Published in:
01-02-2016 | What's New in Intensive Care
Ten recent advances that could not have come about without applying physiology
Published in: Intensive Care Medicine | Issue 2/2016
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Physiology forms the basis of our understanding of disease and most treatments and the means to assess response to treatment. Thus, almost all new therapies are based on physiology. However, ten recent advances clearly reflect this realization well (Table 1). By applying these advances at the bedside the clinician is forced to consider the patient’s physiologic state when making decisions.
Table 1
Ten advances needing physiology
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1
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Assessment of fluid responsiveness
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2
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Estimating cardiac output and left ventricular stroke volume from arterial pressure
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3
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Choice of fluids for resuscitation
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4
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Dialysis and ultrafiltration may cause hypotension but for pulse pressure (PP) different reasons
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5
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Plateau pressure and tidal volume limits to minimize lung injury
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6
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Prone positioning to minimize lung injury and maximize gas exchange
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7
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Limiting airway pressure to optimize cardiovascular function
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8
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Optimizing PEEP according to the severity of lung injury
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9
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Extracorporeal gas exchange may be the future
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10
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Small changes in renal function may indicate significant kidney injury
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1.
Assessing fluid responsiveness