Evaluation of an Enhanced Recovery Pathway in Post Surgical Cardiac Patients in Intensive Care. Warm, Wake and Wean

Evaluation of an Enhanced Recovery Pathway in Post Surgical Cardiac Patients in Intensive Care. Warm, Wake and Wean

Author: Lourdes Noronha

Publisher:

Published: 2013

Total Pages: 0

ISBN-13:

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Aim The aim of this research study was to evaluate the impact of an enhanced recovery pathway, utilizing Warm, Wake and Wean (WWW) protocol in eligible post surgical cardiac patients. Background The cardiothoracic and vascular intensive care unit (CVICU) at Auckland City Hospital began initiatives to increase our elective cardiac surgery cases, streamline patients' journey and improve cardiac service delivery. This initiative led to the development and use of an enhanced recovery pathway for elective cardiac surgical patients. Design An observational study was conducted using quantitative methods. A sample of 83 postsurgical cardiac patients was recruited into the study. They were enrolled if they met the inclusion criteria for the warm wake and wean protocol. Patients were excluded if they returned to theatre, had cardiac tamponade or heat failure. The WWW protocol was applied to all patients recruited into the study. Demographic and postoperative data from the patients clinical bypass charts including sedation, extubation times were measured in hours. Postoperative complications following extubation were analysed in percentages and number of hours in ICU were also measured. Results The overall finding of this study showed that length of sedation time was strongly associated with length of intubation time and was a significant predictor of prolonged intubation time in this small size, single-centre observational study. When sedation time was reduced in CVICU, the study group showed an increased number of extubations within less than six hours. There were also minimal postoperative complications seen post cardiac surgery, but more significantly no complications seen in early extubated patients in this study group. Conclusion This research study concluded that WWW has suggested a promising approach to fast tracking this population group. Multi-centre research is needed to determine whether reducing sedation time in the intensive care unit can promote early extubation safely in a larger sample of patients following cardiac surgery.


Cardiac Surgery Essentials for Critical Care Nursing

Cardiac Surgery Essentials for Critical Care Nursing

Author: Sonya R. Hardin

Publisher: Jones & Bartlett Learning

Published: 2019-03-07

Total Pages: 602

ISBN-13: 1284196003

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Cardiac Surgery Essentials for Critical Care Nursing, Third Edition is an indispensable resource for new and experienced nurses caring for patients in critical care units immediately following cardiac surgery and in the transitioning to home. With an evidence-based foundation, the Third Edition addresses nursing knowledge to meet the needs of acutely ill patients and strategies to optimizing patient outcomes in this dynamic field. Vital information has been added and updated to reflect significant changes in cardiac surgery as well as four new chapters based on needs of patients, families, and readers. These new chapters address nutritional issues, post ICU-care, psychological and spiritual support, and rehabilitation care post cardiac surgery.


Patient and Family Experience in the ICU, An Issue of Critical Care Nursing Clinics of North America

Patient and Family Experience in the ICU, An Issue of Critical Care Nursing Clinics of North America

Author: Judy E Davidson

Publisher: Elsevier Health Sciences

Published: 2020-06-04

Total Pages: 235

ISBN-13: 0323759394

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In collaboration with Consulting Editor, Dr. Cynthia Bautista, Dr. Judy Davidson has put together a comprehensive issue on family and patient experience in the ICU. Expert authors have contributed clinical review articles on the following topics: Humanizing Intensive Care: From Theory to Practice; FiCare; Patient's Own Pets in the ICU; Sleep in the ICU; Implementation of a Patient and Family-Centered ICU Peer Support Program at a Veterans Affairs Hospital; Understanding the Experiences of Patients and Families in the ICU: More than Engagement; Implementing a Patient and Family Communication Bundle in the ICU; Integrating Primary Palliative Care into the ICU: The Critical Care Nurse Communicator Program; Bereavement Care in the Adult ICU: Directions for Practice; A review on the Use of Diaries; Supporting Families of Patients with Rare or Unusual Critical Illnesses; and Meeting the Special Needs of Families of CTICU patients. Readers will come away with the information they need to improve family and patients experiences in the ICU.


Cardiothoracic Surgical Critical Care, an Issue of Critical Care Nursing Clinics of North America

Cardiothoracic Surgical Critical Care, an Issue of Critical Care Nursing Clinics of North America

Author: Bryan Boling

Publisher: Elsevier

Published: 2019-09-28

Total Pages:

ISBN-13: 9780323708685

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In consultation with Consulting Editor, Dr. Jan Foster, Dr. Brian Boling has put together a state-of the-art issue of the Critical Care Nursing Clinics devoted to Cardiothoracic Surgical Critical Care. Clinical review articles are specifically devoted to the following: ? ?Fast Track Cardiac Surgery; Options for Minimally Invasive Valvular Surgery; Surgical Interventions for the Treatment of Advanced Heart Failure; Lung Transplantation; Surgical Treatment of Lung Cancer; ?Post-Operative Management of Tetralogy of Fallot; Advanced Hemodynamic Monitoring in Cardiothoracic Surgery; Vasoactive Infusions in Cardiothoracic Surgery; Common Post Cardiothoracic Surgery Arrhythmias; Pain Control in the Cardiothoracic Surgery Patient; Renal Complications of Cardiothoracic Surgery; The Role of ECMO in Post Cardiotomy Shock; Resuscitation of Patients Who Arrest After Cardiac Surgery; and End of Life Care in Cardiothoracic Surgery. Readers will come away with the latest information they need to improve improves of cardiothoracic surgical patients.


Pulmonary Embolism in the ICU , An Issue of Critical Care Clinics

Pulmonary Embolism in the ICU , An Issue of Critical Care Clinics

Author: Geno J. Merli

Publisher: Elsevier Health Sciences

Published: 2020-07-16

Total Pages: 161

ISBN-13: 0323712940

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This issue of Critical Care Clinics, guest edited by Drs. Geno Merli, Bharat Awsare, and Michael Baram, focuses on Pulmonary Embolism in the ICU. This is one of four issues each year selected by the series consulting editor, Dr. John Kellum. Articles in this issue include, but are not limited to: Making the Diagnosis of Pulmonary Embolism: Stable Versus Unstable; Risk Stratification; Overview of Management of Sub-massive and Massive Pulmonary Embolism; Standard Therapy: Systemic Thrombolytics; IR Therapy: IVC Filter and Catheter-based Therapies; Surgical Therapy: Embolectomy; Supportive Therapy: Management of Acute RV Failure; Supportive Therapy: ECMO/RVAD; Special Considerations; Therapy in Sub-populations; and Post-ICU Follow-up.


Biomarkers in Critical Care,An Issue of Critical Care Clinics E-Book

Biomarkers in Critical Care,An Issue of Critical Care Clinics E-Book

Author: Mitchell Levy

Publisher: Elsevier Health Sciences

Published: 2019-11-28

Total Pages: 240

ISBN-13: 0323683150

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This issue of Critical Care Clinics, guest edited by Dr. Mitchell M. Levy, focuses on Biomarkers in Critical Care. This is one of four issues each year selected by the series consulting editor, Dr. John Kellum. Articles in this issue include, but are not limited to: The History of Biomarkers; Biomarkers for Identifying Infection; Procalcitonin: Where Are We Now?; Soluble TREM-1: Diagnosis or Prognosis?; Lubricin as a Biomarker in Sepsis; Check Point Inhibitors and Their Role in Immunosuppression in Sepsis; Metabolomics and the Microbiome as Biomarkers in Sepsis; Lactate: Where Are We Now?; Predicting Renal Dysfunction; Biomarkers in the Evolution of ARDS; Biomarkers and RV Dysfunction; Biomarkers and Precision Medicine: State of the Art; The Use of Biomarkers for Population Homogeneity in Clinical Trials; and The Future of Biomarkers.


Toxicology, An Issue of Critical Care Clinics, E-Book

Toxicology, An Issue of Critical Care Clinics, E-Book

Author: Janice L. Zimmerman

Publisher: Elsevier Health Sciences

Published: 2021-06-04

Total Pages: 249

ISBN-13: 0323794548

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This issue of Critical Care Clinics, guest edited by Dr. Janice L. Zimmerman, focuses on Toxicology. This is one of four issues each year selected by the series consulting editor, Dr. John Kellum. Articles in this issue include, but are not limited to: Pharmacokinetic and pharmacodynamic principles for toxicology, Use of extracorporeal techniques in poisonings, Drugs of Abuse, Cardiovascular Drug Toxicity, Anticoagulant and Anti-platelet Drug Toxicity and Psychotropic Agents.


Acute Kidney Injury, An Issue of Critical Care Clinics

Acute Kidney Injury, An Issue of Critical Care Clinics

Author: John A. Kellum

Publisher: Elsevier Health Sciences

Published: 2021-03-25

Total Pages: 241

ISBN-13: 0323761690

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This issue of Critical Care Clinics, guest edited by Drs. John Kellum and Dana Fuhrman, focuses on Acute Kidney Injury. This is one of four issues each year selected by the series consulting editor, Dr. John Kellum. Articles in this issue include, but are not limited to: Acute Kidney Injury and Disease, AKI in Cardiac Surgery, AKI in Sepsis, Hepatorenal Disease, Cardiorenal Syndrome, Onconephrology, Renal Functional Reserve and more.