Improvements in intensive care units

Abstract

We have had some important improvements in the intensivecare units (ICU) like high flow oxygen system (HFOS),

therapeutic hypothermia, extra corporeal membrane oxygenation(ECMO), extra corporeal carbon dioxide removal (ECCOR),

echocardiography (ECHO) and ultrasonography (US).

HFOS gives oxygen to the patients at rates of flow higher (upto 60 L/min) than that delivered traditionally in LFOS (up to 16L/

min). It is obtained 1 cmH2O PEEP for every 10L/min of flowdelivered by HFOS. HFOS serves as an important alternative tononinvasive mechanical ventilation especially in the managementof the patients with hypoxemic respiratory failure.

Post-resuscitation care consists of optimization of oxygenationand ventilation, avoiding hypotension, treating immediateprecipitants of cardiac arrest such as acute coronary ischemiaand initiating therapeutic (induced) hypothermia. Therapeutichypothermia decreases cerebral metabolic rate, blood volume, andintracranial pressure, prevents reperfusion injury. So hypotermiaprotects cerebral functions.

ECMO, the type of cardiopulmonary support, has become anessential tool in critical care patients with severe respiratory andcardiac failure, refractory to conventional therapy methods.

Critical care ultrasonography (CCUS) and echocardiographyhave utility for intensivist-performed, immediate diagnoses of lifethreatening diseases, with no need to transport patients to radiologyor cardiology departments or wait for radiologist or cardiologist ona consultative basis. CCUS and echocardiography