Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: by P. Di Giacomo, M. A. De Vita (auth.), Antonino Gullo M.D.

By P. Di Giacomo, M. A. De Vita (auth.), Antonino Gullo M.D. (eds.)

Improving criteria of care is a true problem in in depth Care medication. improving scientific functionality, sufferer protection, possibility administration and audit represents the cornerstone for elevating the standard of care in ICU sufferers. verbal exchange is the platform from the place to begin to arrive a consensus in an exceptionally crowded sector, a special multidisciplinary and multiprofessional atmosphere within which caliber of care and, finally, sufferer survival must be ameliorated.

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Extra resources for Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: Proceedings of the 22nd Postgraduate Course in Critical Care Medicine Venice-Mestre, Italy — November 9–11, 2007

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J. 01). 01) showing that DPOP was influenced by changes in ventricular preload. Ability of the Respiratory Variations in the Pulse Oximeter Plethysmographic Waveform Amplitude to Predict Fluid Responsiveness in Mechanically Ventilated Patients Solus-Biguenet et al where the first to report the ability of DPOP to predict fluid responsiveness in mechanically ventilated patients [17]. While encouraging, their results were at the same time quite disappointing because they found that DPOP was a weak predictor of fluid responsiveness.

Pulse pressure and POP waveform amplitude are related to stroke volume and vascular tone. As vascular tone is considered unchanged between inspiration and expiration, respiratory variations in POP waveform amplitude mainly reflect respiratory changes in left ventricular stroke volume. As pulse oximeters are already widely available in intensive care units and operating rooms, they could be a noninvasive and simple mean of predicting fluid responsiveness in patients with circulatory Use of Pulse Oximeter Waveform 25 failure, especially if they are not equipped with an arterial catheter.

LEHOT Recently published studies have shown that intraoperative fluid optimization decreases postoperative morbidity and hospital stay [1]. On the other hand, if inappropriate, volume expansion may have deleterious effects. Therefore, preload dependence and fluid responsiveness assessments are of major importance during surgery. Static indicators of fluid responsiveness such as central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP), or left ventricular end diastolic area index (LVEDAI) are invasive or uneasily available and have been shown to be poor predictors of fluid responsiveness [2-6].

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