scholarly journals The role of clinical examination, chest X-ray and central venous pressure in volume assessment in critically ill patients: a comparison with PiCCO-derived data

Critical Care ◽  
2007 ◽  
Vol 11 (Suppl 2) ◽  
pp. P283 ◽  
Author(s):  
W Huber ◽  
S Ringmaier ◽  
A Umgelter ◽  
K Holzapfel ◽  
W Reindl ◽  
...  
Keyword(s):  
Central Venous Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Pressure ◽  
Central Venous ◽  
X Ray ◽  
Volume Assessment ◽  
Chest X Ray ◽  
Derived Data

Changing the syringe pump: A challenging procedure in critically ill patients

2020 ◽  
Vol 21 (6) ◽  
pp. 868-874
Author(s):  
Stefano Elli ◽  
Elisa Mattiussi ◽  
Stefano Bambi ◽  
Serena Tupputi ◽  
Salvatore San Fratello ◽  
...  
Keyword(s):  
Central Venous Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Pressure ◽  
Medication Administration ◽  
Syringe Pump ◽  
Central Venous ◽  
Patient Level ◽  
Dangerous Situation ◽  
Infusion Tubing

Introduction: In the literature, the change of a syringe pump is described as a dangerous situation, especially in the case of vasoactive drug administration. Methods: Different variables have been studied (central venous pressure, pump displacement in relation to the patient position, utilization of a stopcock, or a neutral displacement needle-free connector between the syringe and the infusion tubing) to understand their influence on medication administration in terms of backflow or bolus creation when changing the syringe. Results: We performed 576 measurements with different combinations. With respect to all the observations, in comparison with “time zero,” we found the following differences expressed in microliters: 0 (±1) at the plunger opening; 0 (±3) at the syringe extraction from the pump; 0 (±7) at the syringe disconnection from the infusion tubing; 0 (±11) at the syringe reconnection to the infusion tubing; 1 (±7) at the syringe insertion in the pump; 3 (±23) at the plunger closing; 8 (±33) at the stabilization at the maneuver end. Conclusion: The syringe change can be a very critical moment given different influencing variables. Syringe pump position, displaced higher than the patient level, always generates a medication bolus that is higher at the lowering of the central venous pressure value. The presence of a neutral displacement needle-free connector reduces the incidence of boluses. When the pump is placed at the patient level, the presence of neutral displacement needle-free connector reduces the establishment of boluses, even in a central venous pressure of −5 mmHg simulations.

Evaluation Of The Role Of Bedside Lung Ultrasound Versus Chest X-ray In Critically Ill Patients

2019 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Nermeen Ali ◽  
Hassan Maguid ◽  
Neven Gamil ◽  
Mohamed Tawfeek ◽  
Sameh Hegab
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Lung Ultrasound ◽  
X Ray ◽  
Chest X Ray

scholarly journals Ultrasound Measurement of Inferior Vena Cava Diameter versus Central Venous Pressure as a Tool of Assessment of Intravascular Volume in Adult ICU Patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
B B Ghobrial ◽  
A M Alansary ◽  
R M Aly ◽  
A M Bayoumy
Keyword(s):  
Central Venous Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Pressure ◽  
Vena Cava ◽  
Volume Status ◽  
Ultrasound Measurement ◽  
Intravascular Volume ◽  
Central Venous ◽  
Collapsibility Index

Abstract Background Measurements of central venous pressure (CVP), pulmonary arterial catheterization, esophageal Doppler, ultrasound, and trans-esophageal echocardiography may be used to determine the volume status of critically ill patients. Appropriate interpretation of the information offered by hemodynamic monitoring requires the integration of several variables. Echocardiography is increasingly used as a first tool to identify a problem and help select initial treatment. To improve patient management and outcome, the clinician must understand the advantages and the limitations of the various tools and parameters used during ICU stay. Aim of the Work to assess the intravascular volume by comparing between IVC diameter, IVC collapsibility index by ultrasound with central venous pressure (CVP) in critically ill patients. Patients and Methods A clinical interventional study was carried out at department of intensive care at Ain Shams University hospitals – Cairo – Egypt., during a three months (from October 2017 till December 2017).This study was approved by Ethical Committee of Faculty of Medicine, Ain Shams University, including the informed consents which were obtained from either the patient or the closest family member. Results In our study the IVC Collapsibility Index correlated well with the Central Venous Pressure. The sensitivity and specificity of IVC Collapsibility to Central Venous Pressure were also found to be highly statistically significant. The change in IVC diameters were also found to be statistically significant when compared to Central Venous Pressure. Conclusion The IVC CI% can provide a useful guide for noninvasive intravascular volume status and an alternative to CVP measurement assessment in critically ill patients.

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