Critical Care

Publication Title: 
Journal of Clinical Nursing

AIMS AND OBJECTIVES: This study sought to assess the impact of a standardized protocol to maintain nasoenteral tube (NET) patency in patients requiring fluid restriction and identify factors associated with tube patency. BACKGROUND: Nasoenteral tube obstruction may interrupt nutritional support and prohibit drug administration. Balancing NET patency in the context of fluid restriction can be a challenge. DESIGN AND METHODS: The impact of the standardized protocol was assessed by using a quasi-experimental design and an historical control.

Author(s): 
Matsuba, Claudia St
De Gutiérrez, Maria Gr
Whitaker, Iveth Y.
Publication Title: 
PloS One

BACKGROUND: Working in the stressful environment of the Intensive Care Unit (ICU) is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or a brain and skill drain if the healthcare professionals leave their jobs prematurely in order to preserve their own health.

Author(s): 
van Mol, Margo M. C.
Kompanje, Erwin J. O.
Benoit, Dominique D.
Bakker, Jan
Nijkamp, Marjan D.
Publication Title: 
AACN clinical issues

Patients with severe traumatic brain injury resulting in increased intracranial pressure refractory to first-tier interventions challenge the critical care team. After exhausting these initial interventions, critical care practitioners may utilize barbiturate-induced coma in an attempt to reduce the intracranial pressure. Titrating appropriate levels of barbiturate is imperative. Underdosing the drug may fail to control the intracranial pressure, whereas overdosing may lead to untoward effects such as hypotension and cardiac compromise.

Author(s): 
Bader, Mary Kay
Arbour, Richard
Palmer, Sylvain
Publication Title: 
Annales Francaises D'anesthesie Et De Reanimation

Analgesia and hypnosis are two separate entities and should result in distinct assessment and management for patients admitted to an intensive care unit (ICU). Those patients are exposed to moderate-severe pain and they are likely to remember pain as one bothersome experience. Any cause of patient discomfort is sought with the priority given to pain and adequate analgesia. Assessing pain must rely upon the use of clinical scoring systems, although these instruments are still underused in ICU.

Author(s): 
Payen, J.-F.
Chanques, G.
Publication Title: 
Indian Journal of Anaesthesia

Melatonin is a neurohormone secreted by the pineal gland. It is widely present in both plant and animal sources. In several countries, it is sold over the counter as tablets and as food supplement or additive. Currently, it is most often used to prevent jet lag and to induce sleep. It has been and is being used in several clinical trials with different therapeutic approaches. It has sedative, analgesic, anti-inflammatory, anti-oxidative and chronobiotic effects. In the present review, the potential therapeutic benefits of melatonin in anaesthesia and critical care are presented.

Author(s): 
Kurdi, Madhuri S.
Patel, Tushar
Publication Title: 
Journal of Pain and Symptom Management

To review the evidence for efficacy of complementary and alternative medicine (CAM) modalities in treating pain, dyspnea, and nausea and vomiting in patients near the end of life, original articles were evaluated following a search through MEDLINE, CancerLIT, AIDSLINE, PsycLIT, CINAHL, and Social Work Abstracts databases. Search terms included alternative medicine, palliative care, pain, dyspnea, and nausea. Two independent reviewers extracted data, including study design, subjects, sample size, age, response rate, CAM modality, and outcomes.

Author(s): 
Pan, C. X.
Morrison, R. S.
Ness, J.
Fugh-Berman, A.
Leipzig, R. M.
Publication Title: 
Annals of Cardiac Anaesthesia

Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients.

Author(s): 
Mazzeffi, Michael
Johnson, Kyle
Paciullo, Christopher
Publication Title: 
AACN clinical issues

The National Institutes of Health recently recommended further research on the efficacy of acupuncture and allocated Federal funds to stimulate clinical studies. Their decision was based on a growing body of successful research outcomes in which acupuncture was used in the treatment of acute and chronic pain, nausea, circulatory functions, and mood-related behavioral disorders. Despite a burgeoning body of clinical research, the ability to generalize findings has been affected by design flaws, sample type and size, and multiple methods of acupuncture site stimulation.

Author(s): 
Sutherland, J. A.
Publication Title: 
Journal of Pain and Symptom Management

To review the evidence for efficacy of complementary and alternative medicine (CAM) modalities in treating pain, dyspnea, and nausea and vomiting in patients near the end of life, original articles were evaluated following a search through MEDLINE, CancerLIT, AIDSLINE, PsycLIT, CINAHL, and Social Work Abstracts databases. Search terms included alternative medicine, palliative care, pain, dyspnea, and nausea. Two independent reviewers extracted data, including study design, subjects, sample size, age, response rate, CAM modality, and outcomes.

Author(s): 
Pan, C. X.
Morrison, R. S.
Ness, J.
Fugh-Berman, A.
Leipzig, R. M.
Publication Title: 
AACN advanced critical care

A majority of people in the United States use complementary and alternative therapies, and this use is increasing. With the increasing interest, providers must evaluate potential risks and benefits of these therapies. This article describes challenges of a feasibility study of acupuncture as a potential therapeutic adjunct to prevent atrial fibrillation following coronary artery bypass graft surgery. Institutional review board approval, consent logistics, implementation issues, and rapid changes in clinical practice were the primary challenges faced.

Author(s): 
Lindquist, Ruth
Sendelbach, Sue
Windenburg, Denise C.
Vanwormer, Arin
Treat-Jacobson, Diane
Chose, David

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