Comparison of three methods of measurement of pulmonary artery catheter readings in critically ill patients

1995 ◽  
Vol 4 (4) ◽  
pp. 300-307 ◽  
Author(s):  
MK Johnson ◽  
L Schumann
Keyword(s):  
Mechanical Ventilation ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Spontaneous Breathing ◽  
Repeated Measures ◽  
Right Atrial ◽  
Significant Difference ◽  
Methods Of Measurement

BACKGROUND: Pulmonary artery catheter readings are critical for clinical decision making and therapeutic intervention in critically ill patients. Research data of digital display versus graphic strip chart recording of hemodynamic pressures during spontaneous breathing and mechanical ventilation are inconclusive. OBJECTIVES: To compare three methods of measurement of hemodynamic pressure readings from the pulmonary artery catheter in critically ill patients during mechanical ventilation and spontaneous breathing. METHODS: A nonrandomized, repeated-measures design was used to compare hemodynamic pressures (right atrial, systolic, diastolic, and wedge pressures) from the pulmonary artery catheter in cardiovascular patients during mechanical ventilation (n = 25) and again during spontaneous breathing (n = 19). RESULTS: Using repeated measures analysis of variance, statistically significant differences were noted in the pulmonary artery diastolic, wedge, and right atrial pressure during mechanical ventilation. During spontaneous breathing, significant differences occurred in pulmonary artery systolic and wedge pressures only. No statistically significant difference occurred in the systolic pressure during mechanical ventilation, or the pulmonary artery diastolic and right atrial pressures during spontaneous breathing. CONCLUSIONS: The results of this study indicate that graphic recording is the most reliable means of measuring hemodynamic pressure at end-expiration. Further research is needed to validate these findings with other models of monitoring equipment and other patient populations.

Electroacupuncture Reduces the Dose of Midazolam Monitored by the Bispectral Index in Critically Ill Patients with Mechanical Ventilation: An Exploratory Study

2012 ◽  
Vol 30 (2) ◽  
pp. 78-84 ◽  
Author(s):  
Xia Zheng ◽  
Jian-biao Meng ◽  
Qiang Fang
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Bispectral Index ◽  
Critically Ill Patients ◽  
Additional Treatment ◽  
Acupuncture Points ◽  
Sedative Drug ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective Electroacupuncture, a modern variation on a traditional Chinese treatment, might be useful for sedation and analgesia. This study aims to investigate whether electroacupuncture can modify the dose of midazolam monitored by the bispectral index (BIS) in critically ill patients with mechanical ventilation. Methods Orotracheally intubated patients undergoing mechanical ventilation were randomly assigned into three groups (groups A, B and C). All patients were given an intravenous infusion of midazolam. Patients in group A received no additional treatment. Patients in group B were given acupuncture without electrical stimulation at acupuncture points GV24 and EX–HN3 ( Yintang) for 6 h simultaneously, and patients in group C were given electroacupuncture to the same points as in group B. Results Maintaining the BIS between 60 and 80, the hourly mean one dose of midazolam within the first 6 h after sedation in group C was 0.05 (±0.02 mg/kg per hour), which was significantly lower than both group A (0.08±0.03 mg/kg per hour, p<0.001) and group B (0.07±0.01 mg/kg per hour, p<0.021). The doses in groups A and B showed no significant difference. Between-group comparison analysis of hepatic and renal function and severe adverse reactions all showed no significant difference between the three groups. Conclusions Electroacupuncture appears to reduce markedly the dose of sedative drug required in critically ill patients with mechanical ventilation monitored by BIS, without any obvious severe adverse action, and larger studies to confirm the effect are justified.

A randomised, controlled trial of the pulmonary artery catheter in critically ill patients

2002 ◽  
Vol 28 (3) ◽  
pp. 256-264 ◽  
Author(s):  
Andrew Rhodes ◽  
Rebecca J. Cusack ◽  
Philip J. Newman ◽  
Michael R. Grounds ◽  
David E. Bennett
Keyword(s):  
Randomised Controlled Trial ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Controlled Trial ◽  
Randomised Controlled

Early Use of the Pulmonary Artery Catheter and Outcomes in Patients with Shock and Acute Respiratory Distress Syndrome

2018 ◽  
pp. 55-59
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Control Group ◽  
Pulmonary Artery Catheterization ◽  
Catheter Group ◽  
Improved Outcomes ◽  
Pulmonary Artery Catheters ◽  
And Control

This case focuses on how pulmonary artery catheters are used in critically ill patients by asking the question: Do critically ill patients benefit from early insertion of a pulmonary artery catheter to help guide management? In critically ill patients, pulmonary artery catheterization did not lead to improved outcomes compared with standard care without catheterization. There were no significant differences in mortality between patients in the pulmonary artery catheter group and control group. There were also no significant differences between patients in the pulmonary artery catheter group and patients in the control group with respect to organ system failure or the need for mechanical ventilation, dialysis, or vasoactive medications. This trial, along with other trials of pulmonary artery catheterization, demonstrates the importance of evaluating widely used technologies that have never been adequately assessed.

scholarly journals Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: a preliminary study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ata Mahmoodpoor ◽  
Kamran Shadvar ◽  
Sarvin Sanaie ◽  
Mir Reza Hadipoor ◽  
Mohammad Ata Pourmoghaddam ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Vitamin C ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Severe Pneumonia ◽  
High Dose ◽  
Significant Difference ◽  
Vasopressor Use

Abstract Background Critically ill patients frequently suffer from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns, and trauma. Because of the high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia. Methods Eighty critically ill patients with pneumonia were enrolled in this randomized double-blinded clinical trial. Patients with a CURB-65 score > 3, one major criterion, or ≥ 3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as a continuous infusion or normal saline in the same volume correspondingly for 96 h. Serum levels of vitamin C were noted at baseline and 48 h after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO2/FiO2, and mortality rate were noted for all patients till the 28th day. Any complications related to the vitamin C administration were recorded. Results Duration of mechanical ventilation and vasopressor use were significantly lower in the intervention group (p: < 0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have a significant difference but its levels increased in the intervention group and decreased in the control group during the study period. Mortality rate insignificantly decreased in the intervention group (p = 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C. Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, duration of mechanical ventilation, and vasopressor use without any significant effect on mortality. Trial registration: IRCT registration number: IRCT20190312043030N1, Registration date: 2019-08-26, Seied Hadi Saghaleini.

Impact of the Pulmonary Artery Catheter in Critically Ill Patients

JAMA ◽  
2005 ◽  
Vol 294 (13) ◽  
pp. 1664 ◽  
Author(s):  
Monica R. Shah ◽  
Vic Hasselblad ◽  
Lynne W. Stevenson ◽  
Cynthia Binanay ◽  
Christopher M. O’Connor ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Critically Ill ◽  
Critically Ill Patients
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