• R E St John and P D Thomson.
• St. Louis University School of Nursing, USA. restjoh@mkg.com
• Crit Care Nurs Clin North Am. 1999 Dec 1; 11 (4): 423-35.

AbstractAdvances in technology now permit a variety of noninvasive respiratory monitoring options for clinicians. Perhaps a more complex issue is determining how much monitoring is needed as part of routine patient care. Often, practitioners take a "more is better" approach. This reasoning is justified in critical care, because, in theory, the more information clinicians have available to them, the more likely they are to make accurate assessments and proper therapeutic interventions. If one fails to properly understand the physiologic significance and clinical limitations of the numbers or waveforms from the monitor, however, patient care may not improve and, even worse, may be compromised. Therefore, proper training in all aspects of respiratory monitoring should be a basic and fundamental component of any critical care nurse training program. There are important cost considerations to be taken into account with continuous respiratory monitoring. The financial impact as it relates to care of the critically ill patient is often difficult to assess. Issues of cost-effectiveness are often justified because of the complex nature of caring for these patients and their need for intensive clinical observation and evaluation. The fact that many aspects of cardiopulmonary assessment can now be determined noninvasively is an important advantage over more invasive technologies and their associated risks. Clearly, monitoring techniques such as pulse oximetry and capnography do not eliminate the need for arterial blood gases and other invasive cardiopulmonary monitoring techniques. Rather, when appropriately applied, noninvasive monitoring has the potential to reduce the frequency of certain invasive procedures and still provide valuable information to nurses and other health care practitioners.

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