Korean J Anesthesiol.  2010 Sep;59(3):144-159. 10.4097/kjae.2010.59.3.144.

Recent advance in patient monitoring

• Nishiyama

• KMID: 2239770
• DOI: http://doi.org/10.4097/kjae.2010.59.3.144

Abstract

Recent advance in technology has developed a lot of new aspects of clinical monitoring. We can monitor sedation levels during anesthesia using various electroencephalographic (EEG) indices, while it is still not useful for anesthesia depth monitoring. Some attempts are made to monitor the changes in sympathetic nerve activity as one of the indicators of stress, pain/analgesia, or anesthesia. To know the balance of sympathetic and parasympathetic activity, heart rate or blood pressure variability is investigated. For trend of cardiac output, low invasive monitors have been investigated. Improvement of ultrasound enables us to see cardiac structure and function continuously and clearer, increases success rate and decreases complication of central venous puncture and various kinds of nerve blocks. Without inserting an arterial catheter, trends of arterial oxygen tension or carbon dioxide tension can be monitored. Indirect visualization of the airway decreases difficult intubation and makes it easier to teach tracheal intubation. The changes in blood volume can be speculated non-invasively. Cerebral perfusion and metabolism are not ordinary monitored yet, but some studies show their usefulness in management of critically ill. This review introduces recent advances in various monitors used in anesthesia and critical care including some studies of the author, especially focused on EEG and cardiac output. However, the most important is that these new monitors are not almighty but should be used adequately in a limited situation where their meaning is confirmed.

Keyword

Cardiac output; Electroencephalogram; Heart rate variability; Percut aneous carbon dioxide tension; Pulse oximeter; Ultrasound

MeSH Terms

Anesthesia
Blood Pressure
Blood Volume
Carbon Dioxide
Cardiac Output
Cardiac Output, Low
Catheters
Critical Care
Critical Illness
Electroencephalography
Heart Rate
Humans
Intubation
Monitoring, Physiologic
Nerve Block
Organothiophosphorus Compounds
Oxygen
Perfusion
Punctures
Carbon Dioxide
Organothiophosphorus Compounds
Oxygen