(Download) "Monitoring of Extubated Patients: Are Routine Arterial Blood Gas Measurements Useful and How Long should Patients be Monitored in the Intensive Care Unit?(Report)" by Anaesthesia and Intensive Care * eBook PDF Kindle ePub Free
eBook details
- Title: Monitoring of Extubated Patients: Are Routine Arterial Blood Gas Measurements Useful and How Long should Patients be Monitored in the Intensive Care Unit?(Report)
- Author : Anaesthesia and Intensive Care
- Release Date : January 01, 2010
- Genre: Health & Fitness,Books,Health, Mind & Body,
- Pages : * pages
- Size : 242 KB
Description
While invasive mechanical ventilation remains the mainstay of ventilatory support in intensive care units (ICU), intensivists continually strive to minimise the duration of mechanical ventilation to avoid complications associated with prolonged intubation and to curtail the ICU length of stay (LOS) (1). However, early planned extubation comes with the challenge of dealing with the possibility of reintubation and other forms of ventilatory support. Extubated patients often stay extended hours in the ICU for the purpose of monitoring. Much evidence exists on the risk factors associated with the adverse effects of extubation failure (2,3) and reintubation (4). Arterial blood gas (ABG) measurements at the end of a spontaneous breathing trial (SBT) are also not useful in predicting extubation failure (5). However, to our knowledge no study has specifically addressed the utility of ABG measurements and the optimal duration of monitoring after planned extubations. A monitoring duration that is excessively short may lead to premature transfer to the general ward, where life-threatening deteriorations requiring urgent restitution of respiratory support (RRS) may go unnoticed. On the other hand, an overly cautious monitoring protocol will unnecessarily extend the ICU LOS, exposing patients to ICU infections and increasing the healthcare costs.
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