PPIs vs. H2-Receptor Antagonists for Prevention of Upper GI Bleeding
In this meta-analysis published in The American Journal of Gastroenterology, prophylaxis with proton pump inhibitors significantly decreased the rates of clinically significant bleeding compared with histamine-2 receptor antagonists. There were no effects on the development of nosocomial pneumonia or mortality rates. Further study is needed to evaluate the magnitude of benefit, clinical relevance, and cost-effectiveness. Trophic Feeding vs. Full Enteral Feeding in Acute Lung Injury Patients
Initiating trophic enteral feeding instead of full enteral feeding in patients with acute lung injury did not improve ventilator-free days, 60-day mortality, or infectious complications; however less gastrointestinal intolerance did result. Read the full-text of this study in The Journal of the American Medical Association. Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury in Infants, Children, and Adolescents
Read the full-text of these updated guidelines in Pediatric Critical Care Medicine. Several valuable new reports in pediatric traumatic brain injury contribute to new recommendations and updates in this second edition.
Bedside Assessment of Enteral Tube Placement: Aligning Practice with Evidence AJN, American Journal of Nursing, February 2012
Nurses are responsible for confirming the correct placement of enteral feeding tubes prior to their use, but current nursing practice doesn't always reflect the best evidence. In this article, the authors examine the research that's been conducted, compare the accumulated evidence with current practice, and make evidence-based practice recommendations. Advanced Ventilator Modes and Techniques Critical Care Nursing Quarterly, January/March 2012
In addition to supporting gas exchange, important goals of ventilator management include making the patient as comfortable as possible and not causing additional lung injury. This article reviews new advances in ventilator management that may minimize ventilator-induced lung injury, enhance patient-ventilator synchrony, and shorten the duration of ventilation. Determining Brain Death Nursing2012 Critical Care, January 2012
Review criteria for a brain death diagnosis in adults, complicating conditions that must be ruled out, the brain death exam, and various confirmatory tests used to determine brain death. Also highlighted in this article is some of the evidence-based research in the 2010 update of American Academy of Neurology (AAN) guidelines. Exploration of the Association between Professional Interactions and Emotional Distress of Intensive Care Unit Nursing Personnel Dimensions of Critical Care Nursing, January/February 2012
The aim of this descriptive correlational study was to investigate the degree of satisfaction from interaction among ICU nursing personnel, as well as between ICU nursing personnel and physicians, and potential associations with ICU nursing personnel's anxiety symptoms. Anticoagulation and Bleeding in Patients with Ventricular Assist Devices: Walking the Tightrope AACN Advanced Critical Care, January/March 2012
Postoperative anticoagulation therapy requires a detailed approach to management to prevent bleeding and thromboembolic events in patients with an LVAD. Update your knowledge of the differences in anticoagulation with pulsatile and nonpulsatile devices and the many risks of hyper- and hypocoagulation.