CHAPTER 13 - Physiologic Monitoring in Surgery: Principles and Practice скачать в хорошем качестве

CHAPTER 13 - Physiologic Monitoring in Surgery: Principles and Practice

SCHWARTZ SURGERY CHAPTER 13 This explores the multifaceted field of patient monitoring in critical care settings, particularly in operating theatres and intensive care units. It begins by defining monitoring as a crucial tool for detecting physiological changes and guiding timely therapeutic interventions. This elaborates on various monitoring techniques, ranging from routine vital signs to advanced assessments of tissue and organ status, highlighting the importance of accurate data interpretation. A significant portion details hemodynamic monitoring, explaining the goal of ensuring adequate oxygen delivery to cells and discussing methods like arterial blood pressure measurement, electrocardiographic monitoring, and the use of pulmonary artery catheters (PACs). The chapter also critically evaluates the effectiveness of PACs, presenting evidence that questions their routine use due to associated complications and lack of clear outcome benefits, leading to a shift towards less invasive alternatives such as transpulmonary thermodilution, Doppler ultrasonography, and pulse contour analysis. Furthermore, it covers respiratory monitoring, including arterial blood gases, airway pressures, pulse oximetry, and capnometry, alongside renal monitoring (urine output and bladder pressure) and neurologic monitoring (intracranial pressure, EEG, and brain tissue oxygen tension). The overarching theme emphasises the ongoing development of non-invasive technologies and the need for evidence-based strategies to guide patient care.