Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2011
EditorialThe cardiac intensive care unit perspective on hemodynamic monitoring of oxygen transport balance.
The purpose of this consensus statement is to present the available evidence supporting the use of a variety of hemodynamic monitors in a pediatric population. Each article within this supplement and the presentations at the Eighth International Conference of the Pediatric Cardiac Intensive Care Society provide the evidence to support recommendations for the use of each monitoring modality. The purpose of this editorial is to interpret the evidence provided elsewhere in this supplement from the perspective of cardiac critical care.
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Pediatr Crit Care Me · Jul 2011
ReviewMonitoring of standard hemodynamic parameters: heart rate, systemic blood pressure, atrial pressure, pulse oximetry, and end-tidal CO2.
Continuous monitoring of various clinical parameters of hemodynamic and respiratory status in pediatric critical care medicine has become routine. The evidence supporting these practices is examined in this review. ⋯ Use of heart rate, electrocardiography, noninvasive and arterial blood pressure, atrial pressure, pulse oximetry, and end-tidal carbon dioxide monitoring in the pediatric critical care unit is commonplace; this practice, however, is not supported by well-controlled clinical trials. Despite the majority of literature being case series, expert opinion would suggest that use of routine pulse oximetry and end-tidal carbon dioxide is the current standard of care. In addition, literature would suggest that invasive arterial monitoring is the current standard for monitoring in the setting of shock. The use of heart rate, electrocardiography. and atrial pressure monitoring is advantageous in specific clinical scenarios (postoperative cardiac surgery); however, the evidence for this is based on numerous case series only.