Medical technology in the intensive care unit

Scales, Damon C.; Sibbald, William J.

doi:10.1097/01.ccx.0000134334.44403.e3

Cited by 7 publications

(9 citation statements)

References 96 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A substantial knowledge database has been built up since then, in a variety of institutions, patient populations, and circumstances [16]. However, in the absence of any rigidly proven survival benefit, the catheter has become discredited in critical care medicine [12-16]. The lack of apparent benefit may relate, in part, to adverse effects of insertion, improper use, poor interpretation of hemodynamic data, and inadequate treatment decisions based on the collected variables, or combinations of these factors [20].…”

Section: What Do We Have and What Can They Do?mentioning

confidence: 99%

“…This chapter is not intended to compare one technique to another, which has been done abundantly in the literature, but to provide a conceptual framework to guide therapy of individual patients in various hospital settings by defining the elements that may help to choose among the available techniques, in the absence of a clear evidence-based survival benefit of any hemodynamic monitoring tool [12-16]. First, a brief discussion of what is available and of underlying basic principles seems warranted, since knowledge of possibilities, limitations and pitfalls is required before responsible choices can be made.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Choosing patient-tailored hemodynamic monitoring

2010

View full text Add to dashboard Cite

show abstract

Section: What Do We Have and What Can They Do?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Choosing patient-tailored hemodynamic monitoring

2010

View full text Add to dashboard Cite

show abstract

“…One tool may supplement another, so that it is advisable to gain expertise in more than one method, particularly in training environments. Health technology assessment institutions and agencies can be of help in advising on these complex issues and emergency and intensive care medicine organizations could benefi t from their expertise [1,12,13,25,41]. Th e underlying idea, of course, is that helping physicians to direct therapy using numbers rather than signs and symptoms, and helping the medical community by providing clear clinical guidelines on hemodynamic monitoring strategies will eff ectively result in health care improvements.…”

Section: Conclusion and Perspectivementioning

confidence: 99%

“…Th is chapter is not intended to compare one technique to another, which has been done abundantly in the literature, but to provide a conceptual framework to guide therapy of individual patients in various hospital settings by defi ning the elements that may help to choose among the available techniques, in the absence of a clear evidence-based survival benefi t of any hemodynamic monitoring tool [12][13][14][15][16]. First, a brief discussion of what is available and of underlying basic principles seems warranted, since knowledge of possibilities, limitations and pitfalls is required before responsible choices can be made.…”

Section: Introductionmentioning

confidence: 99%

“…A substantial knowledge database has been built up since then, in a variety of institutions, patient populations, and circumstances [16]. However, in the absence of any rigidly proven survival benefi t, the catheter has become discredited in critical care medicine [12][13][14][15][16]. Th e lack of apparent benefi t may relate, in part, to adverse eff ects of insertion, improper use, poor interpretation of hemodynamic data, and inadequate treatment decisions based on the collected variables, or combinations of these factors [20].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Choosing Patient-tailored Hemodynamic Monitoring

Slagt

Breukers

Groeneveld

2010

Intensive Care Medicine

View full text Add to dashboard Cite

This article is one of ten reviews selected from the Yearbook of Intensive Care and Emergency Medicine 2010 (Springer Verlag) and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum/series/yearbook. Further information about the Yearbook of Intensive Care and Emergency Medicine is available from http://www.springer.com/series/2855. Slagt et al. Critical Care 2010, 14:208 http://ccforum.com/content/14/2/208 © Springer-Verlag Berlin Heidelberg 2010. This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. mon i tor ing and measurement of cardiac output [13][14][15]. A substantial knowledge database has been built up since then, in a variety of institutions, patient populations, and circumstances [16]. However, in the absence of any rigidly proven survival benefi t, the catheter has become discredited in critical care medicine [12][13][14][15][16]. Th e lack of apparent benefi t may relate, in part, to adverse eff ects of insertion, improper use, poor interpretation of hemodynamic data, and inadequate treatment decisions based on the collected variables, or combinations of these factors [20]. Conversely, the value of pulmonary artery pressures, pulmonary artery occlusion pressure (PAOP), mixed venous oxygen saturation (SvO 2 ), and right heart volumes, some of the variables that can be uniquely assessed at the bedside of the critically ill patient with help of the PAC and right-sided thermodilution, remains hotly debated [13][14][15]20]. Th e patient population or circumstance that is most likely to benefi t from pulmonary artery catheterization is, therefore, still being actively looked for [13-15, 21, 22]. R E V I E WA second generation hemodynamic monitoring principle includes the less invasive transpulmonary (dye) thermodilution technique, e.g. PiCCO. Th is technique off ers the unique possibility of estimating cardiac preload volumes, measurements of which are not confounded by mechanical ventilation in contrast to pressure and dynamic indices of preload and fl uid responsiveness, and of extravascular lung water as a direct measure of pulmonary edema and permeability. Dilutional methods to measure cardiac output include the transpulmonary lithium and indocyanine green (pulse dye) techniques, allowing peripheral injections and peripheral and, for pulse dye, non-invasive detection.Pulse-contour or pulse-power methods, needing relatively frequent recalibration for optimal performance in tracking changes in cardiac output, are...

show abstract