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Nursing, cardiac, surgery

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https://www.readbyqxmd.com/read/27909640/treating-fasciotomy-wounds-with-negative-pressure-wound-therapy-with-instillation-and-dwell-time-npwti-d
#1
Priscilla Lee
Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* to treat fasciotomy wounds in two patients...
October 28, 2016: Curēus
https://www.readbyqxmd.com/read/27872408/active-expiration-and-the-measurement-of-central-venous-pressure
#2
Sheldon Magder, Karim Serri, Sara Verscheure, Renée Chauvin, Peter Goldberg
PURPOSE: To obtain a point prevalence estimate of alterations in central venous pressure (CVP) produced by active expiration in a consecutive series of intensive care patients. METHODS: We evaluated CVP tracings taken by the nurses at their morning shift change in a consecutive series of 60 cardiac surgery and 59 noncardiac surgery patients. We also assessed change in values due to the change in transducer level. Three physicians and a nurse instructor independently reviewed the tracings and determined whether there was evidence of forced expiration and whether it was type A, defined by decreasing CVP during expiration, or type B, defined by increasing CVP during expiration...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27850044/404-nurse-driven-implementation-of-cardiac-surgery-advanced-life-support-in-a-cardiac-surgery-icu
#3
Lauren Espeso, Timothy Meyenburg, Richard Bell, Daniel Herr
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27821384/the-effectiveness-of-hand-massage-on-pain-in-critically-ill-patients-after-cardiac-surgery-a-randomized-controlled-trial-protocol
#4
Madalina Boitor, Géraldine Martorella, Andréa Maria Laizner, Christine Maheu, Céline Gélinas
BACKGROUND: Postoperative pain is common in the intensive care unit despite the administration of analgesia. Some trials suggest that massage can be effective at reducing postoperative pain in acute care units; however, its effects on pain relief in the intensive care unit and when pain severity is highest remain unknown. OBJECTIVE: The objective is to evaluate the effectiveness of hand massage on the pain intensity (primary outcome), unpleasantness and interference, muscle tension, anxiety, and vital signs of critically ill patients after cardiac surgery...
November 7, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27803362/toward-optimal-decision-making-among-vulnerable-patients-referred-for-cardiac-surgery-a-qualitative-analysis-of-patient-and-provider-perspectives
#5
Ryan A Gainer, Janet Curran, Karen J Buth, Jennie G David, Jean-Francois Légaré, Gregory M Hirsch
OBJECTIVES: Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population...
November 1, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27780607/ultrasound-guided-deep-arm-veins-insertion-of-long-peripheral-catheters-in-patients-with-difficult-venous-access-after-cardiac-surgery
#6
Adam Fabiani, Lorella Dreas, Gianfranco Sanson
OBJECTIVES: To analyze success rate, dwell-time, and complications of long peripheral venous catheters (L-PVCs) inserted under ultrasound guidance. BACKGROUND: In difficult venous access (DVA) patients, L-PVC can represent an alternative to central or midline catheters. METHODS: Prospective observational study. L-PVCs were positioned in DVA patients. The outcome of the cannulation procedure and the times and reasons for catheters removal were analyzed...
October 22, 2016: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27716690/the-myocardial-protective-effect-of-dexmedetomidine-in-high-risk-patients-undergoing-aortic-vascular-surgery
#7
Rabie Soliman, Gomaa Zohry
OBJECTIVE: The aim of the study was to assess the effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery. DESIGN: A randomized prospective study. SETTING: Cairo University, Egypt. MATERIALS AND METHODS: The study included 150 patients undergoing aortic vascular surgery. INTERVENTION: The patients were classified into two groups (n = 75). Group D: The patients received a loading dose of 1 μg/kg dexmedetomidine over 15 min before induction and maintained as an infusion of 0...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27658894/a-unified-hyperglycemia-and-diabetic-ketoacidosis-dka-insulin-infusion-protocol-based-on-an-excel-algorithm-and-implemented-via-electronic-medical-record-emr-in-intensive-care-units
#8
Deepashree Gupta, Meredith Kirn, Zafar A Jamkhana, Richard Lee, Stewart G Albert, Kimberly M Rollins
BACKGROUND: To assess the efficacy of a unified hyperglycemia and diabetic ketoacidosis (DKA) insulin infusion protocol (IIP), based on an Excel algorithm and implemented as an electronic order set, in achieving glycemic targets and minimizing hypoglycemia. METHODS: An IIP was instituted in medical and surgical intensive care units for post-cardiac surgery (PCS) and other stress hyperglycemia (SH), diabetes hyperglycemia (DH), and DKA. The IIP initiated therapeutic insulin rates at elevated blood glucose (BG), and decreased insulin when target range was achieved...
September 15, 2016: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/27633454/heart-score-estimation-by-specialized-nurses-in-a-greek-urban-population
#9
Evaggelia Papadopoulou, Maria Meidani, Maria Boutsikou, Pinelopi Papaspiropoulou, Theodosia Kelaiditou, Afedia Koukouzli, Anastasia Tapola, Ioanna Voudoufianaki, Sophie Mavrogeni, Niki Katsiki, Genovefa Kolovou, Ioannis Lekakis
AIMS: Specialized nurses estimated the HeartScore in an urban Greek population by recognizing cardiovascular disease (CVD) risk factors in the setting of the Onassis Cardiovascular Prevention Program (OCPP). They also provided nursing consultation and assessed the clinical and biochemical characteristics of the studied population. METHODS AND RESULTS: Individuals were recruited through TV announcements and via the website of the Onassis Cardiac Surgery Centre. All participants visited the Onassis Cardiac Centre from 20 September to 30 October 2011...
September 14, 2016: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/27616189/fast-track-cardiac-care-for-adult-cardiac-surgical-patients
#10
REVIEW
Wai-Tat Wong, Veronica Kw Lai, Yee Eot Chee, Anna Lee
BACKGROUND: Fast-track cardiac care is a complex intervention involving several components of care during cardiac anaesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to reduce length of stay in the intensive care unit and in the hospital. Safe and effective fast-track cardiac care may reduce hospital costs. This is an update of a Cochrane review first published in 2003, updated in 2012 and updated now in 2016. OBJECTIVES: To determine the safety and effectiveness of fast-track cardiac care compared with conventional (not fast-track) care in adult patients undergoing cardiac surgery...
September 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27575806/early-extubation-reduces-respiratory-complications-and-hospital-length-of-stay-following-repair-of-abdominal-aortic-aneurysms
#11
Sara L Zettervall, Peter A Soden, Katie E Shean, Sarah E Deery, Klaas H J Ultee, Matthew Alef, Jeffrey J Siracuse, Marc L Schermerhorn
BACKGROUND: Early extubation after cardiac surgery is associated with decreased hospital stay and resource savings with similar mortality and has led to the widespread use of early extubation protocols. In the Vascular Quality Initiative, there is significant regional variation in the frequency of extubation in the operating room (endovascular aneurysm repair [EVAR], 77%-97%; open repair, 30%-70%) after repair of intact abdominal aortic aneurysms (AAAs). However, the effects of extubation practices on patient outcomes after repair of AAAs are unclear...
August 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27556719/nurses-in-post-operative-heart-surgery-professional-competencies-and-organization-strategies
#12
Ana Paula Azevedo Santos, Silvia Helena Henriques Camelo, Fabiana Cristina Dos Santos, Laura Andrian Leal, Beatriz Regina da Silva
OBJECTIVE: To analyze nurses' competencies with regard to their work in post-operative heart surgery and the strategies implemented to mobilize these competencies. METHOD: This was an exploratory study with a qualitative approach and a methodological design of collective case study. It was carried out in three post-operative heart surgery units, consisting of 18 nurses. Direct observation and semi-structured interviews were employed to collect data. Data were construed through thematic analysis...
May 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/27550555/caudal-analgesia-and-cardiothoracic-surgery-a-look-at-postoperative-pain-scores-in-a-pediatric-population
#13
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27533263/effectiveness-of-a-nursing-intervention-in-decreasing-the-anxiety-levels-of-family-members-of-patients-undergoing-cardiac-surgery-a-randomized-clinical-trial
#14
Letícia Hamester, Emiliane Nogueira de Souza, Cibele Cielo, Maria Antonieta Moraes, Lúcia Campos Pellanda
OBJECTIVE: to verify the effectiveness of nursing orientation provided to families of patients in the immediate post-operative following cardiac surgery before the first visit to the post-anesthesia care unit, in decreasing anxiety levels, compared to the unit's routine orientation. METHOD: open randomized clinical trial addressing family members in the waiting room before the first visit in the immediate post-operative period. The family members assigned to the intervention group received audiovisual orientation concerning the patients' conditions at the time and the control group received the unit's routine orientation...
2016: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/27513688/pharmacodynamics-and-pharmacokinetics-of-morphine-after-cardiac-surgery-in-children-with-and-without-down-syndrome
#15
Abraham J Valkenburg, Elisa A M Calvier, Monique van Dijk, Elke H J Krekels, Brendan P O'Hare, William F Casey, Ron A A Mathôt, Catherijne A J Knibbe, Dick Tibboel, Cormac V Breatnach
OBJECTIVE: To compare the pharmacodynamics and pharmacokinetics of IV morphine after cardiac surgery in two groups of children-those with and without Down syndrome. DESIGN: Prospective, single-center observational trial. SETTING: PICU in a university-affiliated pediatric teaching hospital. PATIENTS: Twenty-one children with Down syndrome and 17 without, 3-36 months old, scheduled for cardiac surgery with cardiopulmonary bypass...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27508481/stressors-perceived-by-patients-in-the-immediate-postoperative-of-cardiac-surgery
#16
Carina Aparecida Marosti Dessotte, Hélen Francine Rodrigues, Rejane Kiyomi Furuya, Lidia Aparecida Rossi, Rosana Aparecida Spadoti Dantas
OBJECTIVE: to investigate stressors perceived by patients in the immediate postoperative of cardiac surgery and their association with sociodemographic and clinical characteristics. METHOD: a prospective correlational study conducted in a city in São Paulo, between August 2013 and December 2014. A non-probabilistic sample included patients submitted to their first coronary artery bypass graft or mitral valve surgery. The "Environmental Stressor Questionnaire" adapted to Portuguese was used...
July 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27507106/long-term-quality-of-life-after-cardiac-and-thoracic-aortic-surgery-for-very-elderly-patients-85-years-or-older
#17
Shogo Yokose, Takashi Miura, Koji Hashizume, Youichi Hisata, Kazuki Hisatomi, Kazuyoshi Tanigawa, Kiyoyuki Eishi
PURPOSE: We evaluated the outcomes of open heart surgery and long-term quality of life for patients 85 years and older. METHODS: We enrolled 46 patients 85 years and older who underwent cardiac and thoracic aortic surgery between May 1999 and November 2012. Long-term assessment was performed for 43 patients; three patients who died in the hospital were excluded. Patient conditions were assessed before surgery, 6 months and 12 months after surgery, and during the late period regarding the need for nursing care, degree of independent living, and living willingness...
October 20, 2016: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27487751/cardiac-radiofrequency-ablation-a-clinical-update-for-nurses
#18
Bridget Shoulders, Jillian Mauriello, Tamika Shellman, Corrinne Follett
The field of electrophysiology (EP) has rapidly evolved from a focus on diagnostic procedures to an emphasis on interventions. Many cardiac arrhythmias traditionally treated with antiarrhythmic agents, cardioversion, or cardiac surgery are now routinely cured with cardiac ablation. To optimally manage the care of cardiac ablation patients, it is essential that nurses have an understanding of the EP procedures and related nursing implications. There are extensive evidence-based resources available in the medical literature; however, there are limited publications geared toward nurses caring for cardiac ablation patients...
September 2016: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27453295/how-can-postoperative-delirium-be-predicted-in-advance-a-secondary-analysis-comparing-three-methods-of-early-assessment-in-elderly-patients
#19
Sebastian Stukenberg, Martin Franck, Claudia D Spies, Bruno Neuner, Isaac Myers, Finn M Radtke
BACKGROUND: Postoperative impairment of the cerebral function can appear immediately after general anesthesia and may be predictive for a postoperative delirium. We compared three tools assessing patients on recovery room admission in order to detect early signs of postoperative brain dysfunction: the Postanesthetic Recovery Score (PARS), the Richmond Agitation-Sedation Scale (RASS) and the Nursing Delirium Screening Scale (Nu-DESC). METHODS: Inclusion criteria of this secondary analysis of the randomized SuDoCo trial were: age ≥60 years, schedule for elective non-cardiac surgery with an anticipated duration of ≥60 minutes, general anesthesia, ability to communicate in German language...
July 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27451040/carbapenem-resistant-enterobacteriaceae-on-a-cardiac-surgery-intensive-care-unit-successful-measures-for-infection-control
#20
C S Abboud, E E de Souza, E C Zandonadi, L S Borges, L Miglioli, F C Monaco, V L Barbosa, D Cortez, A C Bianco, A Braz, J Monteiro
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) cause surgical site infections (SSIs) in intensive care units (ICUs). This study aimed to evaluate the impact of intervention and control measures to reduce CRE colonization and infection rates among patients in the ICU of a cardiac surgery hospital following a CRE outbreak. METHODS: An observational study of the pre- and postintervention status of a cohort of colonized or infected patients in the postoperative adult cardiac surgery ICU was performed between April 2013 and December 2014...
September 2016: Journal of Hospital Infection
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