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Lactate Versus Non-Lactate Metabolic Acidosis: A Retrospective Outcome Evaluation Of Critically Ill Patients, Kyle J. Gunnerson, Melissa Saul, Shui He, John A. Kellum

Anesthesiology Publications

Introduction

Acid–base abnormalities are common in the intensive care unit (ICU). Differences in outcome exist between respiratory and metabolic acidosis in similar pH ranges. Some forms of metabolic acidosis (for example, lactate) seem to have worse outcomes than others (for example, chloride). The relative incidence of each type of disorder is unknown. We therefore designed this study to determine the nature and clinical significance of metabolic acidosis in critically ill patients.

Methods

An observational, cohort study of critically ill patients was performed in a tertiary care hospital. Critically ill patients were selected on the clinical suspicion of the presence of …

The Impact Of An Hematocrit Of 20% During Normothermic Cardiopulmonary Bypass For Elective Low Risk Coronary Artery Bypass Graft Surgery On Oxygen Delivery And Clinical Outcome – A Randomized Controlled Study [Isrctn35655335], Christian Von Heymann, Michael Sander, Achim Foer, Anja Heinemann, Bruce Spiess, Jan Braun, Michael Krämer, Joachim Grosse, Pascal Dohmen, Simon Dushe, Jürgen Halle, Wolfgang F. Konertz, Klaus-Dieter Warnecke, Claudia Spies

Anesthesiology Publications

Introduction

Cardiopulmonary bypass (CPB) induces hemodilutional anemia, which frequently requires the transfusion of blood products. The objective of this study was to evaluate oxygen delivery and consumption and clinical outcome in low risk patients who were allocated to an hematocrit (Hct) of 20% versus 25% during normothermic CPB for elective coronary artery bypass graft (CABG) surgery.

Methods

This study was a prospective, randomized and controlled trial. Patients were subjected to normothermic CPB (35 to 36°C) and were observed until discharge from the intensive care unit (ICU). Outcome measures were calculated whole body oxygen delivery, oxygen consumption and clinical outcome. A …

The Shepherd’S Center Of Richmond: Opportunities For Meaning And Personal Growth Through Service, Linda Frank

Case Studies from Age in Action

Educational Objectives

1. To inform Virginians about The Shepherd’s Center of Richmond, a non-profit service organization by, with, and for older adults.

2. To demonstrate the impact of volunteer service as a means to finding a sense of meaning and purpose in later life.

Parish Nursing: A Vital Piece To The Puzzle Of Care For Older Adults, Donna B. Coffman

Case Studies from Age in Action

Educational Objectives

1. To generate awareness of the emerging practice of faith community/parish nursing and its implications for the overall improvement of health care.

2. To explore specific ways parish nursing can help meet the holistic health needs of older adults in local congregations

Elderfriends: Relieving Loneliness Among Elders, Kiersten Seeger Ware, Sarah Coble

Case Studies from Age in Action

Educational Objectives

1. To discuss social isolation among older adults.

2. To promote awareness of the ElderFriends program, an intervention newly established in greater Richmond

3. To seek friendly visitors for the ElderFriends program.

Brain Health: Mending The Mind After Age 50, Susan Hardwicke

Case Studies from Age in Action

Educational Objectives

1. Increase understanding of brain function and its potential to improve with age.

2. Describe an application of neuroscience, cognitive training, and nutrition for solving a problem associated with aging.

3. Evaluate neural plasticity with aging.

Factorial Validity Of The Team Skills Scale As Used For Geriatric Interdisciplinary Team Training (Gitt), Myra G. Owens

Theses and Dissertations

Objective: To examine the factorial validity of the Team Skills Scale (TSS). The TSS is a 17-item scale developed by Hepburn, Tsukuda, and Fasser (1996). The Scale is purported to assess self-perceived team skills.Data Source: Data for this study were provided by The New York University Geriatric Interdisciplinary Team Training (GITT) Resource Center and were collected as part of the evaluation of the GITT program. The data were collected between January 1997 and June 2000.Study Design: This quasi-experiential study was focused on the trainee (N=1,715) as the unit of analysis. The Model of Individual-Level Team Competencies (Model of I-LTC) served …

Perceived Deprivation In Active Duty Military Nurse Anesthetists, Julie Ann Pearson

Theses and Dissertations

Problem: There is a shortage of military certified registered nurse anesthetists (CRNAs). The exodus from military service to civilian careers could be a result of relative deprivation (the discrepancy that one perceives between what one has and what one could or should have). Relative deprivation is a perception of unfairness dependent on feelings (subjective data) as well as facts (objective data). Purpose: The purpose of this study was to measure relative deprivation in active duty military nurse anesthetists, to explore variables which correlate with relative deprivation, and to validate or refute the theory of relative deprivation in active duty military …

Functional Redistribution Of Hippocampal Cannabinoid Cb1 Receptors In The Rat Pilocarpine Model Of Acquired Epilepsy, Katherine Winslow Falenski

Theses and Dissertations

Cannabinoids, such as the marijuana derivative Δ9-THC, are known to have CBl receptor-mediated anticonvulsant effects in several animal models of seizures and epilepsy, including the rat pilocarpine model of acquired epilepsy. However, the distribution of CBl receptor expression and function in brains of epileptic rats has not been characterized. Therefore, this dissertation was initiated to evaluate the effect of epileptogenesis on the distribution and function of the endogenous CBI receptor system in the rat pilocarpine model, a well-established model of acquired temporal lobe epilepsy. Using immunohistochemistry, we demonstrated that chronically epileptic rats exhibit a unique, long-term, and specific redistribution of …

The Corbett Pain Scale: A Multidimensional Pain Scale For Adult Intensive Care Patients, Gina M. Corbett

Theses and Dissertations

There are no reliable tools that evaluate pain in adult critical care patients who cannot communicate as a result of sedation or illness. This was an observational study in which postoperative cardiothoracic intensive care patients were assessed for pain using both the newly devised Corbett Pain Scale (CPS) and the Numerical Pain Scale (NPS). The CPS was evaluated for content validity, criterion validity, construct validity, test re-test reliability and internal consistency. Thirteen male and seven female patients (n=20) were enrolled and underwent a maximum of five pain assessments each. The mean total scores of the CPS (.740, SD+1.03) and the …