Improvements in intensive care units
Abstract
We have had some important improvements in the intensive
care units (ICU) like high flow oxygen system (HFOS),
therapeutic hypothermia, extra corporeal membrane oxygenation
(ECMO), extra corporeal carbon dioxide removal (ECCOR),
echocardiography (ECHO) and ultrasonography (US).
HFOS gives oxygen to the patients at rates of flow higher (up
to 60 L/min) than that delivered traditionally in LFOS (up to 16L/
min). It is obtained 1 cmH2O PEEP for every 10L/min of flow
delivered by HFOS. HFOS serves as an important alternative to
noninvasive mechanical ventilation especially in the management
of the patients with hypoxemic respiratory failure.
Post-resuscitation care consists of optimization of oxygenation
and ventilation, avoiding hypotension, treating immediate
precipitants of cardiac arrest such as acute coronary ischemia
and initiating therapeutic (induced) hypothermia. Therapeutic
hypothermia decreases cerebral metabolic rate, blood volume, and
intracranial pressure, prevents reperfusion injury. So hypotermia
protects cerebral functions.
ECMO, the type of cardiopulmonary support, has become an
essential tool in critical care patients with severe respiratory and
cardiac failure, refractory to conventional therapy methods.
Critical care ultrasonography (CCUS) and echocardiography
have utility for intensivist-performed, immediate diagnoses of life
threatening diseases, with no need to transport patients to radiology
or cardiology departments or wait for radiologist or cardiologist on
a consultative basis. CCUS and echocardiography
Keywords
References
- Spoletini G, Alotaibi M, Blasi F, Hill NS. Heated humidified high-flow nasal oxygen in adults: Mechanisms of action and clinical implications. Chest 2015;148: 253-61.
- Ward JJ. High-flow oxygen administration by nasal cannula for adult and perinatal patients. Respir Care 2013; 58: 98-122.
Details
Primary Language
English
Subjects
Clinical Sciences
Journal Section
Review
Publication Date
November 27, 2016
Submission Date
November 28, 2016
Acceptance Date
November 13, 2016
Published in Issue
Year 2016 Volume: 29 Number: 3