Critical care nursing clinics of North America
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Technologies now exist that measure carbon dioxide levels transcutaneously. Rapid assessment of patients who have depressed ventilation or suspected sepsis can improve treatment decisions including the need for admission to the ICU and pulmonary artery catheterization.
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Crit Care Nurs Clin North Am · Jun 2006
Review Case ReportsContinuous ST-segment monitoring: raising the bar.
ST-segment monitoring is recommended by clinical experts to assist in the early detection of transient myocardial ischemia; however, a gap exists between the recommendations and clinical practice. This article provides a review of research to support the use of ST-segment monitoring in a variety of clinical situations. Patient selection for monitoring, techniques, and strategies to facilitate successful implementation of ST monitoring are included. Nurses are encouraged to advocate for patients by raising the bar of electrocardiogram monitoring practice to aid in optimizing patient outcomes.
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Crit Care Nurs Clin North Am · Jun 2006
Review Case ReportsRecognizing and treating ischemic insults to the brain: the role of brain tissue oxygen monitoring.
This article describes the potential application of brain tissue oxygen monitoring technology in the care of patients who have sustained traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). To accomplish this objective, a review of the intracranial dynamics that are created by primary and secondary brain injury, and the challenges of optimizing oxygen delivery to the injured brain are presented. Furthermore, interventions that facilitate cerebral oxygen supply and reduce oxygen consumption are identified. Finally, application of this technology is highlighted by using case vignettes of patients who have TBI or SAH.
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Crit Care Nurs Clin North Am · Jun 2006
ReviewEnd-tidal carbon dioxide monitoring: a VITAL sign worth watching.
Capnography is the monitoring of end-tidal carbon dioxide in waveform and numeric display. For this technology to be useful, the critical care nurse must have a clear understanding of the normal capnography waveform and what the alterations in this waveform represent. The critical care nurse can use this information to plan patient care interventions with other critical care team members and to adjust care based on the patient's response. End-tidal carbon dioxide physiology, normal waveforms, abnormal waveforms, and clinical aspects of capnography monitoring are included.
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Crit Care Nurs Clin North Am · Jun 2006
ReviewArterial pressure-based technologies: a new trend in cardiac output monitoring.
New trends in cardiovascular monitoring use the arterial pulse as a less invasive means of assessing cardiac output. When adopting a new technology into practice, three questions need to be answered: (1) is the method technologically sound?, (2) is it based on physiologic principles?, and (3) are the applications clinically important? This article provides a clinical review on the technology, physiology, and applications of a new arterial pressure-based method of determining cardiac output and stroke volume variation as an additional parameter for fluid status assessment.