Monitoring in the Intensive Care
- Kipnis, Eric Department of Anesthesiology and Critical Care, Lille University Teaching Hospital, Rue Michel Polonowski, 59037 Lille, France
- Ramsingh, Davinder Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA 92697, USA
- Bhargava, Maneesh Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
- Dincer, Erhan Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
- Cannesson, Maxime Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA 92697, USA
- Broccard, Alain Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
- Vallet, Benoit Department of Anesthesiology and Critical Care, Lille University Teaching Hospital, Rue Michel Polonowski, 59037 Lille, France
- Bendjelid, Karim Centre de Recherche en Nutrition Humaine Auvergne, UMR 1019 Nutrition Humaine, INRA, Clermont Université, Service de Nutrition Clinique, CHU de Clermont-Ferrand, 63009 Clermont-Ferrand, France
- Thibault, Ronan Intensive Care Division, Geneva University Hospitals, 1211 Geneva 14, Switzerland
Published in:
- Critical Care Research and Practice. - Hindawi Limited. - 2012, vol. 2012, p. 1-20
English
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.
- Language
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- English
- Open access status
- gold
- Identifiers
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- DOI 10.1155/2012/473507
- ISSN 2090-1305
- Persistent URL
- https://sonar.ch/global/documents/224792
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