Monitoring in the Intensive Care
In critical care, the monitoring is essential to the daily care of ICU patients, as the optimization of patient’s hemodynamic, ventilation, temperature, nutrition, and metabolism is the key to improve patients' survival. Indeed, the decisive endpoint is the supply of oxygen to tissues according...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/473507 |
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| _version_ | 1832549301079769088 |
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| author | Eric Kipnis Davinder Ramsingh Maneesh Bhargava Erhan Dincer Maxime Cannesson Alain Broccard Benoit Vallet Karim Bendjelid Ronan Thibault |
| author_facet | Eric Kipnis Davinder Ramsingh Maneesh Bhargava Erhan Dincer Maxime Cannesson Alain Broccard Benoit Vallet Karim Bendjelid Ronan Thibault |
| author_sort | Eric Kipnis |
| collection | DOAJ |
| description | In critical care, the monitoring is essential to the daily care of ICU patients, as the optimization of patient’s hemodynamic, ventilation, temperature, nutrition, and metabolism is the key to improve patients' survival. Indeed, the decisive endpoint is the supply of oxygen to tissues according to their metabolic needs in order to fuel mitochondrial respiration and, therefore, life. In this sense, both oxygenation and perfusion must be monitored in the implementation of any resuscitation strategy. The emerging concept has been the enhancement of macrocirculation through sequential optimization of heart function and then judging the adequacy of perfusion/oxygenation on specific parameters in a strategy which was aptly coined “goal directed therapy.” On the other hand, the maintenance of normal temperature is critical and should be regularly monitored. Regarding respiratory monitoring of ventilated ICU patients, it includes serial assessment of gas exchange, of respiratory system mechanics, and of patients' readiness for liberation from invasive positive pressure ventilation. Also, the monitoring of nutritional and metabolic care should allow controlling nutrients delivery, adequation between energy needs and delivery, and blood glucose. The present paper will describe the physiological basis, interpretation of, and clinical use of the major endpoints of perfusion/oxygenation adequacy and of temperature, respiratory, nutritional, and metabolic monitorings. |
| format | Article |
| id | doaj-art-4641887b50d441a494a8449fea8eb4a9 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-4641887b50d441a494a8449fea8eb4a92025-02-03T06:11:40ZengWileyCritical Care Research and Practice2090-13052090-13132012-01-01201210.1155/2012/473507473507Monitoring in the Intensive CareEric Kipnis0Davinder Ramsingh1Maneesh Bhargava2Erhan Dincer3Maxime Cannesson4Alain Broccard5Benoit Vallet6Karim Bendjelid7Ronan Thibault8Department of Anesthesiology and Critical Care, Lille University Teaching Hospital, Rue Michel Polonowski, 59037 Lille, FranceDepartment of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA 92697, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USADepartment of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA 92697, USADivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USADepartment of Anesthesiology and Critical Care, Lille University Teaching Hospital, Rue Michel Polonowski, 59037 Lille, FranceGeneva Medical School, 1211 Geneva 14, SwitzerlandIntensive Care Division, Geneva University Hospitals, 1211 Geneva 14, SwitzerlandIn critical care, the monitoring is essential to the daily care of ICU patients, as the optimization of patient’s hemodynamic, ventilation, temperature, nutrition, and metabolism is the key to improve patients' survival. Indeed, the decisive endpoint is the supply of oxygen to tissues according to their metabolic needs in order to fuel mitochondrial respiration and, therefore, life. In this sense, both oxygenation and perfusion must be monitored in the implementation of any resuscitation strategy. The emerging concept has been the enhancement of macrocirculation through sequential optimization of heart function and then judging the adequacy of perfusion/oxygenation on specific parameters in a strategy which was aptly coined “goal directed therapy.” On the other hand, the maintenance of normal temperature is critical and should be regularly monitored. Regarding respiratory monitoring of ventilated ICU patients, it includes serial assessment of gas exchange, of respiratory system mechanics, and of patients' readiness for liberation from invasive positive pressure ventilation. Also, the monitoring of nutritional and metabolic care should allow controlling nutrients delivery, adequation between energy needs and delivery, and blood glucose. The present paper will describe the physiological basis, interpretation of, and clinical use of the major endpoints of perfusion/oxygenation adequacy and of temperature, respiratory, nutritional, and metabolic monitorings.http://dx.doi.org/10.1155/2012/473507 |
| spellingShingle | Eric Kipnis Davinder Ramsingh Maneesh Bhargava Erhan Dincer Maxime Cannesson Alain Broccard Benoit Vallet Karim Bendjelid Ronan Thibault Monitoring in the Intensive Care Critical Care Research and Practice |
| title | Monitoring in the Intensive Care |
| title_full | Monitoring in the Intensive Care |
| title_fullStr | Monitoring in the Intensive Care |
| title_full_unstemmed | Monitoring in the Intensive Care |
| title_short | Monitoring in the Intensive Care |
| title_sort | monitoring in the intensive care |
| url | http://dx.doi.org/10.1155/2012/473507 |
| work_keys_str_mv | AT erickipnis monitoringintheintensivecare AT davinderramsingh monitoringintheintensivecare AT maneeshbhargava monitoringintheintensivecare AT erhandincer monitoringintheintensivecare AT maximecannesson monitoringintheintensivecare AT alainbroccard monitoringintheintensivecare AT benoitvallet monitoringintheintensivecare AT karimbendjelid monitoringintheintensivecare AT ronanthibault monitoringintheintensivecare |