Monitoring Tissue Perfusion in Shock

Description

This book describes various aspects of the basic physiological processes critical to tissue perfusion and cellular oxygenation, including the roles of the circulatory system, respiratory system, blood flow distribution and microcirculation. In the context of monitoring critically ill patients in the early hours of circulatory shock, it is essential to recognize changes in traditional parameters such as mean arterial pressure and cardiac output, and to assess the need for active intervention. However, even if global macrocirculatory variables are restored, abnormalities in tissue oxygenation may persist. Tissue hypoperfusion is connected to the development of organ failure and, if it goes unrecognized, may worsen the prognosis. As a result, there is a growing interest in methods for monitoring regional perfusion in peripheral tissues to predict or diagnose ongoing hypoperfusion. In this work, eminent experts from a range of disciplines convey a working knowledge of how regional monitoring in shock can complement the conventional global parameters of oxygen transport, and demonstrate that real-time bedside assessment of tissue oxygenation is readily achievable using noninvasive monitoring techniques. Accordingly, the book offers a valuable, easy-to-use guide for the entire ICU team and other clinicians. Front Matter ....Pages i-viii Front Matter ....Pages 1-1 Holistic Monitoring and Treatment in Septic Shock (Glenn Hernández, Lara Rosenthal, Jan Bakker)....Pages 3-12 Front Matter ....Pages 13-13 Oxygen Transport and Tissue Utilization (Ricardo Castro, Glenn Hernández, Jan Bakker)....Pages 15-23 Guyton at the Bedside (David Berlin, Vivek Moitra, Jan Bakker)....Pages 25-34 Tissue Response to Different Hypoxic Injuries and Its Clinical Relevance (Adriano José Pereira, Eliézer Silva)....Pages 35-48 Front Matter ....Pages 49-49 Cardiac Function (Cardiac Output and Its Determinants) (Loek P. B. Meijs, Alexander J. G. H. Bindels, Jan Bakker, Michael R. Pinsky)....Pages 51-76 Oxygen Transport Assessment (Arnaldo Dubin, Eliézer Silva)....Pages 77-92 Central and Mixed Venous O2 Saturation: A Physiological Appraisal (Guillermo Gutierrez)....Pages 93-119 Central Venous-to-Arterial Carbon Dioxide Partial Pressure Difference (Xavier Monnet, Jean-Louis Teboul)....Pages 121-130 Lactate (Glenn Hernández Poblete, Maarten W. Nijsten, Jan Bakker)....Pages 131-142 Front Matter ....Pages 143-143 Clinical Assessment (Roberto Rabello Filho, Thiago Domingos Corrêa)....Pages 145-151 Optical Monitoring (Alexandre Augusto Pinto Lima, Daniel De Backer)....Pages 153-171 Transcutaneous O2 and CO2 Monitoring (Diego Orbegozo-Cortès, Daniel De Backer)....Pages 173-180 Regional Capnography (Jihad Mallat, Benoit Vallet)....Pages 181-192 Clinical Implications of Monitoring Tissue Perfusion in Cardiogenic Shock (John Moore, John F. Fraser)....Pages 193-206