Tag: monitoring

Upvote Story 4
The finger cuff method provides a reasonable estimate of CO and blood pressure, which does not meet the criteria for clinical interchangeability with the currently used invasive devices. Finger cuff is an easy-to-use hemodynamic monitoring technique. Different devices are currently available, which provide continuous arterial blood pressure (Finapress), whereas only ClearSight (previously known as Nexfin; BMEYE) provides an estimate of CO. In most studies, the... Read More | Comment
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The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance was independently associated with improved survival and more days free of delirium and coma after adjusting for age, severity of illness, and presence of mechanical ventilation. Total and partial bundle compliance were measured daily. Random effects regression... Read More | Comment
Upvote Story 5
Shock has potentially reversible causes of morbidity and mortality if appropriately diagnosed and managed. Older methods of invasive monitoring have significant limitations but are still critical for managing shock in certain patients and settings. Newer methods are easier to employ, but further validation is needed. Multiple modalities along with careful clinical assessment are often useful in distinguishing shock subtypes. Best practice standards for monitoring should... Read More | Comment
Upvote Story 8
This highly informative book provides essential insights for ICU nurses at ECMO centers around the world, who face the substantial challenges involved in the management of ECMO patients. Above all, it meets their training needs with regard to bedside monitoring for these patients, which has become a major issue. The editors and most of the contributors serve at La Pitié-Salpétrière ICU, France, which, in terms... Read More | Comment
Upvote Story 6
Acute respiratory distress syndrome (ARDS) is a clinical entity that acutely affects the lung parenchyma, and is characterized by diffuse alveolar damage and increased pulmonary vascular permeability. Currently, computed tomography (CT) is commonly used for classifying and prognosticating ARDS. However, performing this examination in critically ill patients is complex, due to the need to transfer these patients to the CT room. Fortunately, new technologies have... Read More | Comment
Upvote Story 4
Post-intensive care syndrome (PICS) describes new or worsening impairments of physical, cognitive or mental health resulting from an episode of critical illness and its treatment and lasting after discharge from the intensive care unit (ICU). The incidence of PICS varies based on the domain impacted, ranging from up to 25% for physical and cognitive and up to 60% for psychiatric disturbances. Even as we continue... Read More | Comment
Upvote Story 5
The trajectory of recovery from critical illness is often portrayed as a continuum. At one extremity lies an unstable patient dependent on life-sustaining treatments in the intensive care unit. At the other extremity stands an independent community-dwelling individual with restored personal, social and cultural wellbeing. A progressive transition from illness to recovery reflected by gradual de-intensification of healthcare occurs over many weeks to months. This... Read More | Comment
Upvote Story 12
Dutch government is encouraging the healthcare sector to expand telehealth (eHealth) services. Dutch government wants eHealth to become more widely available and is encouraging the healthcare sector to develop it further. These are the following goals: By 2019 80% of the chronically ill have direct electronic access to some of their medical data, such as medication data, vital functions and test results, and is able... Read More | Comment
Upvote Story 5
When obtaining intracompartmental pressures, place the catheter within 5cm of the fracture level, with the transducer secured at the level of the measured compartment. Make sure to keep the catheter tip outside of the actual fracture site. If placed within the fracture, levels will be falsely high. Failure to place the transducer at the same height of the catheter tip will cause a falsely high... Read More | Comment
Upvote Story 10
Objective data and expert guidance on managing critically ill patients in unique question-based chapters that focus on best practices. Now thoroughly updated by Drs. Clifford S. Deutschman, Patrick J. Neligan, and nearly 200 critical-care experts, this highly regarded title remains the only book of its kind that provides a comprehensive framework for translating evidence into practice, making it a valuable resource for both residents and... Read More | Comment
Upvote Story 7
Of the studied ultrasound nICP methods, ONSD is the best estimator of Intracranial Pressure (ICP). The novel combination of ONSD ultrasonography and vTCD of the straight sinus is a promising and easily available technique for identifying critically ill patients with intracranial hypertension. This was a prospective, single-cohort observational study of patients admitted to a tertiary neurocritical care unit. Patients with brain injury requiring invasive ICP... Read More | Comment
Upvote Story 15
Teleologically, the mammalian brain has evolved to be the central component of life. It coordinates afferent and efferent neural pathways, integrates neurohormonal responses and, in humans, produces higher cortical effects that augment developmental and protective processes. Despite this vital role for human survival, the brain is profoundly vulnerable to injury and is in many ways set up to fail with devastating consequences for the patient.... Read More | Comment
Upvote Story 10
Continuous EEG monitoring is an important tool for assessing brain function and allows clinicians to identify malignant EEG patterns quickly and provide more effective care. The revised and updated second edition of Handbook of ICU EEG Monitoring distills the wide range of technical and clinical issues encountered in successful critical care EEG monitoring for the busy practitioner. Written by leading experts in this rapidly evolving... Read More | Comment
Upvote Story 5
A 50-year-old woman with liver failure was admitted to critical care for refractory status epilepticus (RSE). Following tracheal intubation, sevoflurane was administered via the MIRUS system (Pall Medical, Dreieich, Germany). Following incremental increases in minimum alveolar concentration (MAC) from 0.3 to 1.0, there was a suppression of motor activity and continuous electroencephalogram (EEG) monitoring revealed suppression of seizure activity. Sevoflurane was progressively reduced to 0.3... Read More | Comment
Upvote Story 4
Methods to monitor lean body mass in the ICU are under constant development, improving upon bedside usability and offering new modalities to measure. This provides clinicians with valuable markers with which to identify patients at high nutritional risk and to evaluate metabolic support during critical illness. Computed tomography scan analysis, musculoskeletal ultrasound, and bioelectrical impedance analysis are emerging as powerful clinical tools to monitor lean... Read More | Comment