The Art and Science of Caring for Ventilator-Assisted Patients: Learning from Our Clinical Practice

Knebel, Ann R.; Strider, Victoria Church; Wood, Catherine

doi:10.1016/s0899-5885(18)30452-0

Cited by 8 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2002). Furthermore, high levels of perceived dyspnoea with anxiety are often reported as major factors interfering with weaning trials, and lead patients to long‐term respirator dependency (Knebel et al. 1994, Rotondi et al.…”

Section: Introductionmentioning

confidence: 99%

Effects of acupressure therapy for patients having prolonged mechanical ventilation support

Tsay¹,

Wang²,

Lin³

et al. 2005

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Effects of acupressure therapy for patients having prolonged mechanical ventilation support

Tsay¹,

Wang²,

Lin³

et al. 2005

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…For many patients, this sensation of air being forced into the lungs and the inability to control their own breathing, with attendant communication challenges, can be overwhelming. Anxiety, defined as a state marked by apprehension, agitation, increased motor tension or activity, autonomic arousal and fearful withdrawal (McCartney & Boland 1994), is a common symptom for these patients, and results from the numerous distressing physiological and psychological sensations associated with intubation and mechanical ventilation (Knebel et al 1994a, McCartney & Boland 1994, Mazzeo 1995. Researchers have documented moderate anxiety levels in patients receiving mechanical ventilatory support (Chlan 1998, Wong et al 2001.…”

Section: Introductionmentioning

confidence: 99%

Relationship between two anxiety instruments in patients receiving mechanical ventilatory support

Chlan¹

2004

Journal of Advanced Nursing

View full text Add to dashboard Cite

The VAS-A was found to be less burdensome for research participants than the Spielberger SAI, resulting in no missing data on the VAS-A. Findings from this study provide initial validation of the VAS-A as a justifiable instrument to measure anxiety in patients receiving mechanical ventilatory support. Researchers are advised to balance reliability and validity properties with response burden when selecting an instrument to measure anxiety in patients with communication challenges and energy limitations.

show abstract

“…11–14 The vertical presentation of the VAS-A is more sensitive and easier for patients to use, particularly for those with a narrowed visual field or when under stress. 15–17 The VAS-A is an accurate and sensitive measure of anxiety state, is a reliable measure of anxiety in MV patients 12 and can easily be completed by MV patients. 18 …”

Section: Methodsmentioning

confidence: 99%

Safety and Acceptability of Patient-Administered Sedatives During Mechanical Ventilation

Chlan¹,

Skaar²,

Tracy³

et al. 2017

Am J Crit Care

View full text Add to dashboard Cite

Background Sedation is common in critical care. It is unknown if sedative self-administration is a safe or acceptable intervention for mechanically ventilated (MV) patients. Objectives To evaluate whether patient self-administered sedation with dexmedetomidine (Precedex®) (PST-DEX) is safe and acceptable for self-management of anxiety during ventilatory support. Methods Randomized pilot trial in three ICUs. Intubated patients were randomly assigned to PST-DEX (n=17) or usual care (n=20). PST-DEX was administered via standard PCA pumps with a basal infusion (0.1–0.7 mcg/kg/hour) titrated by the number of patient-triggered doses (0.25 mcg/kg/dose). PST-DEX safety goals were heart rate > 40 bpm, systolic BP > 80 mm Hg, diastolic BP > 50 mm Hg. Acceptability was determined by patients’ self-reported satisfaction and ability to administer DEX. A 100-mm visual analog scale assessed patients’ anxiety daily (VAS-A). Results Patients (N = 37) were 60% male, 89% Caucasian. Mean age was 50.6 ±15 years; APACHE III 60.1 ± 32.6 and protocol duration 3.4 ± 1.6 days [median = 4]. Five PST-DEX patients had BP and/or HR readings below safety parameters necessitating short-term treatment. Nursing adherence to safety parameter reporting was 100%; adherence to PST-DEX titration algorithm was 73%. Overall baseline VAS-A was 38.4 ± 28.0 and did not change significantly over time [βday = 2.1((SE=2.5), p = 0.4)]. Most PST-DEX patients (92%) were satisfied/very satisfied with their ability to self-administer medication. Conclusions For select patients, PST-DEX is a safe and acceptable alternative to clinician-administered sedation. Additional research to determine the efficacy of PST DEX is warranted.

show abstract

The Art and Science of Caring for Ventilator-Assisted Patients: Learning from Our Clinical Practice

Cited by 8 publications

References 30 publications

Effects of acupressure therapy for patients having prolonged mechanical ventilation support

Effects of acupressure therapy for patients having prolonged mechanical ventilation support

Relationship between two anxiety instruments in patients receiving mechanical ventilatory support

Safety and Acceptability of Patient-Administered Sedatives During Mechanical Ventilation

Contact Info

Product

Resources

About