Biomedical subjects
Publications and source records attributed to M L Noll.
Incidence of infection with the human immunodeficiency virus (HIV) has increased to epidemic proportions. Strategies are needed to prevent transmission of the virus. One strategy, mandatory HIV testing of nurses, is controversial. Both sides of this issue are debated in this article.
Numerous studies on closed-system suctioning have been conducted including projects evaluating hyperoxygenation, influence of airway pressures and ventilation mode, efficiency in secretion removal, and autocontamination. These authors critique past research projects and propose directions for nursing practice and future research. By analyzing these projects, you can develop current practice standards to improve patient outcomes.
This study examined the relationship between mixed venous oxygen saturation (SvO2) and cardiac output (CO) in coronary artery bypass graft (CABG) surgery patients, age 35 to 70 years, who were 6.0 to 9.5 hours postoperative, hemodynamically stable, and receiving mechanical ventilation. A total of five paired measurements of SvO2 and thermodilution CO's were recorded on 30 subjects during a 45 minute time period. Correlations between SvO2 and CO for the entire sample ranged from 0.27 (NS*) to 0.45 (p less than or equal to 0.01). Additional analysis was done to determine if continuous infusions of vasoactive drugs influenced the relationship between the variables. Correlations for those on continuous vasoactive medications ranged from 0.21 to 0.31 (NS). Correlations for subjects who did not require vasoactive infusions were higher, ranging from 0.53 (NS) to 0.81 (p less than or equal to .01). Although many results were statistically significant, correlations less than 0.7 should not be used for clinical decision making. SvO2 reflects the overall tissue oxygenation and should not be used as a substitute for CO measurements in the CABG patient in the early hours after cardiac surgery.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Despite the limitations noted in this critique, the study provides information regarding the usefulness of pulse oximetry in care of postoperative cardiac surgery patients. Similar studies could be done with other groups of critically ill patients. Evaluation of technology in the critical care setting is essential so that care can be rendered in the safest and most efficient, cost-effective, manner.