Intensive Care Units

Publication Title: 
Acta Anaesthesiologica Scandinavica

BACKGROUND: Patients' difficulties following critical illness and the willingness of intensive care units (ICU) to take an expanded responsibility during the recovery period have led to the development of different follow-up programs. The aim of this study was to explore and describe patients' participation in and evaluation of a follow-up program at a nurse-led clinic (NLC).

Glimelius Petersson, Cecilia
Bergbom, I.
Brodersen, K.
Ringdal, M.
Publication Title: 
Intensive & Critical Care Nursing

OBJECTIVES: When patients are admitted to intensive care units, families are affected. This study aimed to illuminate the meaning of being taken care of by nurses and physicians for relatives in Norwegian intensive care units. RESEARCH METHODOLOGY/DESIGN: Thirteen relatives of critically ill patients treated in intensive care units in southern Norway were interviewed in autumn 2013. Interview data were analysed using a phenomenological hermeneutical method inspired by the philosopher Paul Ricoeur.

Frivold, Gro
Dale, Bj¯rg
Sletteb¯, ≈shild
Publication Title: 
International Journal of Qualitative Studies on Health and Well-Being

This study explores the perceived meaning of dependency on care as experienced by intensive care patients. Research from non-intensive settings shows that dependency is often experienced negatively, but literature on the subject experienced by patients in the ICU is sparse. The study is based on in-depth qualitative semi-structured interviews of lived experience with three former patients admitted to an intensive care unit at a Danish university hospital. The in-depth interviews have been characterized as narratives.

Lykkegaard, Kristina
Delmar, Charlotte
Publication Title: 
Annals of Internal Medicine

Cooperation--working together to produce mutual benefit or attain a common purpose--is almost inseparable from the quest for improvement. Although the case for cooperation can be made on ethical grounds, neither the motivation for nor the effects of cooperation need to be interpreted solely in terms of altruism. Cooperation can be a shrewd and pragmatic strategy for accomplishing personal goals in an interdependent system. Earlier papers in this series have explored the conceptual roots of modern approaches to improvement, which lie in systems theory.

Clemmer, T. P.
Spuhler, V. J.
Berwick, D. M.
Nolan, T. W.
Publication Title: 
Intensive Care Medicine

PURPOSE: Consent for research participation in the intensive care unit (ICU) is often obtained from a substitute decision maker (SDM). In this study we explored SDMs' reasons for declining or providing consent for research studies for critically ill adult family members. METHODS: Two questionnaires were developed, one directed at SDMs who agreed to have their relative participate in a research study (AGREE group), and another for SDMs who declined participation (DECLINE group).

Mehta, Sangeeta
Quittnat Pelletier, Friederike
Brown, Maedean
Ethier, Cheryl
Wells, David
Burry, Lisa
MacDonald, Rod
Publication Title: 

OBJECTIVE: We undertook the current investigation to explore how the pressures of serving as a surrogate decision-maker (SDM) for an acutely ill family member influence attitudes regarding clinical investigation. METHODS: We conducted a prospective study involving SDMs for critically ill patients cared for in the ICUs of two urban hospitals. Measurements included participation in focus groups designed to explore perceptions of ICU care and clinical research. Audiotapes were transcribed and analyzed to identify common patterns and themes using grounded theory.

Iverson, Ellen
Celious, Aaron
Kennedy, Carie R.
Shehane, Erica
Eastman, Alexander
Warren, Victoria
Bolcic-Jankovic, Dragana
Clarridge, Brian
Freeman, Bradley D.
Publication Title: 

Propofol is a phenolic derivative that is structurally unrelated to other sedative hypnotic agents. It has been used extensively as an anaesthetic agent, particularly in procedures of short duration. More recently it has been investigated as a sedative in the intensive care unit (ICU) where it produces sedation and hypnosis in a dose-dependent manner. Propofol also provides control of stress responses and has anticonvulsant and amnesic properties. Importantly, its pharmacokinetic properties are characterised by a rapid onset and short duration of action.

Fulton, B.
Sorkin, E. M.
Publication Title: 
The Clinical Journal of Pain

OBJECTIVE: Burn injuries produce severe wound care pain that is ideally controlled on intensive burn care units with high-dosage intravenous opioid medications. We report a case illustrating the use of hypnosis for pain management when one opioid medication was ineffective. SETTING: Intensive burn care unit at a regional trauma center. PATIENT: A 55-year-old man with an extensive burn suffered from significant respiratory depression from a low dosage of opioid during wound care and also experienced uncontrolled pain. INTERVENTION: Rapid induction hypnotic analgesia.

Ohrbach, R.
Patterson, D. R.
Carrougher, G.
Gibran, N.
Publication Title: 
Critical Care Clinics

The effects of BZ drugs result from interaction at the GABAA receptor within the CNS, producing anxiolysis, hypnosis, and amnesia in a dose-dependent fashion. These sedative effects are best titrated to reproducible clinical endpoints, using scoring systems such as the Ramsay scale. All BZs exhibit similar pharmacologic effects, but the important differences in pharmacokinetics and pharmacodynamics should be recognized to use these drugs safely and effectively within the ICU.

Young, C. C.
Prielipp, R. C.
Publication Title: 
AACN clinical issues

Psychological and psychosocial stressors perceived by the mechanically ventilated patient include intensive care unit environmental factors, communication factors, stressful symptoms, and the effectiveness of interventions. The studies reviewed in this article showed four stressors commonly identified by mechanically ventilated patients including dyspnea, anxiety, fear, and pain. Few interventional studies to reduce these stressors are available in the literature.

Thomas, Loris A.


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