Evidence-Based Review of Clinical Trials in Neurocritical Care

2018 ◽  
Vol 29 (2) ◽  
pp. 195-203 ◽  
Author(s):  
Molly McNett ◽  
Cristina Moran ◽  
Halee Johnson
Keyword(s):  
Clinical Trials ◽  
Critically Ill ◽  
Care Setting ◽  
Neurocritical Care ◽  
Critical Care Nurses ◽  
Neurological Injury ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Advanced Practice ◽  
Evidence Based Care

Neurocritical care is a rapidly growing specialty of complex care for the critically ill patient with neurological injury. This rapid growth has led to an increase in the number of important clinical trials to guide clinical practice and evidence-based care of the critically ill patient with neurological injury. Specialty-trained critical care nurses and advanced practice providers are integral members of neurocritical care teams and must remain informed about pivotal trials shaping practice recommendations. This article presents a summary of recent trials that have affected current practice and influenced care recommendations in the neurocritical care setting.

Fever

2007 ◽  
Vol 18 (1) ◽  
pp. 76-87
Author(s):  
Richard Henker ◽  
Karen K. Carlson
Keyword(s):  
Critically Ill ◽  
Critical Care Nurses ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Patient Morbidity ◽  
Salient Points ◽  
Assessment And Treatment ◽  
Fever Management ◽  
Planning Intervention

Fever occurs frequently in critically ill patients and requires knowledgeable assessment and treatment by critical care nurses. Fever can result from infection or inflammation and should be differentiated from simple hyperthermia. Although temperature measurement and fever management are not often priorities in the management of a critically ill patient, the physiologic consequences of fever may affect patient morbidity. This article defines and describes fever and its pathophysiology. An evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with fever is outlined, using levels of recommendation based on the strength of the available evidence. A case study is presented to illustrate application to clinical practice. Commentary about the case is provided to review the salient points of care.

Evidence-based practice: fever-related interventions

1999 ◽  
Vol 8 (1) ◽  
pp. 481-487 ◽  
Author(s):  
R Henker
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
American Association ◽  
Critical Care Nurses ◽  
Critically Ill Patient ◽  
Evidence Based ◽  
Common Phenomenon ◽  
Research Questions ◽  
Research Studies

Fever is a common phenomenon in critically ill patients. Ideally, all decisions about treatment of fever would be based on results of well-developed research studies. Instead, some research questions related to treatment of fever have been studied more extensively than others. This article is an evaluation of the usefulness of the research studies related to treatment of fever in the critically ill. Two questions are addressed: when is treatment of fever most beneficial to a critically ill patient, and how is fever most effectively treated in the critically ill? Evidence related to the treatment of fever is evaluated by using the recommendation levels of the research-based practice protocols of the American Association of Critical-Care Nurses.

Adrenocortical Insufficiency in the Critically Ill Patient

1992 ◽  
Vol 3 (3) ◽  
pp. 705-713
Author(s):  
Carol Diane Epstein
Keyword(s):  
Adrenal Insufficiency ◽  
Critically Ill ◽  
Patient Outcomes ◽  
Primary Diagnosis ◽  
Critical Care Nurses ◽  
Electrolyte Imbalance ◽  
Critically Ill Patient ◽  
Patient Assessment ◽  
Multiple Organs ◽  
Adrenocortical Failure

The fluid and electrolyte imbalances associated with adrenocortical failure affect multiple physiologic systems in the critically ill patient. Because of its widespread effect, the objective signs of adrenocortical failure may escape recognition. In the context of shock states affecting the function of multiple organs that have been previously diagnosed, empirical evidence suggesting the presence of adrenal insufficiency may be attributed to the primary diagnosis and illness. However, it is most important that critical care nurses question whether adequate adrenal function is present. When effective patient assessment and management are standard components of care, adrenocortical dysfunction may be reversed, while failure to assess for signs of adrenal insufficiency may lead to irreversible patient outcomes. This paper describes phenomena of adrenocortical failure in critically ill patients and presents the problems of fluid and electrolyte imbalance that accompany them

The ART of Antiretroviral Therapy in Critically Ill Patients With HIV

2018 ◽  
Vol 34 (11-12) ◽  
pp. 897-909 ◽  
Author(s):  
Tyler Finocchio ◽  
William Coolidge ◽  
Thomas Johnson
Keyword(s):  
Intensive Care ◽  
Antiretroviral Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Critically Ill Patient ◽  
Intensive Care Setting ◽  
Antiretroviral Medications ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

The management of patients with human immunodeficiency virus (HIV) can be a complicated specialty within itself, made even more complex when there are so many unanswered questions regarding the care of critically ill patients with HIV. The lack of consensus on the use of antiretroviral medications in the critically ill patient population has contributed to an ongoing clinical debate among intensivists. This review focuses on the pharmacological complications of antiretroviral therapy (ART) in the intensive care setting, specifically the initiation of ART in patients newly diagnosed with HIV, immune reconstitution inflammatory syndrome (IRIS), continuation of ART in those who were on a complete regimen prior to intensive care unit admission, barriers of drug delivery alternatives, and drug-drug interactions.

Caring for critically ill infants: strategies to promote physiological stability and improve developmental outcomes

1999 ◽  
Vol 19 (6) ◽  
pp. 64-79 ◽  
Author(s):  
LT Taquino ◽  
T Lockridge
Keyword(s):  
Supportive Care ◽  
Critically Ill ◽  
Care Setting ◽  
Well Being ◽  
Critical Care Nurses ◽  
Adverse Outcomes ◽  
Cognitive Growth ◽  
Staff Members ◽  
Improved Outcomes ◽  
Developmentally Supportive Care

Promoting organization and delivering developmentally supportive care leads to improved outcomes for infants and their families. Critical care nurses must function as catalysts to expand the thinking of caregivers from a dimension consisting primarily of physiology to one that embraces the emotional and cognitive growth and well-being of the patient, the patient's family, and staff members. For critically ill infants, developmentally supportive care that is relationship based and that promotes the balance of organized neurobehavioral and physiological function is an avenue to achieve that end. Beneficial or adverse outcomes of nursing care used during this critical period can persist long after an infant is discharged from the intensive care setting.

Anticonvulsants: Pharmacotberapeutic Issues in the Critically Ill Patient

1991 ◽  
Vol 2 (4) ◽  
pp. 639-656 ◽  
Author(s):  
Robert E. Dupuis ◽  
Jorge Miranda-Massari
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Critical Care Setting ◽  
Critically Ill Patient ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Epilepsy Treatment

Critically ill patients often have or develop conditions that make them susceptible to seizures and epilepsy. Treatment frequently involves the use of anticonvulsants. In order to use these effectively, the critical care nurse must be aware of the indications and controversies surrounding their use, the pathophysiologic conditions that impact on the disposition, and appropriate dosing and monitoring of these agents in the critical care setting

Abstracts Presented at the 5th National Advanced Practice Neonatal Nurses Conference Miami, Florida, April 24–26, 2008

2008 ◽  
Vol 27 (4) ◽  
pp. 287-290
Keyword(s):  
Neonatal Intensive Care ◽  
Care Setting ◽  
Nursing Practice ◽  
Evidence Based ◽  
Advanced Practice ◽  
Intensive Care Setting ◽  
Neonatal Nurses ◽  
Care Community ◽  
Evidence Based Nursing ◽  
Support Evidence

These podium and poster abstracts summarize the topics that were presented at the recent 5th National Advanced Practice Neonatal Nurses Conference in Miami, Florida. They represent a broad range of neonatal and perinatal issues. By sharing this information we hope to increase awareness of research and innovative programs within the neonatal health care community, and support evidence-based nursing practice in a neonatal intensive care setting.

Noninvasive Assessment of Gas Exchange in the Critically Ill Patient

1990 ◽  
Vol 1 (2) ◽  
pp. 239-247 ◽  
Author(s):  
Kathryn T. Von Rueden
Keyword(s):  
Critically Ill ◽  
Arterial Oxygen Saturation ◽  
Critical Care Nurses ◽  
Arterial Oxygen ◽  
Critically Ill Patient ◽  
Patient Assessment ◽  
Transcutaneous Monitoring ◽  
Noninvasive Assessment ◽  
Monitoring Devices ◽  
Pulse Oximeters

A variety of technologies is available to noninvasively evaluate arterial oxygen saturation and partial pressure of serum oxygen (PaO2) and carbon dioxide (PaCO2) in the critically ill patient. These include pulse oximeters, transcutaneous monitoring devices, capnometry, and capnography. Understanding the technology, the clinical significance of the data, and the associated limitations is fundamental in optimizing patient assessment and management. Accordingly, critical care nurses have increasing responsibilities related to these aspects of patient care

Abstracts Presented at the 6th National Advanced Practice Neonatal Nurses Conference Boston, Massachusetts, April 3–5, 2009

2009 ◽  
Vol 28 (3) ◽  
pp. 27-30
Keyword(s):  
Neonatal Intensive Care ◽  
Care Setting ◽  
Evidence Based ◽  
Advanced Practice ◽  
Intensive Care Setting ◽  
Neonatal Nurses ◽  
Care Community ◽  
Poster Presentations ◽  
Evidence Based Nursing ◽  
Support Evidence

These abstracts summarize poster presentations from the recent 6th National Advanced Practice Neonatal Nurses Meeting in Boston, Massachusetts. They represent a broad range of neonatal and perinatal issues. By sharing this information we hope to increase awareness of research and innovative programs within the neonatal health care community, and support evidence-based nursing practice in a neonatal intensive care setting.

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