Quantitative research article Critique

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Annotated Bibliography on Research for Immobile Post-Surgical Clients

Annotated Bibliography on Research for Immobile Post-Surgical Clients

Carvalho, B., Zheng, L. L., & Butwick, A. (2017). Comparative Effectiveness of Lower Leg Compression Devices Versus Sequential Compression Devices to Prevent Postspinal Hypotension During Cesarean Delivery. Anesthesia & Analgesia, 124(2), 696–697.

The article explores the effects associated with women’s caesarean delivery, particularly hypotension brought about by spinal anaesthesia. The authors significantly focus on the consequences that can occur when the individual does not get the correct attention and treatment. For example, the authors state that lack of treatment of the post-delivery effects can promote the occurrence of fetal acidosis, cardiovascular instability, vomiting, and maternal nausea. The authors proceed to state the relevant treatment that can help with mitigating the occurrence of spinal hypotension. For instance, they present that sequential compression mechanical devices and thromboembolic deterrent hose stockings can significantly aid with the reduction of hypotension incidences. Nevertheless, the authors also point out that there is no significant research that compares the efficiency of leg compression mechanisms in alleviating post-spinal difficulties. The article presents findings from the institutional review board (IRB) regarding the comparison of maternal hemodynamics and vasopressor requirements. The researchers used both intraoperative TEDs and intraoperative SCDs to compare their effectiveness for women who had undergone caesarean delivery. They also examined the health records of 210 women (the women received 105 TEDs and 105 SCDs), and they were all aged between eighteen and forty years. The study excluded women that displayed any signs of hypertensive conditions linked with pregnancy. The study’s conclusions indicated that all patients that receive TEDs and SCDs have the same needs in terms of pressors. The article is credible because it focuses on post-delivery outcomes and associated treatment mechanisms, which aligns with the PICOT question’s post-surgical evaluation research (Carvalho et al., 2017).

Dhakal, P., Wang, L., Gardiner, J., Shrotriya, S., Sharma, M., & Rayamajhi, S. (2019). Effectiveness of Sequential Compression Devices in Prevention of Venous Thromboembolism in Medically Ill Hospitalized Patients: A Retrospective Cohort Study. Turkish Journal of Hematology.

The objective of the study is to assess the effectiveness of SCDs required for the prevention of venous thromboembolism (VTE) among ill patients in the hospital. The materials and method for the study included the use of adult patients that were admitted to a teaching hospital with the exclusion of patients that did not have SCDs. Additionally, the authors focused on analyzing the risk of VTE among individuals that were hospitalized. Understanding the threat that VTE posed was essential as it presented the scope of which VTE should be approached to maintain and manage it. The authors also explored the patients’ length of stay in hospital as it was a factor in the intensity and magnitude of the effect of VTE, depending on how long the adult patients stayed in hospital beds. Moreover, the study also considered other disorders among the patients that had been score-matched on SCDs. The study’s results were varying, with different conditions being observed. For example, out of the 30,824 patients considered in the study, 67 patients contracted VTE when in hospital. Deep Vein Thrombosis was observed among 55 people, 12 recorded pulmonary embolisms (PE). Even with the adjustment of risk, there was no essential change in the incidence of VTE among the group with SCD compared to the ones that had no SCD. The authors concluded that the SCDs are not a factor in mitigating VTE occurrence among patients staying in the hospital. In this sense, the article is significant as it focuses on all aspects that can help evaluate the occurrence of VTE among patients and the use of SCDs (Dhakal et al., 2018).

Manici, M., Alemanno, G., & Nuzzaco, M. I. (2018). Venous Thromboembolism Prevention and Prophylaxis. In Nursing in Critical Care Setting (pp. 317-333). Springer, Cham.

The central focus of this article is on Venous thromboembolism (VTE), described as a common disorder among patients on intensive care. The authors define VTE as a complication that occurs among patients that are critically ill and is associated with hypercoagulability, hematic flow stasis, and endothelial alterations. The study points out that VTE accelerates mortality if not treated and managed in the hospital. However, the authors also present the correct procedures to prevent and mitigate deaths associated with DVT and PE. The authors state that appropriate and adequate fundamental thromboprophylaxis can assist with the reduction of mortality and morbidity among individuals with VTE. The article also provides guidelines that can promote the safety of critically ill patients, including division and provision of care to ICU patients depending on their illness process. For example, patients that have ACUTE illness linked with the failure of organs must be provided care separately from the patients that are facing end-of-life. The authors also evaluated the aspects that increased threat among patients and concluded that inflammatory reactions to intravascular devices, reduced mobilization, and increased physical stress increased the risk of developing VTE. The authors present that the use of medications can prevent the risk of the thromboembolic condition. However, the authors point out that, for the medicine to be effective and efficient, it has to be administered and implemented mechanically. Moreover, the correct application of advanced compression stocking and patient mobilization can help with prevention. The article provides significant information regarding the mechanical use of medication and its association with the prevention of DVT and PE among critically ill patients in the hospital, making it meaningful in the PICOT question’s research (Manici et al., 2018).

Snyder, M. A., Sympson, A. N., Scheuerman, C. M., Gregg, J. L., & Hussain, L. R. (2017). Efficacy in deep vein thrombosis prevention with extended mechanical compression device therapy and prophylactic aspirin following total knee arthroplasty: a randomized control trial. The Journal of arthroplasty, 32(5), 1478-1482.

The study involves the evaluation and assessment of Aspirin as a nationally recognized medication for VTE prevention. The authors point out that 325 mg of Aspirin administered twice daily help with the prophylaxis of VTE among patients. The study enters its focus on the examination of whether the utilization of Aspirin limits the incidence of DVT without the application of advanced mechanical devices. The methodology for the study entailed the use of one hundred patients that underwent Aspirin medication for three weeks to manage their DVT threat. The researchers also used MCD for post discharged patients to provide a comparison for the inpatients that used Aspirin in hospital. The results of the study indicated that the risk of DVT among those that were discharged and under MCD was zero per cent compared to those who were in a hospital, who showed a 23.1% DVT rate. The authors concluded that patients who experienced early mobilization and used limited toumiquet (TKA) performed well when put under Aspirin medication. Additionally, they also concluded that individuals who used MCD alone without Aspirin had inferior prevention from DVT risk. However, the patients that had Aspirin for three weeks displayed superior DVT prevention and prophylaxis. The study’s conclusion indicates the increased benefit and contribution of Aspirin towards the prevention and reduction of DVT incidence among patients in and out of the hospital. The study is significant to the PICOT question in the sense that it provides an evidence-based solution for the prevention and reduction of DVT risk besides the mechanical-based interventions presented by other studies (Snyder et al., 2017).

Tanaka, K., Kamada, H., Shimizu, Y., Aikawa, S., Nishino, T., Ochiai, N., ... & Yamazaki, M. (2016). The use of a novel in-bed active Leg Exercise Apparatus (LEX) for increasing venous blood flow. Journal of Rural Medicine, 11(1), 11-16.

The study explores the increase of bedridden individuals and the high rate of aging among adults, leading to a surge in DVT and PE. The researchers established an in-bed mechanism and named in Leg Exercise Apparatus (LEX). The mechanism was meant for the prevention of deep vein thrombosis. The authors compared the impact of exercise, targeting legs utilizing the apparatus to standard active exercises and their connection to blood flow. The study involved healthy adults between the ages of twenty and thirty, two men and three women. The subjects took part in different exercises that were used as a comparison with exercises conducted using the LEX. The findings included the same levels of blood flow for both exercises in one minute and a significant rise in blood flow with exercise increase. Additionally, the exercises recorded the same blood flow rate and velocity within one minute and thirty seconds. The conclusions reached by the researchers from the study include the rise of lower leg blood flow and the diameter of blood vessels. The authors present the use of LEX as a mechanism to prevent the incidence of DVT among aging people and those that are bedridden. The article presents a new method of preventing increased DVT risk among older individuals. The credibility of the article comes from the fact that it focuses on the factors that can help increase blood flow and opening of the vessels to allow a significant flow of blood. In this sense, the article is essential as it provides details regarding the prevention of DVT and the increased use of exercise to prevent (Tanaka et al., 2016).