Minerva anestesiologica
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Several recent studies have advanced our understanding of dead-space ventilation in patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). They have demonstrated the utility of measuring physiologic dead-space-to-tidal volume ratio (VD/VT) and related variables in assessing outcomes as well as therapeutic interventions. These studies have included the evaluation of mortality risk, pulmonary perfusion, as well as the effectiveness of drug therapy, prone positioning, positive end-expiratory pressure (PEEP) titration, and inspiratory pattern in improving gas exchange. ⋯ Much of this has been accomplished using volumetric capnography. This allows for more sophisticated measurements of pulmonary gas exchange function including: alveolar VD/VT, the volume of CO(2) excretion and the slope of the alveolar plateau which reflects ventilation: perfusion heterogeneity. Many of these measurements now can be made non-invasively which should only increase the research and clinical utility of volumetric capnography in studying and managing patients with ALI/ARDS.
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Minerva anestesiologica · Nov 2012
Admission decisions to a medical intensive care unit are based on functional status rather than severity of illness. A single center experience.
Few data exist on Medical Intensive Care Unit (MICU) triage practices. We assessed MICU triage practices in our medical center. ⋯ MICU admission decisions are implicitly based on patients' baseline functional status rather than severity of illness.