Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2011
EditorialThe nursing perspective on monitoring hemodynamics and oxygen transport.
Maintenance of adequate systemic oxygen delivery requires careful clinical assessment integrated with hemodynamic measurements and calculations to detect and treat conditions that may compromise oxygen delivery and lead to life-threatening shock, respiratory failure, or cardiac arrest. The bedside nurse constantly performs such assessments and measurements to detect subtle changes and trends in patient condition. The purpose of this editorial is to highlight nursing perspectives about the hemodynamic and oxygen transport monitoring systems summarized in the Pediatric Cardiac Intensive Care Society Evidence- Based Review and Consensus Statement on Monitoring of Hemodynamics and Oxygen Transport Balance. There is no substitute for the observations of a knowledgeable and experienced clinician who understands the patient's condition and potential causes of deterioration and is able to evaluate response to therapy.
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The hemodynamic evaluation and monitoring in the critically ill newborn (particularly the premature infant) poses unique challenges because of urgency, size limitations, and the persistence of fetal shunt channels. Echocardiography and other noninvasive methods are currently the mainstay of hemodynamic assessment. ⋯ There is a need for evaluating a number of assessments as targets of goal-directed therapy in the unstable newborn infant. We provide an interpretation of the evidence supporting various monitoring strategies.
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Pediatr Crit Care Me · Jul 2011
Editorial CommentDisasters, humanitarian responses, and critical care.