A., Sauaia, A., Moore, E. E., Haenel,
J. B., Burch, J. M., and Lezotte, D. C., 1996) involving multiprofessional medical-
nursing work of care (Lederer, J. A., Rodrick, M. L., Mannick, J. A., 1999). As I reflect, I
can now arrange the events that were relevant to this patient. On the first admission of the
patient from theater to intensive therapy unit, the patient was placed on pressure-control
ventilation with 100% oxygen with a PEEP of 10, rate of 12, tidal volume 500, and
pressure support of 10. On estimation at that time, arterial blood gas was initially on pH
7.13, pCO2 of 7.0, pO2 of 21.4 with a base excess of -10. SpO2 was 99.8 and bicarbonate
16.9. Lactate was18. The patients in the intensive therapy unit constitute an extremely
heterogeneous population in terms of admission diagnosis, co-morbidities, age, race, sex,
and socioeconomic conditions, but one feature is common to almost all of them,
cardiopulmonary dysfunction (Kelly, J. L. et al., 1997). During my shift hours, I could
easily sense that the environment of ITU. It provided highly integrated and coordinated
care with many novel machines and minute-to-minute therapy and observation. This
posting in the ITU could improve my understanding of the physiology of such patients in
that, I could observe the changes in the patient's parameters in real time. I could see the
changes in central venous pressure with a change in rate of fluid therapy (Stone, P.W, and
Gershon, R.R.M., 2006). I observed changes in blood gases when the oxygen
concentration and ventilation settings were changed. I could detect when
pharmacotherapeutic interventions would fail to produce intended changes in the cardiac
output studies. In short, this...
Journal of Trauma; 42: pp. 532-536.
Fan, J., Marshall, J. C., Jimenez, M., Shek, P. N., Zagorski, J., and Rotstein, O. D., (1998). Hemorrhagic Shock Primes For Increased Expression Of Cytokine-Induced Neutrophil Chemoattractant In The Lung: Role In Pulmonary Inflammation Following Lipopolysaccharide. Journal of Immunology; 161, pp. 440-447.
Gadek, J.E., DeMichele, S.J., Karlstad, M.D., et al., (1999). Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral Nutrition in ARDS Study Group. Critical Care Medicine; 27: pp. 1409-1420.
Gibbs, C.R., Davies, M.K., and Lip, G.Y.H., (2000). ABC Of Heart Failure: Management: Digoxin And Other Inotropes, Blockers, And Antiarrhythmic And Antithrombotic Treatment. British Medical Journal; 320: 495.
Inman, K.J., Sibbald,W.J., Rutledge,F.S., Speechley,M., Martin,C.M., and Clark, B.J., (1993). Does Implementing Pulse Oximetry In A Critical Care Unit Result In Substantial Arterial Blood Gas Savings Chest; 104: 542.
Kelly, J. L., O'Sullivan, C., O'Riordain, M., O'Riordain, D., Lyons, A., Doherty, J., Mannick, J. A., and Rodrick, M. L., (1997). Is Circulating Endotoxin The Trigger For The Systemic Inflammatory Response Syndrome Seen After Injury Annals of Surgery; 225, pp. 530-541.