Joe
I'm going to hang in there with my NG plays for a while..Well, 90 days or so anyway. LOL
CDIC excerpt from the CHEST study published in the magazine...thanks to a Dr. that pasted it to the Yahoo board.
Vital Sign Technology?"
Joseph M. Van De Water, MD, FCCP; Timothy W. Miller, RRT; Robert L. Vogel, PhD; Bruce E. Mount, BS and Martin L. Dalton, MD
* From the Departments of Surgery (Drs. Van De Water and Dalton, and Mr. Miller and Mr. Mount) and Family Practice (Dr. Vogel), Mercer University School of Medicine, Macon, GA.
Conclusions:
Our evaluation of this ICG monitor (BioZ ICG monitor) has demonstrated clinically acceptable accuracy and superior intrapatient reproducibility compared to CO-TD via PAC. These findings, coupled with the drastically lower cost per patient and continuous monitoring capability of this ICG monitor led us to conclude that in those circumstances in which intracardiac pressures and mixed venous blood samples are not necessary, ICG is preferable to CO-TD via PAC in determining CO. Furthermore, the ICG monitor enables us to quickly and easily monitor CO and SVR in clinical areas where the PAC is not typically utilized, such as the emergency department, subacute care, and outpatient hypertension and heart failure clinics. More successful treatment of chronic outpatient diseases could reduce the development of even more costly short-term interventions, such as CABG surgery. Recent results22 have demonstrated up to 70% improvement in the treatment success of patients with hypertension when using ICG hemodynamic measurements to guide treatment compared to clinician-only-directed treatment without the availability of hemodynamic measurements.
Our retrospective intermethod comparison also confirmed the findings of other investigators that CO-K, CO-S, and CO-SB were not accurate enough to be used in assessing seriously ill patients. They also confirmed that clear advancements have been made with the ICG monitor used in this study, providing a level of agreement that is equivalent to CO-TD.
Currently, noninvasive pulse oximetry is considered to be a de facto vital sign by clinicians. While the accuracy of pulse oximetry has been established, it is not without its limitations. In addition, to date no conclusive outcome studies on prospective assessments, diagnoses, and treatments based on pulse oximetry values have been completed. Contrasted to oxygen saturation via pulse oximetry, CO and SVR are affected by a wide range of pharmacologic agents that are routinely prescribed for managing both acute and chronic diseases. In most cases, these agents are prescribed and the patients are treated without any direct, objective evaluation of the complete hemodynamic condition by the treating clinician. Based on our findings of the equivalent and clinically acceptable accuracy and reproducibility of the ICG monitor use in this study, we believe that there is substantial merit in declaring noninvasive CO to be a useful vital sign in the assessment, diagnosis, and treatment of postoperative CABG patients.
TA wise, present volume is comfirming the crossover of 50dMA over 200dMA..STOCH's are oversold and turned up RSI back over 50...4.40ish is the target from here on a very short term basis.
DFIB did the trade thing again...YEEEHHHHAAAAA
ARDM headed for the overhead gap at 2.30ish.
Ken |
