Minimally Invasive and Noninvasive Diagnosis and Therapy in Critically Ill and Injured Patients

Abstract

n this review, both the newer noninvasive (ie, those that pose no breach of an epithelial barrier) and minimally invasive techniques relevant to the treatment of the critically ill or injured patient will be discussed. In some cases, the development of the technology is so recent that published data describing their clinical applications may be scant. The emphasis herein is on newer technologies; therefore, the discussion of certain established noninvasive techniques, such as pulse oximetry, and minimally invasive therapies, such as percutaneous abscess drainage, will be deferred.

Sepsis bundles: time for a nursing initiative?

“… Reduce inflammation by implementation and investigation of non‐invasive technology for organ support and monitoring. Such technologies minimize tissue trauma and inflammation and may, overall, improve patients’ outcomes (Eachempati and Barie, 1999; Demoule, 2009); Reduce suffering, pain and hopelessness by implementation and investigation of proper analgesia and anxiety protocols and psychological support protocols for communicative and non‐communicative patients. Non‐communicative patients, either because of sedation or because of compromised neurological status, still experience stress responses (Etkin et al , 2004); Interrupt the inflammatory vicious circle by implementation and investigation of relaxation techniques, proper physiotherapy and mobilization, support of sleep and vagus nerve stimulation techniques.…”

“…Reduce inflammation by implementation and investigation of non‐invasive technology for organ support and monitoring. Such technologies minimize tissue trauma and inflammation and may, overall, improve patients’ outcomes (Eachempati and Barie, 1999; Demoule, 2009);…”

Monitoring of Cardiovascular and Respiratory Function

“…Other more rare complications have been reported, including catheter knotting resulting from redundancy of the catheter within the right ventricle (especially in patients with heart failure, cardiomyopathy, or increased pulmonary pressure); pulmonary Yu et al 48 Balogh et al 59 Tuchschmidt et al 53 Fleming et aU 2 Hayes et al 54 infarction secondary to an overinflated or "permanently wedged" balloon; pulmonary artery perforation; intracardiac perforation; valvular injury; and endocarditis. A devastating complication is pulmonary artery rupture, which occurs in less than 0.1% of cases of PAC usage.…”