journal article
LitStream Collection
Home
GRIBBINS, RONALD E.; MARSHALL, RICHARD E.
doi: N/Apmid: N/A
Neonatal Intensive Care Units (NICUs) are complex environments in which caregivers from different disciplines work together under continuous stress.1,2Nurses, social workers, house officers, and attending neonatologists are forced to develop sensitivity to and awareness of one another's problems if optimal patient care is to be achieved. However, there is little systematic information available in the current literature about how any one group within the neonatal team perceives its stresses and develops coping strategies for remaining productive within the NICU.3,4The purpose of this report is to describe stresses experienced and coping strategies utilized by staff nurses in an academic NICU. Furthermore, we wish to report ways in which the information obtained in the investigation has been utilized to improve the environment of the NICU.
CHUTE, EDMUND ; CERRA, FRANK B.
doi: N/Apmid: N/A
A syndrome of late developing hydrothorax and hydromediastinum after central vein catheterization is presented. Use of inflexible catheters in sharply curved intrathoracic veins is proposed as a mechanism for the development of late hydrothorax and hydromediastinum. The authors recommend that physicians avoid the use of a large inflexible central venous catheter when not essential to the patient's management. The right jugular venous approach is recommended when inflexible catheters need to be used.
doi: N/Apmid: N/A
Computer techniques have been developed to image, noninvasively, anatomical structure, vessel blood flow, and physiological and biochemical functions, utilizing a number of physical principles. These devices, though costly, appear to provide sufficient diagnostic benefits to warrant their use in some critical care units. The emergence of x-ray, digital subtraction angiography, ultrasound, emission and nuclear magnetic resonance imaging techniques and their medical applications are described. It is shown that the physical variables measured by these techniques are sensitive to disease conditions and, thus, their incorporation in critical care procedures are likely in the future.
EBERHART, ROBERT C.; THOMASSON, TIMOTHY H.; MUNRO, MARK S.; KUMAR, ANUJ ; SZABO, GABOR
doi: N/Apmid: N/A
Indwelling chemical sensors have been designed and built which operate on similar principles to field effect transistors, the fundamental structural unit of the computer. By appropriate use of ion-filtering membranes with these devices, it is possible to measure, continuously, serum electrolytes, including hydrogen ion, and CO2tension. Semiconductor processing techniques allow incorporation of multiple ion sensors on a single miniaturized chip. Chip-based signal processing can also allow compensation for temperature effects and other sources of instability. Because these devices can be produced inexpensively, they seem to be promising for patient monitoring in the critical care environment. Problems with stability, blood compatibility, and reference electrode design are addressed and potential solution methods are proposed. The performance of preliminary devices in vitro and in vivo is discussed.
BECKER, RICHARD A.; VAUGHAN, GEORGE M.; ZIEGLER, MICHAEL G.; SERAILE, LEONARD G.; GOLDFARB, I. WILLIAM; MANSOUR, ESBER H.; McMANUS, WILLIAM F.; PRUITT, BASIL A.; MASON, ARTHUR D.
doi: N/Apmid: N/A
The free tetraiodothyronine index (FT4I) and free triiodothyronine index (FT3I) in burn patients represented the serum levels of free (dialyzable) T4and free T3, respectively. FT4I and FT3I were lower with greater burn size and were lower in nonsurvivors than expected for the burn size. There was no compensatory elevation of basal or releasing hormone-stimulated thyrotrophin (TSH) concentrations. Reverse T3was higher with greater burn size. T3treatment restored FT3I but did not affect mortality or resting metabolic rate (MR) measured in survivors, compared with placebo therapy. Whereas the hypermetabolic response to burn injury appeared to be independent of thyroid hormones, MR was correlated positively with burn size and with elevated plasma nor-epinephrine and epinephrine concentrations for several weeks after injury. Lack of augmented TSH concentrations, absence of low plasma reverse T3, and presence of hypermetabolism suggest that the reduced plasma free T3does not indicate functional hypothyroidism, but may represent an adaptation to the assumption of metabolic control by the sympathetic nervous system.
Showing 1 to 10 of 27 Articles