Advertisement

Noninvasive Monitoring in the Intensive Care Unit

  • Francis C. Cordova
  • Nathaniel Marchetti
Chapter

Abstract

After studying this chapter, you should be able to do the following: Know the different noninvasive monitoring techniques commonly used in the intensive care unit (ICU) setting. Know the advantages and limitations of the different noninvasive monitoring methods. Know the different technologies used in noninvasive monitoring. Correlate the findings observed during noninvasive monitoring with the patient’s changing physiology.

Keywords

Force Vital Capacity Pulse Oximetry Noninvasive Positive Pressure Ventilation Intensive Care Unit Setting Impedance Cardiography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Hinkelbein J, Koehler H, Genzwuerker HV, Fiedler F. Artificial acrylic finger nails may alter pulse oximetry measurement. Resuscitation. 2007;74(1):75-82.PubMedCrossRefGoogle Scholar
  2. 2.
    Cote CJ, Goldstein EA, Fuchsman WH, Hoaglin DC. The effect of nail polish on pulse oximetry. Anesth Analg. 1988;67(7): 683-686.PubMedGoogle Scholar
  3. 3.
    Hinkelbein J, Genzwuerker HV, Sogl R, Fiedler F. Effect of nail polish on oxygen saturation determined by pulse oximetry in critically ill patients. Resuscitation. 2007;72(1):82-91.PubMedCrossRefGoogle Scholar
  4. 4.
    Barker SJ, Badal JJ. The measurement of dyshemoglobins and total hemoglobin by pulse oximetry. Curr Opin Anaesthesiol. 2008;21(6):805-810.PubMedCrossRefGoogle Scholar
  5. 5.
    Pedersen T. Does perioperative pulse oximetry improve outcome? Seeking the best available evidence to answer the clinical question. Best Pract Res Clin Anaesthesiol. 2005;19(1):111-123.PubMedGoogle Scholar
  6. 6.
    Pedersen T, Moller AM, Pedersen BD. Pulse oximetry for perioperative monitoring: systematic review of randomized, controlled trials. Anesth Analg. 2003;96(2):426-431; table of contents.Google Scholar
  7. 7.
    Shoemaker WC, Wo CC, Chien LC, et al. Evaluation of invasive and noninvasive hemodynamic monitoring in trauma patients. J Trauma. 2006;61(4):844-853; discussion 853-854.Google Scholar
  8. 8.
    Quigley FG, Faris IB. Transcutaneous oxygen tension measurements in the assessment of limb ischaemia. Clin Physiol. 1991; 11(4):315-320.PubMedCrossRefGoogle Scholar
  9. 9.
    Dowd GS, Linge K, Bentley G. Measurement of transcutaneous oxygen pressure in normal and ischaemic skin. J Bone Joint Surg Br. 1983;65(1):79-83.PubMedGoogle Scholar
  10. 10.
    Faglia E, Clerici G, Caminiti M, Quarantiello A, Curci V, Morabito A. Predictive values of transcutaneous oxygen tension for above-the-ankle amputation in diabetic patients with critical limb ischemia. Eur J Vasc Endovasc Surg. 2007;33(6):731-736.PubMedCrossRefGoogle Scholar
  11. 11.
    Clark JS, Votteri B, Ariagno RL, et al. Noninvasive assessment of blood gases. Am Rev Respir Dis. 1992;145(1):220-232.PubMedCrossRefGoogle Scholar
  12. 12.
    Eletr S, Jimison H, Ream AK, Dolan WM, Rosenthal MH. Cutaneous monitoring of systemic PCO2 on patients in the respiratory intensive care unit being weaned from the ventilator. Acta Anaesthesiol Scand Suppl. 1978;68:123-127.PubMedCrossRefGoogle Scholar
  13. 13.
    Janssens JP, Howarth-Frey C, Chevrolet JC, Abajo B, Rochat T. Transcutaneous PCO2 to monitor noninvasive mechanical ventilation in adults: assessment of a new transcutaneous PCO2 device. Chest. 1998;113(3):768-773.PubMedCrossRefGoogle Scholar
  14. 14.
    Griffin J, Terry BE, Burton RK, et al. Comparison of end-tidal and transcutaneous measures of carbon dioxide during general anaesthesia in severely obese adults. Br J Anaesth. 2003;91(4): 498-501.PubMedCrossRefGoogle Scholar
  15. 15.
    Parker SM, Gibson GJ. Evaluation of a transcutaneous carbon dioxide monitor (“TOSCA”) in adult patients in routine respiratory practice. Respir Med. 2007;101(2):261-264.PubMedCrossRefGoogle Scholar
  16. 16.
    Rodriguez P, Lellouche F, Aboab J, Buisson CB, Brochard L. Transcutaneous arterial carbon dioxide pressure monitoring in critically ill adult patients. Intensive Care Med. 2006;32(2):309-312.PubMedCrossRefGoogle Scholar
  17. 17.
    Tremper KK, Mentelos RA, Shoemaker WC. Effect of hypercarbia and shock on transcutaneous carbon dioxide at different electrode temperatures. Crit Care Med. 1980;8(11):608-612.PubMedCrossRefGoogle Scholar
  18. 18.
    Nolan LS, Shoemaker WC. Transcutaneous O2 and CO2 monitoring of high risk surgical patients during the perioperative period. Crit Care Med. 1982;10(11):762-764.PubMedCrossRefGoogle Scholar
  19. 19.
    Eberhard P. The design, use, and results of transcutaneous carbon dioxide analysis: current and future directions. Anesth Analg. 2007;105(6 Suppl):S48-S52.PubMedCrossRefGoogle Scholar
  20. 20.
    Janssens JP, Perrin E, Bennani I, de Muralt B, Titelion V, Picaud C. Is continuous transcutaneous monitoring of PCO2 (TcPCO2) over 8 h reliable in adults? Respir Med. 2001;95(5):331-335.PubMedCrossRefGoogle Scholar
  21. 21.
    Cotter G, Moshkovitz Y, Kaluski E, et al. Accurate, noninvasive continuous monitoring of cardiac output by whole-body electrical bioimpedance. Chest. 2004;125(4):1431-1440.PubMedCrossRefGoogle Scholar
  22. 22.
    Suttner S, Schollhorn T, Boldt J, et al. Noninvasive assessment of cardiac output using thoracic electrical bioimpedance in hemodynamically stable and unstable patients after cardiac surgery: a comparison with pulmonary artery thermodilution. Intensive Care Med. 2006;32(12):2053-2058.PubMedCrossRefGoogle Scholar
  23. 23.
    Taler SJ, Textor SC, Augustine JE. Resistant hypertension: comparing hemodynamic management to specialist care. Hypertension. 2002;39(5):982-988.PubMedCrossRefGoogle Scholar
  24. 24.
    Summers RL, Parrott CW, Quale C, Lewis DL. Use of noninvasive hemodynamics to aid decision making in the initiation and titration of neurohormonal agents. Congest Heart Fail. 2004;10(2 suppl 2):28-31.PubMedCrossRefGoogle Scholar
  25. 25.
    Packer M, Abraham WT, Mehra MR, et al. Utility of impedance cardiography for the identification of short-term risk of clinical decompensation in stable patients with chronic heart failure. J Am Coll Cardiol. 2006;47(11):2245-2252.PubMedCrossRefGoogle Scholar
  26. 26.
    Doering L, Lum E, Dracup K, Friedman A. Predictors of between-method differences in cardiac output measurement using thoracic electrical bioimpedance and thermodilution. Crit Care Med. 1995;23(10):1667-1673.PubMedCrossRefGoogle Scholar
  27. 27.
    Moshkovitz Y, Kaluski E, Milo O, Vered Z, Cotter G. Recent developments in cardiac output determination by bioimpedance: comparison with invasive cardiac output and potential cardiovascular applications. Curr Opin Cardiol. 2004;19(3):229-237.PubMedCrossRefGoogle Scholar
  28. 28.
    Claassen J, Mayer SA, Kowalski RG, Emerson RG, Hirsch LJ. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004;62(10):1743-1748.PubMedCrossRefGoogle Scholar
  29. 29.
    Jordan KG. Neurophysiologic monitoring in the neuroscience intensive care unit. Neurol Clin. 1995;13(3):579-626.PubMedGoogle Scholar
  30. 30.
    Jaitly R, Sgro JA, Towne AR, Ko D, DeLorenzo RJ. Prognostic value of EEG monitoring after status epilepticus: a prospective adult study. J Clin Neurophysiol. 1997;14(4):326-334.PubMedCrossRefGoogle Scholar
  31. 31.
    DeLorenzo RJ, Waterhouse EJ, Towne AR, et al. Persistent nonconvulsive status epilepticus after the control of convulsive status epilepticus. Epilepsia. 1998;39(8):833-840.PubMedCrossRefGoogle Scholar
  32. 32.
    Young GB, Jordan KG, Doig GS. An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring: an investigation of variables associated with mortality. Neurology. 1996;47(1):83-89.PubMedCrossRefGoogle Scholar
  33. 33.
    Kress JP, Pohlman AS, O’Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000;342(20):1471-1477.PubMedCrossRefGoogle Scholar
  34. 34.
    Jacobi J, Fraser GL, Coursin DB, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002;30(1):119-141.PubMedCrossRefGoogle Scholar
  35. 35.
    Riker RR, Picard JT, Fraser GL. Prospective evaluation of the sedation-agitation scale for adult critically ill patients. Crit Care Med. 1999;27(7):1325-1329.PubMedCrossRefGoogle Scholar
  36. 36.
    Sessler CN, Gosnell MS, Grap MJ, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166(10):1338-1344.PubMedCrossRefGoogle Scholar
  37. 37.
    Ely EW, Margolin R, Francis J, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001;29(7):1370-1379.PubMedCrossRefGoogle Scholar
  38. 38.
    McGough EK, Boysen PG. Benefits and limitations of pulse oximetry in the ICU. J Crit Illness. 1989;4:23.Google Scholar
  39. 39.
    Tobin MJ. Respiratory monitoring in the intensive care unit. Am Rev Respir Dis. 1988;138:1625-1642.PubMedGoogle Scholar
  40. 40.
    Trempee K, Burker S. Using pulse oximetry when does hemoglobin levels are high. J Crit Illness. 1988;3:103-107.Google Scholar
  41. 41.
    Loeb RG, Santos WC. Monitoring ventilation. In: Hanowell LH, Waldron RJ, eds. Airway management. Philadelphia: Lippincott-Raven; 1996.Google Scholar
  42. 42.
    Djordjevich L, Sadove MS. Basic principles of electrohaemodynamics. J Biomed Eng. 1981;3(1):25-33.PubMedCrossRefGoogle Scholar
  43. 43.
    Kaplan PW. EEG monitoring in the intensive care unit. Am J END Technol. 2006;46(2):81-97.Google Scholar

Additional Reading

  1. Bowton DI, Scuderi PE, Harris L, Haponik EF. Pulse oximetry monitoring outside the intensive care unit: progress or problem? Ann Intern Med. 1991;115:450-454.PubMedGoogle Scholar
  2. Clark JS, Votteri B, Ariagno RL, et al. Noninvasive assessment of blood gases. Am Rev Respir Dis. 1992;145:220-232.PubMedCrossRefGoogle Scholar
  3. Clements FM, de Bruijn NP. Noninvasive cardiac monitoring. Crit Care Clin. 1998;4(3):435-454.Google Scholar
  4. Curley FJ, Smyrnios NS. Routine monitoring of critically ill patients. In: Irwin RS, Cerra FB, Rippe JM, eds. Intensive Care Medicine. 4th ed. Philadelphia: Lippincott-Raven; 1999.Google Scholar
  5. Schnapp LM, Cohen NH. Pulse oximetry: uses and abuses. Chest. 1990;98:1244-1250.PubMedCrossRefGoogle Scholar
  6. St. John RE, Thompson PD. Noninvasive respiratory monitoring. Crit Care Nurs Clin North Am. 1999;11(4):423-435.Google Scholar
  7. Tsadok S. The historical evolution of bioimpedance. AACN Clin Issues. 1999;10(3):371-384.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Francis C. Cordova
    • 1
  • Nathaniel Marchetti
    • 2
  1. 1.Department of Internal Medicine, Division of Pulmonary and Critical CareTemple University School of MedicinePhiladelphiaUSA
  2. 2.Division of Pulmonary and Critical Care MedicineTemple University School of MedicinePhiladelphiaUSA

Personalised recommendations