Articles: monitoring.
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This review has focused on several aspects of monitoring the critically ill patient. A few of the more commonly used monitoring devices have been discussed to emphasize that their use carries some risk. ⋯ We have dealth with hemodynamic assessment, renal insufficiency, pulmonary monitoring and stress ulceration. Guidelines and specific examples have been presented to illustrate the prevention, early diagnosis and management of problems.
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A triple human catheter was used for the determination of cardiac output during the acute phase of moycardial infarction in 23 patients. The correlation coefficient between thermodilution and the Fick method was 0.91. ⋯ Quadruplicate determinations allowed to detect variations of cardiac output in the range of 0.465 1/min. Variation between two successive determinations of more than 9.4% can probably be attributed to a technical error.
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Optimum results are obtained in the care of the critically ill patient if efforts are directed to maintaining the internal environment in a state as near normal as possible. This cannot be done without the use of basic monitoring procedures. ⋯ There is, however, a real risk of complex procedures becoming an end in themselves in general intensive therapy units, where they are apt to distract overworked nurses and medical attendants from the care of their patients. It is important, therfore, for clearcut indications for various monitoring procedures to be defined, and in this paper an attempt has been made to outline alogical approach to the monitoring of critically ill genral surgical patients admitted intensive therapy units.