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 unplanned extubation. Hypoactive delirium does not include outward agitation; its incidence and relationship to ventilatory outcomes, specifically unplanned extubation and duration of mechanical ventilation, are relatively unexplored. OBJECTIVE:To determine the occurrence rate of each delirium type in the first 7 days after intensive care unit admission and explore the relationship between delirium type and ventilatory outcomes. METHODS:This was a retrospective cohort study that enrolled adult patients consecutively admitted to a medical intensive care unit over 12 months. Data were abstracted on patient demographic variables, daily clinical variables (morning and evening delirium, coma, and sedation scores), and outcome variables (unplanned extubation, length of stay, and duration of mechanical ventilation). RESULTS:We enrolled 171 patients in the study. Hypoactive delirium occurred in up to 44% of patients. Of 25 instances of unplanned extubation, up to 74% of patients had hypoactive delirium. Delirium was not a predictor of unplanned extubation; smoking history, chronic obstructive pulmonary disease, and failed breathing trials best predicted unplanned extubation (odds ratios = 3.2, 5.2, and 12.6, respectively; P < .05). CONCLUSIONS:Hypoactive delirium is common among intensive care unit patients and may precede unplanned extubation. Patient history and comorbidities remain the strongest predictors of unplanned extubation.
journal_name
Crit Care Nursejournal_title
Critical care nurseauthors
Kerber K,Zangmeister J,McNett Mdoi
10.4037/ccn2020697subject
Has Abstractpub_date
2020-04-01 00:00:00pages
24-31issue
2eissn
0279-5442issn
1940-8250pii
30913journal_volume
40pub_type
杂志文章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::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::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::Both pharmacological and nonpharmacological methods are used to control shivering in therapeutic hypothermia. An evidence-based protocol based on the most current research has been developed for the management of shivering during therapeutic hypothermia. Meperidine is the drug of choice and provides the greatest reduc...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2011618
更新日期:2011-12-01 00:00:00
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journal_title:Critical care nurse
pub_type: 杂志文章
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更新日期:1998-06-01 00:00:00
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journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1990-07-01 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
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pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:Critical care nurse
pub_type: 杂志文章,评审
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更新日期:2012-08-01 00:00:00
abstract::Staff nurse preceptors are integral members of effective critical care orientation programs. Much of the success of the orientation experience and orientee satisfaction depends on them. A critical care preceptor workshop containing a review of the orientation program and the application of educational principles in cr...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
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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::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
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更新日期:2012-04-01 00:00:00
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journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2016756
更新日期:2016-08-01 00:00:00
abstract::Although methemoglobinemia is not commonly seen in the ER or the critical care setting, it can be life threatening if unrecognized and left untreated. A detailed case history illustrates the symptoms and some of the possible precipitating factors, and outlines treatment for a successful patient outcome. ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::As surgery for complex congenital heart disease is becoming more advanced, an increasing number of patients are surviving into adulthood, yet many of these adult patients remain in the pediatric hospital system. Caring for adult patients is often a challenge for pediatric nurses, because the nurses have less experienc...
journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:10.4037/ccn2016131
更新日期:2016-08-01 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
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journal_title:Critical care nurse
pub_type: 杂志文章,评审
doi:
更新日期:1996-12-01 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::Background Vanderbilt University Hospital's original rapid response team included a critical care charge nurse and a respiratory therapist. A frequently identified barrier to care was the time delay between arrival of the rapid response team and arrival of the primary health care team. Objective To assess the impact o...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2014847
更新日期:2014-02-01 00:00:00
abstract::Cardiac output and cardiac index values are traditionally used by critical care nurses as indicators of myocardial contractility. Due to the incidence of compensatory tachycardia in many critically ill patients, however, the value of LVSWI as an indicator of myocardial contractility is enhanced, because the formula fo...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::IABP timing challenges the nurse not only with a waveform analysis but also an understanding of complex physiologic concepts crucial to patient management. Optimizing timing through assessment of the five points of the IABP waveform permits the critical care nurse to increase the hemodynamic benefits of IABP therapy, ...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1994-06-01 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:Immobility contributes to many adverse effects in critically ill patients. Early progressive mobility can mitigate these negative sequelae but is not widely implemented. Appreciative inquiry is a quality improvement method/change philosophy that builds on what works well in an organization. OBJECTIVES:To ex...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:10.4037/ccn2020251
更新日期:2020-08-01 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::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::Nurses in a full range of settings from acute to home care are increasingly exposed to the use and maintenance of central VADs. Although the advantages of central VADs are well recognized, the incidence and potential for complications associated with these devices should not be minimized. The major complication of cat...
journal_title:Critical care nurse
pub_type: 杂志文章
doi:
更新日期:1989-05-01 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
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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
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journal_title:Critical care nurse
pub_type: 杂志文章
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更新日期:2018-10-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2009-02-01 00:00:00