours. Consideration of adult respiratory distress syndrome in the setting of preeclampsia is discussed, with emphasis on early confirmation of the diagnosis and determination of the precise mechanisms of pulmonary edema.
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To investigate the effects of four nonneutral neck positions on intracranial pressure. ⋯ These data support previous studies that indicated that a patient at risk for pathological increase in intracranial pressure should not be positioned with the neck in flexion or the head turned to either side.
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Randomized Controlled Trial Comparative Study Clinical Trial
Accuracy of drawing coagulation samples from heparinized arterial lines.
To determine the accuracy of activated partial thromboplastin time and prothrombin time studies when samples are drawn through heparinized arterial lines. ⋯ Results indicated that the minimal amount of discard volume for accurate activated partial thromboplastin time values in this population of percutaneous transluminal coronary angioplasty patients was the catheter deadspace volume plus 2 mL (total 3.6 mL).
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Review Comparative Study
Myocardial contusion: new concepts in diagnosis and management.
Myocardial contusion is diagnosed with one or a combination of four diagnostic procedures: electrocardiography, echocardiography, creatine kinase MB fractions and/or radionuclide procedures. This article presents a critical review of 18 recent studies addressing the utility, sensitivity and specificity of these tests. ⋯ Echocardiography is useful in the management of myocardial decompensation but not as a primary screening tool in blunt cardiac injury. Cost comparisons, resource allocation and implications for critical care practice are discussed.