Essay on Mechanically Ventilated Patients, An Annotated...

Review of literature Monnet et al(1) published a review article on assessment of volume responsiveness in mechanically ventilated patients using heart and lung interactions. He explained that mechanical ventilation produces cyclic changes left ventricular stroke volume due to inspiration and expiration induced changes in LV preload. It denotes preload dependency of left ventricle indirectly right ventricle. He also describes various limitations of respiration variations in SV for predicting fluid responsiveness. Guidet et al(2) conducted a study in sepsis patients to find haemodynamic efficacy and safety between 6%HES 130/0.4 vs 0.9% NaCl. He found that volume requirement was less with HES than NaCl in inial phase of fluid†¦show more content†¦He found that there was less colloid consumption, less hypotension episodes and lower lactate level at end of surgery in vigileo group. He concluded that haemodynamic stability was better when SVV was used a guide for fluid optimization. Fiessel M et al(5) related fluid responsiveness and respiratory variation in inferior vena cava diameter in mechanically ventilated patients with septic shock. He induced volume change by loading patients with 8ml/kg of colloid solution. Changes in IVC diameter and cardiac output were measured using echography before and after volume loading. 15% increase in Cardiac output post volume loading were called as responders. 16 out of 39 pt responded to fluids and he has given 12% delta IVC cut off for detection those volume responders. Stawicki SP et al(6) studied the correlation between inferior vena cava collapsibility index(IVC-CI) and central venous pressure(CVP). They used intensivist-performed bedside ultrasonography(INBU) for assessing IVC-CI. They divided the patients into three groups based on IVC-CI (0.20,0.20-0.60 and 0.60). They concluded that IVC-CI correlate well with CVP in low(0.20) and high(0.60) collapsibility ranges. Nagdev et al(7) conducted a study to find that greater than or equal to 50% increase in caval index is associated with CVP 8 mmHg. The study was done among adult patients undergoing centralShow MoreRelatedTransference and Counterference3996 Words   |  16 Pagesphenomena that may arise during the course of the therapeutic relationship. Understanding these phenomena in nursing is important because the primary focus of nursing is the nurse-patient relationship (Imura, 1991). This discussion will describe how these phenomena occur, and how they may manifest in the nurse-patient relationship. Furthermore, this discussion will highlight nursing interventions in these situations, in order to provide insight into how nurses can maintain and improve the therapeuticRead MoreWatsons Theory of Human Caring2041 Words   |  9 Pageshuman caring. The utilization of Watson’s theory of human caring is extremely relevant within the critical care arena, specifically because of the high acuity of the patient population. The practical application of this theory is explored utilizing several important elements to describe a personal interaction between the patient populations. The Caring Moment Defined Watson (2012) defines the caring moment as, â€Å"An actual caring moment occasion involves action and choice both by the nurse and