Crit Care Resusc
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To discuss the clinical indications and complications of non-invasive ventilation. ⋯ Non-invasive ventilation using the modes of CPAP, PSV, BiPAP and NIPPV should be considered in patients with respiratory disorders who remain in acute respiratory failure despite conventional therapy, before considering invasive mechanical ventilation.
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To present an overview of acidosis following intravenous fluid infusion and to highlight the current controversy in acid-base physiology. ⋯ There is controversy regarding mechanisms in acid-base physiology. The clinical significance of post infusion acidosis is unclear, however use of Hartmann's solution may minimize the acidosis.
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To review the technology and the role of continuous intra-arterial blood gas monitoring in critical illness. ⋯ Over the last 10 years, a number of continuous intra-arterial blood gas monitoring systems have been developed. Only a few have reached commercial availability. While the performance characteristics of these systems are comparable, the levels of accuracy of these systems obtained in vitro are not consistently obtained in clinical trials. Arterial blood flow, wrist movement, wall effect and variability of blood gas analysers are some of the factors which determine the accuracy and reproducibility of these systems. Evidence to support the clinical usefulness of these monitors exists only in the form of case studies. Controlled studies demonstrating an improvement in outcome with the use of these monitors are lacking.