Critical care nursing clinics of North America
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The new modes and techniques of ventilation provide much needed alternative ventilatory support for the critically ill patient. Reduction of airway pressure, improved oxygenation, recruitment of alveoli, and redistribution of ventilation are the major advantages of these new modes. Continued research and clinical application will help develop a mechanical ventilation system that optimizes the patient respiratory status with minimal adverse effects.
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Crit Care Nurs Clin North Am · Dec 1989
Case ReportsExtravascular lung water. Concepts in clinical application.
EVLW holds the potential to serve as a better clinical end point to clinical decision than current cardiopulmonary parameters. Evidence is present that the use of EVLW data may improve patient outcome, particularly in the population of high EVLW and low PCWP. The key area of clinical value with EVLW is the importance of understanding that EVLW may not be readily predicted by current methods. ⋯ The current methods consume substantial nursing time to perform, limiting practicality in clinical settings. The ideal device will not only be easy to use but will be noninvasive. This device has not yet been developed.
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Crit Care Nurs Clin North Am · Sep 1989
ReviewCardiac output: theory, technique, and troubleshooting.
Cardiac output is a hemodynamic parameter used by critical care nurses to guide and evaluate therapy. The thermodilution method of cardiac output measurement has allowed this parameter to be obtained at the bedside that is easily performed, timely, and reliable. ⋯ Potential physiologic and technical problems may yield erroneous cardiac output values. Critical care nurses must strive to maintain up-to-date knowledge and skill in performing thermodilution cardiac output measurements to ensure accurate and reliable values.
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Crit Care Nurs Clin North Am · Sep 1989
Review Case ReportsPhysiologic rationale of Sv-O2 monitoring.
Mixed venous oxygen saturation is a global indicator of the balance between oxygen transport and oxygen demand. In critically ill patients, the delivery of adequate quantities of oxygen to meet the cellular oxygen demands is paramount. While parameters such as SaO2, PaO2, and CO reveal important information about oxygen transport, the SvO2 indicates the adequacy of supply in relation to tissue oxygen demands.
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Crit Care Nurs Clin North Am · Sep 1989
Using hemodynamic waveforms to assess cardiopulmonary pathologies.
The pulmonary artery catheter brought measurement of hemodynamic parameters to the bedside in the early 1970s. The critical care clinician has been able to obtain direct and derived parameters that have proved useful in the diagnosis, management, and evaluation in various clinical conditions. The evaluation of the mechanical events in the heart, as evidenced through accurate interpretation of waveform configuration, has enhanced the diagnostic ability of the clinician. A wide variety of cardiopulmonary conditions can be recognized, including valvular defects, shunts, electrical disturbances and others, which allow the clinician to optimize hemodynamic function and impact patient survival.