Current opinion in critical care
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The aim of this study was to review the role of haemodynamic monitoring in the perioperative setting, highlighting who are the patients who most benefit, to describe the type of devices, to analyse the scientific evidence and to suggest algorithms of haemodynamic care in high-risk surgical patients. ⋯ In this review, we summarize the benefits of haemodynamic monitoring, the type of devices with advantages and disadvantages, the scientific evidence supporting perioperative haemodynamic therapy, and we suggest a multimodal approach to improve patients' care.
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Curr Opin Crit Care · Jun 2023
ReviewThe role of the electroencephalogram and evoked potentials after cardiac arrest.
In comatose cardiac arrest survivors, the electroencephalogram (EEG) is the most widely used test to assess the severity of hypoxic-ischemic brain injury (HIBI) and guide antiseizure treatment. However, a wide variety of EEG patterns are described in literature. Moreover, the value of postarrest seizure treatment is uncertain. Absent N20 waves of short-latency somatosensory-evoked potentials (SSEPs) are a specific predictor of irreversible HIBI. However, the prognostic significance of the N20 amplitude is less known. ⋯ Standardized EEG terminology and quantitative approach to SSEP are promising for improving the neuroprognostic accuracy of these tests. Further research is needed to identify the potential benefits of antiseizure treatment after cardiac arrest.
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To discuss the different techniques used to assess tissue oxygenation in critically ill patients. ⋯ Recent studies have highlighted the interest of surrogate measurements of tissue oxygenation and in particular PCO2 gradients.