ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Hemodynamic and oxygen transport responses to four preoxijgenation techniques prior to endotracheal auctioning (ETS) were evaluated in 24 critically ill trauma patients with no preexisting lung disease. A within-subjects, repeated measures design was used. All patients had functional arterial and pulmonary artery catheters and were ventilated with a Puritan-Bennett 7200 which could immediately deliver a fraction of inspired oxygen (FIO2) of 1.0. Six breaths of maintenance FIO2and hyperinflation without hyperoxygenation caused a fall in tissue oxygen delivery as measured by continuous transcutaneous oximetry (Ptc02). The largest increases in PtcO2and arterial oxygen tension were seen with hyperoxygenation alone and a combination of hyperoxygenation and hyperinflation. No significant changes were found in hemodynamic (cardiac index, mean arterial pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, systemic vascular resistance, pulmonary vascular resistance) or oxygen transport variables (oxygen delivery, oxygen extraction, oxygen consumption) 5 minutes postsuctioning. During both hyperinflation protocols, patients experienced dyspnea. It was concluded that three hyperoxygenation breaths before ETS, using a clinically feasible protocol, are adequate in preventing postsuction hypoxemia in ijoung, hemodynamically stable trauma patients. Large volumes of hyperinflation, although found to increase Ptc02, are not advocated because of demonstrated patient discomfort and the possibility of barotrauma.

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The purpose of the experitnental study was to identify mechanical and/or neural factors contributing to the heart rate alterations associated with endotracheal auctioning (ETS). Effects of catheter insertion alone and catheter insertion with the application of negative pressure on the partial pressure of arterial oxygen (PaO2) and heart rate prior to and following vagal blockade with atropine were examined. Eleven newborn swine less than 24 h of age were randomly exposed to (a) suction catheter insertion alone and (b) suction catheter insertion and the application of suction. Preoperatively, the subjects were anesthetized with ketamine and xylazine (.05 mL/kg). The ECG in lead II was recorded on a Gould 2600S recorder. Arterial Wood (aB) O2levels were withdrawn 1 min before and at 20 s, 1 min, 2 min, and 3 min following ETS and analyzed on a calibrated Corning 158 semi-automated aB gas machine. There was a significant decline in PaO2from baseline at 20 s post ETS in both the no suction and suction protocols, p < .05. The application of suction caused a greater decline in mean PaO2(41 torr) compared to no suction (13 torr) at 20 s post ETS which was similar in pattern following vagal blockade (suction: 37 torr; no suction: 2 torr). Following the first pass of the catheter, mean heart rate (HR) declined 14 beats per min with suction and 9 beats per min with no suction. The difference was obliterated following the second pass of the catheter. There was no difference in the HR following vagal blockade.

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The purpose of this study was to investigate the influence of age, coping behavior, and self-care on psychological, social, and physiologic adaptation in preadolescents and adolescents with diabetes. Children (N = 103) with insulin-dependent diabetes mellitus (IDDM) between 8 and 18 years of age and their parents participated in the study. Findings indicated that preadolescent children were significantly less depressed, less anxious, coped in more positive ways, had fewer adjustment problems, and were in better metabolic control than their adolescent counterparts. Age and secondary sexual development were related to psychosocial adaptation and. metabolic control of the diabetes. Further, those who coped by avoiding their problems and who were more depressed were the most likely to have problems in both adjustment and metabolic control with 56% of the variance in metabolic control explained by the variables studied. These findings indicate that preadolescents and adolescents cope differently with a chronic illness, and that interventions should be designed to identify and help those with inappropriate coping styles.

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Numerous aspects of the intensive care environment are stressful for low birth weight infants and may play a role in adverse developmental and behavioral outcome. The purpose of this study was to determine whether staff education in care protocols designed to make the environment less stressful and thereby support the infant's development would improve short-term outcomes. Twenty-one infants (< 1,501 gms) were studied during the preeducation period and 24 infants were studied following staff education. The educational program successfully altered nursing care. Experimental infants had more optimal respiratory and feeding status, lower levels of morbidity, shorter hospitalization, and improved behavioral organization.

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The ability of acoustic characteristics, both separately and in linear combination with others, to differentiate among procedural pain-induced, hungry, and fussy crying was explored using audiorecordings of cries from healthy 2 to 4-month-old infants. Fussy cries were less tense than hungry or pain-induced cries and pain-induced cries had significantly stronger second formant amplitudes than fussy or hungry cries. Formants and tenseness were important contributors to a linear combination of acoustic measures, derived from discriminant function analysis, which correctly classified 74% of the procedural pain-induced crying specimens. The inability of this linear combination of acoustic measures to identify correctly approximately one-third of the cry specimens suggests that the discrete acoustic differences among the three situationally defined types of crying is not large.

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A middle-range theory of caring was inductively derived and validated through phenomenological investigations in three separate perinatal contexts. Caring was described in Study I by 20 women who had recently miscarried, in Study II by 19 careproviders in the newborn intensive care unit, and in Study III by 8 young mothers who had been the recipients of a long-term public health nursing intervention. The empirical development and refinement of the theory is discussed. The five caring processes and an overall definition of caring are presented. Finally, study findings are compared and contrasted with Cobb's (1976) definition of social support, Watson's (1979, 1985) “carative” factors, and Benner's (1984) description of the helping role of the nurse.

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The purpose of this study was to test a portion of the uncertainty in illness model to determine whether mastery would be strengthened or weakened under conditions of uncertainty, and to test the ability of mastery and coping to function as mediators in the model. Mastery was proposed to mediate the relationship between uncertainty and the appraisal of danger and opportunity. Coping was proposed to mediate the relationships between danger or opportunity and emotional distress. Data were collected on a sample of 131 women receiving treatment for gynecological cancer. Findings support mastery as weakened under conditions of uncertainty and functioning as a situationally specific personality factor. Mastery was a significant mediator of the relationship between uncertainty and the appraisal of danger and opportunity; although the mediation effect for the relationship between uncertainty and danger was stronger. While two coping strategies were found to function as significant mediators between danger or opportunity and emotional distress, the mediation effect was very small.

ISSN:0029-6562    

出版商:OVID    

年代:1991

数据来源: OVID