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Breast Surgery

Friday 31 July 2009

Experiences of intensive care nurses assessing sedation/agitation in critically ill patients

Experiences of intensive care nurses assessing sedation/agitation in critically ill patients. Nursing in critical care, vol. 13(4), 2008. [journal article]

Weir, S. and O'Neill, A.

http://www3.interscience.wiley.com/cgi-bin/fulltext/119878662/PDFSTART

Patients admitted to the intensive care unit (ICU) will more often than not require sedative and analgesic drugs to enable them to tolerate the invasive procedures and therapies caused as a result of their underlying condition and/or necessary medical interventions. This article reports a study exploring the perceptions and experiences of intensive care nurses using a sedation/agitation scoring (SAS) tool to assess and manage sedation and agitation amongst critically ill patients.
Withdrawal of mechanical ventilation in anticipation of death in the intensive care unit. New England Journal of Medicine, vol. 349(12), Sept. 2003. [journal article]

Cook, D., et al.

http://content.nejm.org/cgi/reprint/349/12/1123.pdf

In critically ill patients who are receiving mechanical ventilation, the factors associated with physicians’ decisions to withdraw ventilation in anticipation of death are unclear. The objective of this study was to examine the clinical determinants that were associated with the withdrawal of mechanical ventilation.

Non-invasive ventilation: don't push too hard

Non-invasive ventilation: don't push too hard. New england journal of medicine, Vol. 350(24), June 2004. [journal article]

Truwit, J.D. and Bernard, G.R.

http://content.nejm.org/cgi/reprint/350/24/2512.pdf

Noninvasive mechanical ventilation has been used increasingly over the past decade in an effort to avoid endotracheal intubation and to accelerate the discontinuation of mechanical ventilation. Noninvasive ventilation as adjunctive therapy can be applied before intubation or after extubation. The literature indicates that in both settings, outcomes in patients with chronic obstructive pulmonary disease (COPD) or cardiogenic pulmonary edema are successful.

Hydrocortisone therapy for patients with septic shock

Hydrocortisone therapy for patients with septic shock. New england journal of medicine, Vol 358 (2), January 2008 [journal article]

Sprung, C.L., et al.

http://content.nejm.org/cgi/reprint/358/2/111.pdf


Hydrocortisone is widely used in patients with septic shock, even though a survival benefit has been reported only in patients who remained hypotensive after fluid and vasopressor resuscitation and whose plasma cortisol levels did not rise appropriately after the administration of corticotropin.

Determinants of weaning success in patients with prolonged mechanical ventilation

Determinants of weaning success in patients with prolonged mechanical ventilation. Critical care 13(3), June 2009 [journal article]

Carlucci, A., et al.

http://ccforum.com/content/13/3/R97

Physiological determinants of weaning success and failure are usually studied in ventilator-supported patients, comparing those who failed a trial of spontaneous breathing with those who tolerated such a trial and were successfully extubated. A major limitation of these studies was that the two groups may be not comparable, concerning the severity of the underlying disease and the presence of comorbidities. In this physiological study, we assessed the determinants
of weaning success in patients acting as their own control, once they are eventually liberated from the ventilator.