Hemodinamski monitoring u središnjoj jedinici intenzivnog liječenja

SAŽETAK

Budući da je temelj intenzivnog liječenja biti u korak sa vremenom, kako korištenjem najnovijih spoznaja liječenja, tako i korištenjem suvremene aparature u cijelom prostoru SJIL-a dostupan je novi najsuvremeniji monitoring uz svaku krevetnu jedinicu. Novim monitoringom uz svaki krevet imamo 2 monitora. Jedan osnovni monitor namjenjen je uobičajenom nadzoru i praćenju vitalnih funkcija bolesnika (tzv. Infinity Delta monitor), dok je drugi monitor (tzv. Infinity Explorer) namjenjen naprednom praćenju bolesnika i dobivanju preciznije slike o bolesniku, te je on zapravo računalo uz krevet bolesnika. Oba monitora uz svaki krevet čine cjelinu koja se naziva Infinity Omega rješenje. Kako bi nadzor bolesnika bio što precizniji svih 15 osnovnih i dodatnih monitora umreženo je na centralnu nadzornu jedinicu na sestrinskom pultu, koja nam omogućuje kontinuirano, praćenje svih bolesnika sa jednog mjesta u isto vrijeme, te istovremeno prilikom poremećaja stanja bolesnika pravovremeno reagiranje na novonastalu, moguću akcidentalnu situaciju.

Također, u svakodnevnom radu, a zbog zahtijevnosti i težine stanja bolesnika rutinski se provode sve metode monitoringa kako neinvazivne, tako i invazivne.

Od neinvazivnih metoda rutinski se provodi monitoring:

  • EKG-a,
  • pulsa,
  • analiza aritmija (osnovna i proširena),
  • respiracije,
  • periferne saturacije kisikom,
  • neinvazivno mjerenje arterijskog tlaka,
  • temperature (više vrsta i mogućnosti mjerenja) i
  • CO2 na kraju izdaha (EtCO2)
  • EEG monitoring.

Od invazivnih metoda koristimo:

  • invazivno mjerenje arterijskog tlaka,
  • kontinuirano mjerenje CVT-a,
  • kontinuirano mjerenje intraabdominalnog tlaka (IAP),
  • monitoring intrakranijalnog tlaka (ICP),
  • invazivni monitoring arterijskim termodilucijskim kateterom (PiCCO),
  • monitoring Swan ganz termodilucijskim kateterom,
  • monitoring saturacije u bulbusu vene jugularis (SvjO2),
  • Lidco hemodinamski monitoring i
  • Limon hemodinamski monitoring

Poznato je da razvoj suvremene medicine, intenzivnog liječenja, kao i zdravstvene njege bolesnika u JIL-a, zahtijeva visoko educirane medicinske sestre/tehničare, stoga je kontinuirana edukacija imperativ sestrinske prakse.

Ključne riječi: hemodinamski monitoring, jedinica intenzivnog liječenja, medicinska sestra

 

HEMODINAMIC MONITORING IN CENTRAL INTENSIVE CARE UNIT

Author:

Igor Pelaić

Clinical Hospital “Sisters of Charity” in Zagreb

Department of Anesthesiology, Reanimation and Intensive Care

Central Intensive Care Unit

 

SUMMARY

The goal of the intensive care since its founding has to be up with the times, using the latest knowledge of treatment, using modern equipment in the entire area of Central intensive care unit and the availability of new contemporary monitoring for every single hospital bed. The new monitoring system with each hospital bed includes 2 monitors. One main monitor is designed for normal surveillance and monitoring of vital functions of the patient (ie. Infinity Delta monitor), while the second monitor (the so-called. Infinity Explorer) is designed for an advanced patient monitoring and obtaining more accurate picture of the patient, and it is actually a computer for patient. Both monitors with each bed are called Infinity Omega Solution. In order to control patients more accurately, all 15 basic and additional units of the monitor is connected to a network to a central monitoring unit at the nursing desk, which allows to continuously monitor all patients from one place at the same time and at the same time when impairment of patients timely response to the new, possible accidental situation.

Also, in their daily work, and because of the demanding and severity of the patient’s state routinely carried out all the methods of monitoring in noninvasive and invasive.

Non-invasive methods of monitoring are:

  • ECG
  • Pulse
  • Analysis of arrhythmia (basic and extended)
  • Respiration
  • Peripheral oxygen saturation
  • Non-invasive measurement of blood pressure
  • Temperature (several types and possibilities of measurement)
  • CO2 at the end of exhalation (EtCO2) and
  • EEG monitoring

Invasive methods in use are:

  • Invasive measurement of blood pressure
  • Continuous measurement of CVT
  • Continuous measurement of intra-abdominal pressure (IAP)
  • Monitoring of intracranial pressure (ICP)
  • Invasive monitoring of arterial thermodilution catheter (PICC)
  • Monitoring Swan Ganz thermodilution catheter
  • Monitoring of saturation in the bulb of the jugular vein (SvjO2)
  • LIDC hemodynamic monitoring and
  • Limon hemodynamic monitoring

It is well known that the development of modern medicine, development of intensive care and medical care in the Intensive Care Units, requires highly trained nurses/technicians, so it is imperative to continuing education in nursing practice.

Keywords: hemodynamic monitoring, intensive care unit nurse

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