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Monitoring During NIV

  • Stefano Nava
  • Francesco Fanfulla
Chapter

Abstract

The minimum monitoring is that appropriate for the severity of the patient’s condition, taking into account that clinical conditions can change rapidly. It does not, therefore, make sense to have invasive hemodynamic monitoring available when we are treating a simple, early stage of an exacerbation of COPD, just as it would be unthinkable to use NIV in a patient with pneumonia and severe hypoxia with only pulse oximetry available. It would obviously be desirable to work in a structure that has an integrated system of non invasive and invasive monitoring in order not to have to transfer the patient to another structure if his condition worsens. Outside intensive care units, this is possible only in third level respiratory intensive care units.

Keywords

Tidal Volume Simplified Acute Physiological Score Inspiratory Effort Maximum Inspiratory Pressure Systemic Arterial Blood Pressure 
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.

Suggested Reading

  1. Aubier M, Murciano D, Lecocquic Y et al (1985) Bilateral phrenic stimulation: a simple technique to assess diaphragmatic fatigue in humans. J Appl Physiol 58(1):58–64PubMedGoogle Scholar
  2. Bellemare F, Grassino A (1983) Force reserve of the diaphragm in patients with chronic obstructive pulmonary disease. J Appl Physiol 55(1 Pt 1):8–15PubMedGoogle Scholar
  3. Bergeron N, Dubois MJ, Dumont M et al (2001) Intensive care delirium screening checklist: evaluation of a new screening tool. Intensive Care Med 27(5):859–864PubMedCrossRefGoogle Scholar
  4. Bone RG (1990) Monitoring respiratory and hemodynamic function in the patient with respiratory failure. In: Kirby RR, Banner MJ, Downs JB (eds) Clinical applications of ventilatory support. Churchill Livingstone Med, New YorkGoogle Scholar
  5. Carlucci A, Schreiber A, Mattei A et al (2013) The configuration of bi-level ventilator circuits may affect compensation for non-intentional leaks during volume-targeted ventilation Intensive Care Med 39(1):59–65Google Scholar
  6. Ceriana P, Fanfulla F, Mazzacane F et al (2010) Delirium in patients admitted to a step-down unit: analysis of incidence and risk factors. J Crit Care 25(1):136–143PubMedCrossRefGoogle Scholar
  7. Corrado A, Ambrosino N, Rossi A et al (1994) Unità di terapia intensiva respiratoria. Rassegna di patologia dell’apparato respiratorio 9(2):115–123Google Scholar
  8. Cunnion RE, Natanson C (1994) Echocardiography, pulmonary artery catheterization, and radionuclide cineangiography in septic shock. Intensive Care Med 20(8):535–537PubMedCrossRefGoogle Scholar
  9. Ely WE, Inouye SK, Bernard GR et al (2001) Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA 286(21):2703–2710PubMedCrossRefGoogle Scholar
  10. Grandjean T (1968) Une microtechnique du cathétérisme cardiaque droit praticable au lit du malade sans contrôle radioscopique (A microtechnic of right heart catheterization useful at the bedside without fluoroscopic monitoring). Cardiologie 51(3):184–192Google Scholar
  11. Johnson DC, Batool S, Dalbec R (2008) Transcutaneous carbon dioxide pressure monitoring in a specialized weaning unit. Respir Care 53(8):1042–1047PubMedGoogle Scholar
  12. Kelly BJ, Matthog MA (1993) Prevalence and severity of neurological dysfunction in critically ill patients. Influence on need for continued mechanical ventilation. Chest 104:1818–1824PubMedCrossRefGoogle Scholar
  13. Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13(10):18–23CrossRefGoogle Scholar
  14. Laghi F, Cattapan SE, Jubran A et al (2003) Is weaning failure caused by low-frequency fatigue of the diaphragm? Am J Respir Crit Care Med 167(2):120–127PubMedCrossRefGoogle Scholar
  15. Laporta D, Grassino A (1985) Assessment of transdiaphragmatic pressure in humans. J Appl Physiol 58(5):1469–1476PubMedGoogle Scholar
  16. Lichtenstein DA, Meziére GA (2008) Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 134(1):117–125PubMedCrossRefGoogle Scholar
  17. Lofaso F, Fodil R, Lorino H, Leroux K, Quintel A, Leroy A, Harf A (2000) Inaccuracy of tidal volume delivered by home mechanical ventilators. Eur Respir J 15(2):338–341PubMedCrossRefGoogle Scholar
  18. Milic-Emili J, Mead J, Turner JM, Glauser EM (1964) Improved technique for estimating pleural pressure from esophageal balloons. J Appl Physiol 19:207–211PubMedGoogle Scholar
  19. Miller JM, Moxham J, Green M (1985) The maximal sniff in the assessment of diaphragm function in man. Clin Sci (Lond) 69(1):91–96Google Scholar
  20. Nava S, Ambrosino N, Crotti P et al (1993) Recruitment of some respiratory muscles during three maximal inspiratory manoeuvres. Thorax 48(7):702–707PubMedCrossRefGoogle Scholar
  21. Sassoon CS, Te TT, Mahutte CK, Light RW (1987) Airway occlusion pressure. An important indicator for successful weaning in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 135(1):107–113PubMedGoogle Scholar
  22. Talmor D, Sarge T, Malhotra A et al (2008) Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 359(20):2095–2104PubMedCrossRefGoogle Scholar
  23. Tobin MJ, Perez W, Guenther SM et al (1986) The pattern of breathing during successful and unsuccessful trials of weaning from mechanical ventilation. Am Rev Respir Dis 134(6):1111–1118PubMedGoogle Scholar
  24. Tobin MJ (1988) Respiratory monitoring in the intensive care unit. Am Rev Respir Dis 138(6):1625–1642PubMedCrossRefGoogle Scholar
  25. Vassilakopoulos T (2008) Understanding wasted/ineffective efforts in mechanically ventilated COPD patients using the Campbell diagram. Intensive Care Med 34(7):1336–1339PubMedCrossRefGoogle Scholar
  26. Withelaw WA, Derenne JP, Milic-Emili J (1975) Occlusion pressure as a measure of respiratory center output in conscious man. Respir Physiol 23(2):181–199CrossRefGoogle Scholar
  27. Yang KL, Tobin MJ (1991) A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med 324(21):1445–1450PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  1. 1.Respiratory and Critical Care UnitAO Sant’ Orsola Malpighi HospitalBolognaItaly
  2. 2.Sleep Medicine UnitFondazione Salvatore Maugeri Division PneumologicaPaviaItaly

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