Autonomic Nervous System Function and

SAMPLE EXCERPT:

The researchers were looking for evidence that the transfusion significantly increased the mortality rate of these patients.

The authors found that in a univariable analysis the transfusion did increase he risk of death in all three time periods studied (0-30, 31-180, an >180 days). However, when a multivariate analysis was conducted they found that patients did not have a higher risk of death in the two shorter time periods and that they had between a 25% and 29% better chance of survival if they reached the >180 day limit. The authors of the study reported that "We found that administration of a blood transfusion to patients in the ICU was associated with improved survival in those patients who survived at least 180 days after admission to the ICU." This bodes well for all patients in the ICU .

7. Transcatheter and transapical aortic valve replacement.

This is an article which discusses the use of minimally invasive aortic valve replacement for patients which are at a higher risk of complications and mortality as a result of a traditional procedure which is more invasive and therefore dangerous. The study found that several factors increased risk to patients, the greatest of which was advanced age. The two procedures studied, transcatheter and transapical, are looked at from the perspective of care required and efficacy for patients who are at a higher risk of complications from a traditional procedure.

First, the article looks at the procedure itself and details how it is conducted. The transcatheter procedure involves not removing the entire defective valve, as is the case in traditional valve replacement, but the new valve is loaded onto a "stent or frame." The stent is then inflated to anchor the valve. This procedure is said to last as long as the typical procedure with the same type of valve. These procedures are typically less invasive because they are not as invasive as a typical heart valve replacement. The article also makes the statement that both of these procedures are still in the trial stages, and the article is concerned with the results of those studies.

The issues that they have had so far in the trials is that there is a greater chance that this procedure will result kin death because there is some danger that "perivalvular regurgitation will occur." This is because the stent or structure is not secured to the same extent as a typical valve in a valve replacement. The valve in the case of transcatheter and transapical replacement may become dislodged, whereas, in the traditional method, that is much less common.

8. Transparent film dressing vs. pressure dressing after percutaneous transluminal coronary angiography.

The focus of the study is to asses three different types of dressing that can be used after an angiography "with respect to effect on bleeding, discomfort voiced by patients, and ease of groin assessment in patients after percutaneous transluminal coronary angiography." The reason for this concern is that patients complain of pain when they receive the traditional pressure dressing when the dressing is applied, during the time when the dressing is in place and of skin irritation after it is removed.

Patients in the study received one of three types of dressing after the procedure. Either they were given pressure dressing, transparent film dressing or they were given an adhesive bandage. 100 patients were chosen for the study who had undergone the specific procedure and they were assessed for the comfort and issues that they complained of from the type of dressing they were given.

Among the patients who received one of the three dressing types, almost two-thirds had previously undergone the same procedure, and could more accurately assess the difference in the types of dressing. The pressure dressing was deemed by both nurses and patients to cause the most difficulties. The nurses were less able to assess the groin when the pressure dressing was used, and the patients had more pain and general discomfort with the pressure dressing. Both the transparent film dressing and the adhesive bandage were seen as superior for both patients and nurses. Nurses liked the transparent film the best.

References

Engoren, M., & Arslanian-Engoren, C. (2009). Long-term survival in the intensive care unit after erythrocyte blood transfusion. American Journal of Critical Care, 18(2), 124-131.

Gallagher, J.J. (2010). Intra=abdominal hypertension: Detecting and managing a lethal complication of critical illness. AACN Advanced Critical Care, 21(2), 205-217.

McIe, S. Pettite, T., Pride, L., Leeper, D., & Ostrow, C.L. (2009). Transparent film dressing vs. pressure dressing after percutaneous transluminal coronary angiography. American Journal of Critical Care, 18(1), 14-19.

McKean, S. (2009). Induced moderate hypothermia after cardiac arrest. AACN Advanced Critical Care, 20(4), 343-352.

McRae, M.E., Rodger, M., & B.A. (2009). Transcatheter and transapical aortic valve replacement. Critical Care Nurse, 29(1), 22-36.

Munro, C.L., Grap, M.J., Jones, D.J., McClish, D.K., & Sessler, C.N. (2009). Chlohexidine, toothbrushing, and preventing ventilator-associated pneumonia in critically ill adults. American Journal of Critical Care, 18(5), 428-437.

Unoki, T., Grap, M.J., Sessler, C.N., Best, A.M., Wetzel, P., Hamilton, A., Mellott, K.G., & Munro, C.L. (2009). Autonomic nervous system function and depth of sedation in adults receiving mechanical ventilation. American Journal of Critical…