Respiratory monitoring in an intermediate intensive unit.
The major goal of monitoring is continuous recording of indices that enhance our understanding of the underlying pathophysiology, in order to improve diagnosis and guide management, and identify trends that assist in assessing the therapeutic response and predicting prognosis. Nowadays, technology has made it possible to automatically sense and display a wide variety of physiological indices. An ideal monitoring system should be pertinent to patient management, propose interpretable data, show high technical accuracy, high sensitivity, good reproducibility, be practical to use. The international literature, our personal experience, and cost considerations have proposed the following monitoring standards as the best for a noninvasive respiratory intermediate intensive care unit (RIICU): 1) mandatory indices: respiratory rate, oxygen saturation, haemogas-analysis, tidal volume, minute ventilation, maximum voluntary ventilation, forced expiratory volume in one second, forced vital capacity, vital capacity, maximal inspiratory pressure, heart rate and blood pressure; 2) second choice indices: capnometry, respiratory inductive plethysmography, transcutaneous monitoring of gases, haemodynamic monitoring, mechanics data by means of an oesophageal balloon, and central drive. Pulmonary monitoring devices shorten the time for patients who remain on mechanical ventilators; a reduction both in the risk of associated complications and the costs involved is a natural consequence. Continuous monitoring of significant physiological indices has the potential for predicting a critical event, and providing an opportunity for the institution of lifesaving measures.(ABSTRACT TRUNCATED AT 250 WORDS)
Vitacca
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M
Division of Pneumology, Clinica del Lavoro Foundation IRCCS (PV), Medical Center of Rehabilitation, Gussago (BS), Italy.
Clini
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D003422:Critical Care / Q000592:standards; D006801:Humans; D008991:Monitoring, Physiologic / Q000592:standards*; D012119:Respiration; D012124:Respiratory Care Units / Q000592:standards*; D012449:Safety