Respiratory monitoring in adult intensive care unit

Expert Rev Respir Med. 2017 Jun;11(6):453-468. doi: 10.1080/17476348.2017.1325324. Epub 2017 May 10.

Abstract

The mortality of patients with respiratory failure has steadily decreased with the advancements in protective ventilation and treatment options. Although respiratory monitoring per se has not been proven to affect the mortality of critically ill patients, it plays a crucial role in patients' care, as it helps to titrate the ventilatory support. Several new monitoring techniques have recently been made available at the bedside. The goals of monitoring comprise alerting physicians to detect the change in the patients' conditions, to improve the understanding of pathophysiology to guide the diagnosis and provide cost-effective clinical management. Areas covered: We performed a review of the recent scientific literature to provide an overview of the different methods used for respiratory monitoring in adult intensive care units, including bedside imaging techniques such as ultrasound and electrical impedance tomography. Expert commentary: Appropriate respiratory monitoring plays an important role in patients with and without respiratory failure as a guiding tool for the optimization of ventilation support, avoiding further complications and decreasing morbidity and mortality. The physician should tailor the monitoring strategy for each individual patient and know how to correctly interpret the data.

Keywords: Respiratory monitoring; acute respiratory distress syndrome; mechanical ventilation; respiratory mechanics; ventilator-induced lung injury.

Publication types

  • Review

MeSH terms

  • Adult
  • Critical Illness
  • Electric Impedance
  • Humans
  • Intensive Care Units*
  • Lung / physiopathology*
  • Monitoring, Physiologic / methods*
  • Respiration, Artificial*
  • Respiratory Insufficiency / diagnosis*
  • Respiratory Insufficiency / mortality
  • Respiratory Insufficiency / physiopathology
  • Tomography