Abstract:
:The most common measurements of pulmonary hypertension include systolic and mean pulmonary artery pressures, PVR, and transpulmonary gradient. Pulmonary artery pressures greater than 50 mm Hg, PVR greater than 6 Woods units, and transpulmonary gradient greater than 15 mm Hg that are unresponsive to optimal vasodilators are contraindications to orthotopic heart transplantation. Therapies used to reduce PVR in the cardiac catheterization laboratory include high-flow oxygen; sublingual nitroglycerin; and intravenous inotropic agents, vasodilators, and selective pulmonary vasodilators. Systemic hypotension may be an undesirable side effect of vasodilators. Inhaled agents such as nitric oxide and prostacyclin are specific to the pulmonary vasculature and reduce PVR without causing systemic hypotension. All pharmacological therapies used to optimize pulmonary hemodynamics before transplantation can be used during transplantation in patients who are at high risk for acute right ventricular failure and death after orthotopic heart transplantation because of elevated pulmonary hemodynamic values. Use of larger donor hearts for patients with elevated PVR and referral for heart-lung transplantation are potential treatment options. A heterotopic heart transplantation might also be attempted. However, because of the poor success with heterotopic transplantation, other options such as treatment with inhaled pulmonary vasodilators show much more promise and are associated with long-term survival after transplantation. Finally, nursing knowledge and implementation of transplantation protocols are essential for continued assessment and management of candidates for heart transplantation who are cared for in the intensive care or coronary care unit.
journal_name
Crit Care Nursejournal_title
Critical care nurseauthors
Coe PFsubject
Has Abstractpub_date
2000-04-01 00:00:00pages
22-8; quiz 29-30issue
2eissn
0279-5442issn
1940-8250journal_volume
20pub_type
杂志文章,评审abstract:TOPIC:The growing use of acute mechanical circulatory support devices to provide hemodynamic support that has accompanied the increasing prevalence of heart failure and cardiogenic shock, despite significant improvement in the treatment of acute myocardial infarction. CLINICAL RELEVANCE:The critical care nurse plays a...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020764
更新日期:2020-02-01 00:00:00
abstract::Scientists are only beginning to fully understand the purpose of sleep and its underlying mechanisms. Lack of sleep is associated with many diseases, including infection, and with increased mortality. Lack of proper sleep is an important problem in the intensive care unit, and interventions have been designed to impro...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2012689
更新日期:2012-04-01 00:00:00
abstract::Music therapy is an effective intervention for critically ill patients for such purposes as anxiety reduction and stress management. The therapy is readily accepted by patients and is an intervention patients thoroughly enjoy. The MAIT is one resource that nurses caring for critically ill patients can use to implement...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::There are many traditional beliefs about the need to restrict visitors on coronary care units (CCUs). Some hospitals, however, have modified their visiting policies. This article identifies factors related to the setting and control of visiting policies on CCUs. ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::Hypoplastic left heart syndrome is a severe form of congenital heart disease that results in single-ventricle physiology. Although surgical palliation in infants with this syndrome is widely agreed on in practice, variation occurs in both surgical and medical management. Perinatal factors that affect preoperative mana...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2016461
更新日期:2016-02-01 00:00:00
abstract:TOPIC:Acute respiratory distress syndrome is a complex respiratory disease that can be induced by influenza virus infection. Critical care providers are uniquely positioned to manage this pathological progression in adult patients through evidence-based practice. CLINICAL RELEVANCE:Influenza and subsequent acute respi...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020746
更新日期:2020-10-01 00:00:00
abstract::As the field of surgery advances and the conservative use of banked blood transfusion increases the need for postoperative autotransfusion has increased. By using the CATR, the patient's demands for blood can be more adequately met without causing further complications for the patient. This article presents one method...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:Delirium is a common neuropsychiatric diagnosis in intensive care units and often leads to extended hospital stays and an increased rate of complications. Delirium can be classified as hypoactive, hyperactive, or mixed. Hyperactive delirium is often accompanied by agitation, which is a predictive factor for ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020697
更新日期:2020-04-01 00:00:00
abstract::Transplant cardiologists in our hospital have performed the percutaneously placed axillary-subclavian intra-aortic balloon pump procedure since 2007. This procedure allows patients to mobilize and walk while they wait for a heart transplant, rather than remaining on bed rest as they would with a traditional femoral in...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2019729
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Hospitals are increasingly turning to clinical decision support systems for sepsis, a life-threatening illness, to provide patient-specific assessments and recommendations to aid in evidence-based clinical decision-making. Lack of guidelines on how to present alerts has impeded optimization of alerts, specif...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2018352
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. OBJECTIVES:To establish the prevalence of compassion satisfa...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2015392
更新日期:2015-08-01 00:00:00
abstract::The insertion of Silastic sheeting provides an opportunity for improved survival of patients with severe abdominal trauma. This new treatment modality represents a challenge to nurses to expand their knowledge base. ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::IL-2 is a biotherapeutic drug and a biological response modifier. This drug has not been approved by the Food and Drug Administration for general use but continues to undergo clinical trials. Candidates for this therapy are patients with advanced carcinoma that has not responded to standard modalities of treatment. Ad...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::The results of this evaluation indicate that specially trained critical care nurses can remove femoral sheaths with an acceptable margin of safety. As a result, these nurses can provide quality, cost-effective care to angioplasty patients. However, before this procedure is included as part of the RN's responsibility, ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::If no complications arise, the near-drowning victim is usually discharged within 48 hours. However, some patients require complex care because of multisystem failure. These patients challenge the critical care nurse, who must understand the interrelationships of the problems to provide quality care. The major focus of...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1993-08-01 00:00:00
abstract::Because of the potential severity of the associated complications, nurses have an essential role in the care of patients with HAT. Bedside nurses have the opportunity to report information that may indicate a change in a patient's condition after administration of heparin. This information could lead to diagnosis of h...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::To prepare a presentation, the critical care staff member must be willing to invest time and effort. Time and effort combined with an organized approach to the development process should result in a quality presentation. ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract::Provision of nutritional support to critically ill patients can be challenging. Critical care nurses must be aware of which patients require specific nutritional support, when to initiate nutritional support, and by which route to provide nutritional support. Consultation with a dietitian or nutritional support servic...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:2001-08-01 00:00:00
abstract::Hematologic assessment is part of the routine assessment of acute and critically ill patients. Nurses must be aware of the reference ranges for complete blood cell counts and common coagulation profiles. A case study is presented of an elderly patient, taking warfarin for atrial fibrillation, who falls and sustains a ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2012596
更新日期:2012-10-01 00:00:00
abstract::Errors related to health care devices are not well understood. Nurses in intensive care and progressive care environments can benefit from understanding manufacturer-related error and device-use error, the principles of human factors engineering, and the steps that can be taken to reduce risk of errors related to heal...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2012925
更新日期:2012-08-01 00:00:00
abstract::Family engagement in rounds has been recommended to improve communication, but its impact on patient outcomes is unknown. At the authors' institution, nurses encouraged family presence at rounds as part of a larger project to enhance communication during rounding. In the case reported here, family engagement resulted ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2019647
更新日期:2019-10-01 00:00:00
abstract::The congenital heart defect of HLHS is nearly uniformly fatal without intervention. As surgeons gain experience with the techniques the success rates are improving; more infants with HLHS are being offered hope for survival and quality of life. The critical nature of this diagnosis, the relatively new treatment option...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract::Clinical practice must be based on evidence. When evidence suggests that a certain practice may be ineffective or even harmful, that practice should be discontinued. The Choosing Wisely campaign, an initiative of the ABIM (American Board of Internal Medicine) Foundation, is intended to bring attention to tradition-bas...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2019534
更新日期:2019-12-01 00:00:00
abstract::Designed for independent study, this module explores some of the common, but often missed, pupillary abnormalities and eye movement irregularities. Part 3 concludes the module and provides the posttest and answer keys for the posttest and the three review exercises in Part 2. ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::The patient in septic shock who develops vascular insufficiency secondary to purpura fulminans is a challenge to the healthcare team. Initial management is directed toward reversing the disease process by administering antibiotics immediately and initiating life-support measures. Emergency measures include optimizing ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:The outbreak of coronavirus disease 2019 (COVID-19) rippled across the world from Wuhan, China, to the shores of the United States within a few months. Hospitals and intensive care units were suddenly faced with a "tsunami" warning requiring instantaneous implementation and escalation of disaster plans. EVI...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2020799
更新日期:2020-12-01 00:00:00
abstract::A 9-member educational task force and a 4-member panel of experts was used to establish the validity of the PEDS-BKAT, which was modified from version 4 of the adult BKAT for critical care nursing. A sample of 105 pediatric ICU nurses from 6 settings took the PEDS-BKAT. Test results include a mean score of 78.9 points...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
abstract::A patient with a new tracheostomy will face threatening changes upon discharge from hospital support. Nurses, particularly in the critical care unit, frequently and closely support a patient and family through new and often difficult situations during hospitalization. The patient leaving the hospital with a new trache...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::TEB is proving to be an exciting hemodynamic monitoring technique. It has been shown to accurately measure trends in the patient's volume and vasoactive state without the risks and discomfort of invasive monitoring. It can be applied easily and does not require specialized skill of nurses or physicians. A broad range ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract::BACKGROUND Many hospitals have well-planned nursing competency assessment programs, but these are meant to measure competency in traditional bedside roles, not in tele-intensive care unit (tele-ICU) nurses practicing remotely. OBJECTIVE To determine whether current tele-ICU programs have a formal competency assessment...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2011552
更新日期:2011-10-01 00:00:00