Current opinion in critical care
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Curr Opin Crit Care · Jun 2023
ReviewAdvantages and limitations of noninvasive devices for cardiac output monitoring: a literature review.
Individualized hemodynamic optimization often requires cardiac output monitoring, mostly for goal-directed therapy in the operating room and fluid responsiveness assessment in the intensive care unit. Different technologies for noninvasive cardiac output determination have become available over the recent years. It is therefore crucial for care providers to be made aware of the advantages and limitations of those different devices for an appropriate use at the bedside. ⋯ Noninvasive cardiac output monitoring may have a clinical impact on patient outcomes. Further studies are required to evaluate their clinical relevance, notably in the intensive care unit. Noninvasive monitoring opens up the possibility for hemodynamic optimization in specific or low-risk populations, the benefit of which remains to be assessed.
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This review considers the latest evidence relating to the epidemiology and outcomes, treatment guidelines, diagnostic and therapeutic interventions in traumatic cardiac arrest. ⋯ Trauma related cardiac arrest differs from cardiac arrest due to medical causes. Whilst the core principles of treatment are similar, a higher priority is placed on identifying and treating reversible causes.
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The ANDROMEDA-SHOCK trial positioned capillary refill time (CRT) assessment as a novel resuscitation target for septic shock.The purpose of this article is to summarize pathophysiological determinants of CRT, review new technical developments on peripheral perfusion assessment, and explore recent evidence on the role of CRT monitoring in septic shock and other critical conditions. ⋯ Recent data confirm the relevance of peripheral perfusion assessment in septic shock and other conditions in critically ill patients. Future studies should confirm these findings, and test the potential contribution of technological devices to assess peripheral perfusion.
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To discuss the different techniques used to assess tissue oxygenation in critically ill patients. ⋯ Recent studies have highlighted the interest of surrogate measurements of tissue oxygenation and in particular PCO2 gradients.
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The purpose of this review was to provide an overview of head-up (HUP) CPR physiology, relevant preclinical findings, and recent clinical literature. ⋯ HUP CPR is a new and novel therapy increasingly used in the prehospital setting and discussed in the resuscitation community. This review provides a relevant review of HUP CPR physiology and preclinical work, and recent clinical findings. Further clinical studies are needed to further explore the potential of HUP CPR.