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Category: Critical Care Nursing Careful clinical examination should be performed in the early phase of shock, as it can provide useful information about the causative mechanism. Pa...
Category: Critical Care Nursing Acute respiratory insufficiency occurs when the lungs no longer meet the metabolic demands of the body, which by tradition is divided into two type...
Category: Critical Care Nursing Mottling or prolonged capillary refill time (CRT) is suggestive of low cardiac output with great specificity but low sensitivity. A strategy guided...
Category: Critical Care Nursing In the 1990s, the pulmonary artery catheter was at its apogee, as it was the only method to assess/monitor hemodynamics. It measures cardiac output,...
Category: Critical Care Nursing Dead-space ventilation, the portion of tidal volume that does not encounter perfused alveoli, directly affects CO2 excretion and is used as an indi...
Category: Critical Care Nursing Clinically, the P/F ratio (PaO2/FiO2) is most commonly used to approximately quantitate the degree of venous admixture, composed of ventilation/per...
Category: Critical Care Nursing Capnometry is used for a variety of purposes, such as in the diagnosis of a pulmonary embolism, determination of lung recruitment, detection of aut...
Category: Critical Care Nursing Tachypnea is often the earliest sign of impending respiratory failure, even when arterial blood gases remain within normal limits. This may reflect...
Category: Critical Care Nursing Normal subjects have a PaCO2-PETCO2 gradient of 4-5 mm Hg. In critically ill patients, the PaCO2-PETCO2 gradient can be elevated, such as in obstru...
Category: Critical Care Nursing Often considered the “fifth vital sign,” pulse oximetry is one of the most important technologic advances for monitoring patients during anesthe...
Category: Critical Care Nursing Pulse oximetry targets the signal arising from the arterial bed as light absorbance fluctuates with changing blood volume. Arterial blood flow cause...
Category: Critical Care Nursing In cases of shock, a low ScvO2 (less than 70%) is suggestive of insufficient DO2 and should prompt clinicians to increase DO2. Conversely, a high va...
Category: Critical Care Nursing The pulmonary artery catheter's use declined due to (1) insufficient knowledge in measuring/interpreting data, (2) a report showing increased mortal...
Category: Critical Care Nursing Under conditions of passive mechanical ventilation, peak airway pressure denotes the total force per unit area necessary to overcome the resistive...
Category: Critical Care Nursing Measuring the respiratory rate corresponding to the minute ventilation gives the clinician an indication of the central ventilatory drive, but it i...
Category: Critical Care Nursing Tissue oxygenation depends on the delivery of oxygenated blood (both dissolved and bound to hemoglobin). The PaO2 is the partial pressure of oxygen...
Category: Critical Care Nursing The expired CO2 waveform can distinguish a variety of pathologies. An esophageal intubation is discernible when the end-tidal waveform becomes lowe...
Category: Critical Care Nursing An rapid shallow breathing index (RSBI) threshold of less than 105 has both a high positive predictive value (0.78) and high negative predictive va...
Category: Critical Care Nursing Insertion of an arterial catheter has been recommended in patients with shock. In addition to providing real-time accurate measurement of arterial b...
Category: Critical Care Nursing Hypoxia is unlikely to occur in mild hypoxemia (PaO2 = 60-79 mm Hg) when cardiovascular reflexes remain intact. Moderate hypoxemia (PaO2 = 45-59 mm...
Category: Critical Care Nursing Positive end-expiratory pressure (PEEP) may recruit collapsed alveoli, improve ventilation-perfusion matching, and reduce alveolar dead space, but...
Category: Critical Care Nursing TEE is used in the evaluation of infectious and embolic sources in patients with unexplained sepsis or embolic strokes. In an acute setting, regurgi...
Category: Critical Care Nursing Motion artifact and poor perfusion are the most common sources of SpO2 inaccuracies, which occur because the photoplethysmographic pulse signal is v...
Category: Critical Care Nursing Intrinsic/Auto PEEP is common in mechanically ventilated patients with COPD (in which dynamic hyperinflation slows elastic recoil) and patients who...
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