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Breast Surgery

Thursday 16 August 2012

Neuro--ventilatory efficiency and extubation readiness in critically ill patients

Neuro--ventilatory efficiency and extubation readiness in critically ill patients. Critical care, July 2012, 16: R143.

Liu, L., et al.

http://ccforum.com/content/16/4/R143/abstract

Based on the hypothesis that weaning failure from mechanical ventilation is caused by respiratory demand exceeding the capacity of the respiratory muscles, we evaluated whether extubation failure could be characterized by increased respiratory drive and impaired efficiency to generate inspiratory pressure and ventilation.

Depressive symptoms in spouses of older patients with severe sepsis

Depressive symptoms in spouses of older patients with severe sepsis. Critical care medicine, August 2012, Vol. 40(8), p.2335-41.

Davydow, D., et al.

http://journals.lww.com/ccmjournal/Abstract/2012/08000/Depressive_symptoms_in_spouses_of_older_patients.10.aspx

Objective: To examine whether spouses of patients with severe sepsis are at increased risk for depression independent of the spouse’s presepsis history, whether this risk differs by sex, and is associated with a sepsis patient’s disability after hospitalization.

Light and the outcome of the critically ill

Light and the outcome of the critically ill: an observational cohort study. Critical care, July 2012, 16: R132.

Castro, R.A., et al.

http://ccforum.com/content/16/4/R132/abstract

Light before and during acute illness has been associated with both benefit and harm in animal models and small human studies. Our objective was to determine the associations of light duration (photoperiod) and intensity (insolation) before and during critical illness with hospital mortality in ICU patients. Based on the 'winter immunoenhancement' theory, we tested the hypothesis that a shorter photoperiod before critical illness is associated with improved survival.

Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation

Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation. Critical care medicine, August 2012, Vol. 40(8), p.2327-34.

Cox, C.E., et al.

http://journals.lww.com/ccmjournal/Abstract/2012/08000/Development_and_pilot_testing_of_a_decision_aid.9.aspx

Shared decision making is inadequate in intensive care units. Decision aids can improve decision making quality, though their role in an intensive care units setting is unclear. We aimed to develop and pilot test a decision aid for shared decision makers of patients undergoing prolonged mechanical ventilation.

Identifying family members who may struggle in the role of surrogate decision maker

Identifying family members who may struggle in the role of surrogate decision maker. Critical care medicine, August 2012, Vol. 40(8), p.2281-86.

Majesko, A., et al.

http://journals.lww.com/ccmjournal/Abstract/2012/08000/Identifying_family_members_who_may_struggle_in_the.2.aspx

Although acting as a surrogate decision maker can be highly distressing for some family members of intensive care unit patients, little is known about whether there are modifiable risk factors for the occurrence of such difficulties.

Do earplugs stop noise driving critical care patients into delirium?

Do earplugs stop noise driving critical care patients into delirium? Critical care, July 2012, 16: 139.

Mills, G.H. and Bourne, R.S.

http://ccforum.com/content/16/4/139/abstract

Quality sleep is a problem for the critically ill who are cared for in an environment where interventions night and day are common, staff members are constantly present in relatively high numbers, and treatment is accompanied by a range of changing warning tones and alarms and lights. These critical care units are generally designed without a focus on patient comfort, sleep, and rest and often lack access to appropriate natural daylight. To add to this problem, critical illness, particularly sepsis, disrupts circadian rhythms and sleep patterns, and disruption of circadian rhythms, in turn, impairs immunity and contributes to delirium. 

Critical care nurses' judgement of pain status

Critical care nurses' judgement of pain status: A case study design. Intensive & critical care nursing, August 2012, Vol.28(4), p.215-23.

Connor, L.O.

http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000055/abstract?rss=yes

In the performance of their professional activities, critical care nurses routinely make important judgements based on uncertain, fallible and inter-substitutable data. It is anticipated that this study will make visible the strategy by which critical care nurses use and combine multiple fallible cues, of which little is known, to reach a judgement about the pain status of the ventilated patient after coronary artery bypass graft (CABG) surgery.  

How can nurses facilitate patient's transitions from intensive care?

How can nurses facilitate patient's transitions from intensive care? Intensive & critical care nursing, August 2012, Vol. 28(4), p.224-233.

Haggstrom, M., et al.

http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000031/abstract?rss=yes

Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process.

End of life in intensive care

End of life in intensive care: Is transfer home an alternative? Intensive & critical care nursing, August 2012, Vol. 28(4), p.234-241.

Tellett, L., et al.

http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000079/abstract?rss=yes

The past decade has witnessed an increased focus on improving the quality of end of life care internationally. This has resulted in the development of specific health policy work streams to support patient choice and improve standards of care and patient experience. One concept well explored in areas outside of critical care is that of home care at the end of life. This paper seeks to challenge assumptions and practices about the options for transferring the critically ill patient home at end of life.