Current opinion in critical care
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Curr Opin Crit Care · Jun 2022
ReviewRemote monitoring in the use of extracorporeal membrane oxygenation and acute mechanical circulatory support.
To provide an overview of the role of remote monitoring tools in management of critically-ill patients requiring acute mechanical circulatory support (MCS). ⋯ Remote monitoring for MCS devices represents a major opportunity for further investigation to improve the utilization of these devices and better serve patients.
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Curr Opin Crit Care · Jun 2022
ReviewThe weaning from mechanical ventilation: a comprehensive ultrasound approach.
Due to heart, lung and diaphragm interactions during weaning from mechanical ventilation, an ultrasound integrated approach may be useful in the detection of dysfunctions potentially leading to weaning failure. In this review, we will summarize the most recent advances concerning the ultrasound applications relevant to the weaning from mechanical ventilation. ⋯ The present review summarizes the potential role of ultrasonography in the weaning process. A multimodal integrated approach allows the clinician to comprehend the pathophysiological processes of weaning failure.
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Curr Opin Crit Care · Jun 2022
ReviewElectrical impedance tomography in the adult intensive care unit: clinical applications and future directions.
Electrical impedance tomography (EIT) is a novel, noninvasive, radiation-free, bedside imaging and monitoring tool to assess and visualize regional distribution of lung ventilation and perfusion. Although primarily a research tool, rapidly emerging data are beginning to define its clinical role, and it is poised to become a ubiquitous addition to the arsenal of the intensive care unit (ICU). In this review, we summarize the data supporting clinical use of EIT in adult ICUs, with an emphasis on appropriate application while highlighting future directions. ⋯ As EIT becomes more common and its clinical role more defined, intensivists will benefit from a clear understanding of its applications and limitations.
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The purpose of this article is to review various contemporary cardiac output (CO) measurement technologies available and their utility in critically ill patients. ⋯ PAC thermodilution for CO measurement is still gold standard and most suitable in patients with cardiac pathology and with experienced user. CCE offers an alternative to thermodilution and is suitable for all ICUs; however, structural training is required.
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Out-of-hospital cardiac arrest (OHCA) is a time-critical emergency in which a rapid response following the chain of survival is crucial to save life. Disparities in care can occur at each link in this pathway and hence produce health inequities. This review summarises the health inequities that exist for OHCA patients and suggests how they may be addressed. ⋯ OHCA disproportionately affects deprived communities and ethnic minorities. These groups experience disparities in care throughout the chain of survival and this appears to translate into poorer outcomes. Addressing these inequities will require coordinated action that engages with disadvantaged communities.