Articles: adult.
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Randomized Controlled Trial Comparative Study
Comparison of the Surgical Pleth Index with autonomic nervous system modulation on cardiac activity during general anaesthesia.
Surgical plethysmographic index (SPI) has been proposed as a tool to measure the nociception/antinociception balance during general anaesthesia. Untreated nociception may increase sympathetic tone, but the relationship between SPI and the autonomic nervous system (ANS) is poorly understood. ⋯ In the context of a balanced general anaesthesia in healthy patients undergoing laparoscopic abdominal surgery, ANS modulation seems to correlate with changes in SPI. Further studies are warranted to assess whether this may reflect a change in nociception/antinociception balance or a pharmacodynamic effect of remifentanil.
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The objective was to determine if use of ultrasound (US) by emergency physicians (EPs) to localize spinal landmarks improves the performance of lumbar puncture (LP). ⋯ These data do not suggest any advantage to the routine use of US localization for LP insertion, although further study may be warranted to look for benefit in the difficult to palpate or obese patient subgroups.
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Scand J Trauma Resus · Jan 2014
Randomized Controlled Trial Multicenter Study Observational StudyRed blood cell transfusion in septic shock - clinical characteristics and outcome of unselected patients in a prospective, multicentre cohort.
Treating anaemia with red blood cell (RBC) transfusion is frequent, but controversial, in patients with septic shock. Therefore we assessed characteristics and outcome associated with RBC transfusion in this group of high risk patients. ⋯ The decision to transfuse patients with septic shock was likely affected by disease severity and bleeding, but haemoglobin level was the only measure that consistently differed between transfused and non-transfused patients.
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Critical care nurse · Dec 2013
Randomized Controlled TrialExtubation with or without spontaneous breathing trial.
Purpose- To evaluate whether spontaneous breathing trials (SBTs) are necessary when extubating critical care patients. Methods- A prospective, randomized, double-blind study was performed in adult patients supported by mechanical ventilation for at least 48 hours in the general intensive care unit of a teaching hospital. Patients ready for weaning were randomly assigned to either the SBT group (extubation with an SBT) or the no-SBT group (extubation without an SBT). ⋯ In the SBT and no-SBT groups, 5 (8.2%) and 6 (10.0%) patients, respectively, needed reintubation; 7 (11.5%) and 9 (15.0%) patients, respectively, required noninvasive ventilation after extubation. In-hospital mortality did not differ significantly between the groups. Conclusion- Intensive care patients can be extubated successfully without an SBT.
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Randomized Controlled Trial
A pilot study: the effect of healing touch on anxiety, stress, pain, pain medication usage, and physiological measures in hospitalized sickle cell disease adults experiencing a vaso-occlusive pain episode.
This pilot study was conducted to determine the effectiveness of Healing Touch on anxiety, stress, pain, pain medication usage, and selected physiological measures of hospitalized adults with sickle cell disease experiencing a vaso-occlusive pain episode. ⋯ Further research is needed.