Editorials:

Kathleen Dracup and Christopher W. Bryan-Brown

The United States Healthcare Crisis: Using Our Bold Voices to Effect Change
Am J Crit Care 2003 12(4): 306-308. [Full Text] [PDF]  

AACN 2003 Distinguished Research Lecture:

Kathleen Puntillo

Pain Assessment and Management in the Critically Ill: Wizardry or Science?
The author describes the state of nursing science of pain in critically ill patients, including development and testing of pain assessment methods and clinical trials of pharmacological interventions. Special emphasis is placed on results from the Thunder Project II, a multisite investigation of procedural pain.
Am J Crit Care 2003 12(4): 310-316. [Abstract] [Full Text] [PDF]  

End-of-Life Care:

Tom Ahrens, Valerie Yancey, and Marin Kollef

Improving Family Communications at the End of Life: Implications for Length of Stay in the Intensive Care Unit and Resource Use
At Barnes-Jewish Hospital, the authors implemented a quality improvement project in the medical ICU, which has a 19% mortality rate, to evaluate the effect of a physician-nurse communication team on length of stay and costs of patients near the end of life.
Am J Crit Care 2003 12(4): 317-324. [Abstract] [Full Text] [PDF]  

Guest Editorials:

Kedar S. Deshpande

Total Parenteral Nutrition and Infections Associated With Use of Central Venous Catheters
Am J Crit Care 2003 12(4): 326-327. [Full Text] [PDF]  

Defining Nursing Practice in Critical Care:

Justin B. Dimick, Sandra Swoboda, Mark A. Talamini, Robert K. Pelz, Craig W. Hendrix, and Pamela A. Lipsett

Risk of Colonization of Central Venous Catheters: Catheters for Total Parenteral Nutrition Vs Other Catheters
In 260 critically ill surgical patients, the authors compared the risk of colonization and infection for TPN catheters placed and maintained by the nutrition team with risk of colonization and infection for other central venous catheters placed and maintained by the ICU team.
Am J Crit Care 2003 12(4): 328-335. [Abstract] [Full Text] [PDF] [CE Test]  

Manuel G. Iregui, Donna Prentice, Glenda Sherman, Lynn Schallom, Carrie Sona, and Marin H. Kollef

Physicians’ Estimates of Cardiac Index and Intravascular Volume Based on Clinical Assessment Versus Transesophageal Doppler Measurements Obtained by Critical Care Nurses
The authors compare physicians' estimates of cardiac index and intravascular volume with transesophageal Doppler measurements obtained by critical care nurses, assess the overall safety of transesophageal Doppler imaging by critical care nurses, and compare hemodynamic measurements obtained via esophageal Doppler imaging with those obtained via pulmonary artery catheterization.
Am J Crit Care 2003 12(4): 336-342. [Abstract] [Full Text] [PDF]  

Sedation in Critical Care:

Marjolein de Wit and Scott K. Epstein

Administration of Sedatives and Level of Sedation: Comparative Evaluation via the Sedation-Agitation Scale and the Bispectral Index
In this study, the authors addressed 2 questions: What effect does the mode of sedative/hypnotic or narcotic administration have on sedation level? What is the relationship between subjective and objective sedation scales?
Am J Crit Care 2003 12(4): 343-348. [Abstract] [Full Text] [PDF]  

Nutritional Aspects of Critical Care:

Andrea P. Marshall and Sandra H. West

Gastric Tonometry and Enteral Nutrition: a Possible Conflict in Critical Care Nursing Practice
Gastric tonometry is used to assess gastrointestinal mucosal perfusion in critically ill patients. However, enteral feeding is withheld during monitoring with gastric tonometry because enteral feeding is believed to influence tonometric measurement. These authors examined the influence of enteral feeding on the measurement of PtCO2 in critically ill patients during a 48-hour period.
Am J Crit Care 2003 12(4): 349-356. [Abstract] [Full Text] [PDF]  

Sylvia Lenart and Nayak L. Polissar

Comparison of 2 Methods for Postpyloric Placement of Enteral Feeding Tubes
Multiple techniques are available for postpyloric placement of feeding tubes. In this study, the authors determine which method, administration of 10 mg of metoclopramide or gastric insufflation of 350 mL of air, is superior for successful postpyloric placement of feeding tubes at the bedside.
Am J Crit Care 2003 12(4): 357-360. [Abstract] [Full Text] [PDF]  

Research-Based Practice:

Margaret Hodge, Larry D. Kochie, Leslie Larsen, and Maurine Santiago

Clinician-Implemented Research Utilization in Critical Care
The authors describe how research utilization was implemented in the critical care units of the University of California Davis Health System in Sacramento. They review barriers related to the implementation of research utilization, discuss ways to overcome these barriers, and describe a process for using research findings to guide practice.
Am J Crit Care 2003 12(4): 361-366. [Abstract] [Full Text] [PDF] [CE Test]  

Curriculum in Critical Care:

Jeffrey Walker and Laura M. Criddle

Pathophysiology and Management of Abdominal Compartment Syndrome
Abdominal compartment syndrome is a potentially lethal condition caused by any event that produces intra-abdominal hypertension. The authors give brief case examples of patients with ACS and discuss its clinical manifestations and management.
Am J Crit Care 2003 12(4): 367-371. [Abstract] [Full Text] [PDF] [CE Test]  

Current Controversies in Critical Care:

Patricia Benner

Enhancing Patient Advocacy and Social Ethics
Am J Crit Care 2003 12(4): 374-375. [Full Text] [PDF]  

Cardiology Casebook:

Laurie G. Futterman and Louis Lemberg

Diuretics, The Most Critical Therapy in Heart Failure, Yet Often Neglected in the Literature
Am J Crit Care 2003 12(4): 376-380. [Full Text] [PDF]  

ECG Puzzler:

Michele M. Pelter and Mary G. Adams

Increased Automaticity of the AV Node
Am J Crit Care 2003 12(4): 381-382. [Full Text] [PDF]  

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