CRITICAL CARE ISSUES FOR THE NEPHROLOGIST: The Pulmonary Artery Catheter in Critical Care

McGee, William T.; Mailloux, Patrick; Jodka, Paul; Thomas, Joss J.

doi:10.1111/j.1525-139x.2006.00210.x

Cited by 20 publications

(2 citation statements)

References 51 publications

(47 reference statements)

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“…The product of the absolute value of R des and mean THI value quantifies the amount of desaturated hemoglobin [16]. The latter can be converted to thenar VO 2 using the hemoglobin-oxygen binding constant [39]. …”

Section: Introductionmentioning

confidence: 99%

Near infrared spectroscopy (NIRS) of the thenar eminence in anesthesia and intensive care

Lipcsey

Woinarski

Bellomo

2012

Ann. Intensive Care

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Near infrared spectroscopy of the thenar eminence (NIRSth) is a noninvasive bedside method for assessing tissue oxygenation. The NIRS probe emits light with several wavelengths in the 700- to 850-nm interval and measures the reflected light mainly from a predefined depth. Complex physical models then allow the measurement of the relative concentrations of oxy and deoxyhemoglobin, and thus tissue saturation (StO2), as well as an approximation of the tissue hemoglobin, given as tissue hemoglobin index.Here we review of current knowledge of the application of NIRSth in anesthesia and intensive care.We performed an analytical and descriptive review of the literature using the terms “near-infrared spectroscopy” combined with “anesthesia,” “anesthesiology,” “intensive care,” “critical care,” “sepsis,” “bleeding,” “hemorrhage,” “surgery,” and “trauma” with particular focus on all NIRS studies involving measurement at the thenar eminence.We found that NIRSth has been applied as clinical research tool to perform both static and dynamic assessment of StO2. Specifically, a vascular occlusion test (VOT) with a pressure cuff can be used to provide a dynamic assessment of the tissue oxygenation response to ischemia. StO2 changes during such induced ischemia-reperfusion yield information on oxygen consumption and microvasculatory reactivity. Some evidence suggests that StO2 during VOT can detect fluid responsiveness during surgery. In hypovolemic shock, StO2 can help to predict outcome, but not in septic shock. In contrast, NIRS parameters during VOT increase the diagnostic and prognostic accuracy in both hypovolemic and septic shock. Minimal data are available on static or dynamic StO2 used to guide therapy.Although the available data are promising, further studies are necessary before NIRSth can become part of routine clinical practice.

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Section: Introductionmentioning

confidence: 99%

Near infrared spectroscopy (NIRS) of the thenar eminence in anesthesia and intensive care

Lipcsey

Woinarski

Bellomo

2012

Ann. Intensive Care

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“…Since there existed a vital need to monitor the severely ill patients’ pulmonary artery, catheterization has been widely introduced into clinical practice, including pediatrics, cardiac surgery, invasive treatments in different kinds of clinical settings, including a wide variety of shock states originating from the circulatory and/or septic background [60,61,62,63,64,65,66,67,68]. The use of this technology, mainly without appropriate guidance or experience, resulted in few complications, reported thereafter in the form of case reports [69,70,71,72,73,74,75].…”

Section: Clinical Practice Implicationsmentioning

confidence: 99%

Right Heart Catheterization—Background, Physiological Basics, and Clinical Implications

Kubiak

Ciarka

Biniecka

et al. 2019

JCM

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The idea of right heart catheterization (RHC) grew in the milieu of modern thinking about the cardiovascular system, influenced by the experiments of William Harvey, which were inspired by the treatises of Greek philosophers like Aristotle and Gallen, who made significant contributions to the subject. RHC was first discovered in the eighteenth century by William Hale and was subsequently systematically improved by outstanding experiments in the field of physiology, led by Cournand and Dickinson Richards, which finally resulted in the implementation of pulmonary artery catheters (PAC) into clinical practice by Jeremy Swan and William Ganz in the early 1970s. Despite its premature euphoric reception, some further analysis seemed not to share the early enthusiasm as far as the safety and effectiveness issues were concerned. Nonetheless, RHC kept its significant role in the diagnosis, prognostic evaluation, and decision-making of pulmonary hypertension and heart failure patients. Its role in the treatment of end-stage heart failure seems not to be fully understood, although it is promising. PAC-guided optimization of the treatment of patients with ventricular assist devices and its beneficial introduction into clinical practice remains a challenge for the near future.

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Hemodynamic Monitoring

Nácul¹,

O’Donnell²

2010

Surgical Intensive Care Medicine

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CRITICAL CARE ISSUES FOR THE NEPHROLOGIST: The Pulmonary Artery Catheter in Critical Care

Cited by 20 publications

References 51 publications

Near infrared spectroscopy (NIRS) of the thenar eminence in anesthesia and intensive care

Near infrared spectroscopy (NIRS) of the thenar eminence in anesthesia and intensive care

Right Heart Catheterization—Background, Physiological Basics, and Clinical Implications

Hemodynamic Monitoring

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