Applied Physiology at the Bedside to Drive Resuscitation Algorithms

Abstract

Hemodynamic instability is associated with significant morbidity and mortality. Goal-directed therapeutic algorithms have been used in various clinical settings to reverse or prevent organ damage and death that could occur with a low oxygen delivery state. Most current resuscitative algorithms use static physiologic measures to determine if a patient will respond to proven therapies. While static parameters are useful in identifying the potential for clinical instability, they cannot tell us how patients will respond to an intervention. Applied physiology, through the use of functional hemodynamic monitoring can predict the body's reaction to therapy because they are based on cardiovascular dynamics. A growing body of evidence supports the use of applied physiologic principles in goal directed therapeutic algorithms for appropriate and effective resuscitation/optimization. Over time, applied physiology should be incorporated into standardized protocol-driven care to improve outcomes in patients experiencing, or at risk for hemodynamic instability.

Pediatric post-thrombotic syndrome in children: Toward the development of a new diagnostic and evaluative measurement tool

“…Additional skin signs were: skin discoloration (defined as reticulate erythema (40), erythema hyperemicum (41), and livedo reticularis (42)), trophic changes (defined as atrophy and lipoatrophy (40)), easy bruising (43), recurrent superficial infections/poor healing, and altered perfusion (44). Skin perfusion was measured with a DermaTemo Infrared Surface Skin Scanner, a non-invasive high precision hand-held infrared thermographic scanner designed to detect the subtle variations in skin temperature due to changes in the underlying perfusion.…”