Monitoring Patients: What’s New in Intensive Care Setting?

  • Matteo Manici
  • Claudio Torbinio


Monitoring (“to monitor”) is a term that involves the observation, actions, measuring, and understanding of many human activities in time. Historically, monitoring started as a physiological measurement problem and probably will end up as an overall assessment of the patient in intensive care. Monitoring is an activity that involves the entire ICU staff: nurses, doctors, respiratory therapists and rehabilitation therapists, and dietitians too. Monitoring is based on different operational models implemented in different countries of the world. Nurses, wherever present 24 h a day, often play the role of liaison between the various staff components, ensuring security, continuity, and harmony and coordinating and communicating all aspects of treatment and care that patient needs. Nurses also provide continuous monitoring and caring for patients and equipment and for their interactions.

Monitoring can be instrumental by the use of various technologies, or it can be derived by observation and the use of scales: both systems provide “bed monitoring” that represents the base of all intensive care unit activity.

We purposed MAGIS, a conceptual model to describe intensive care nursing monitoring which will be explained in later chapters.


Monitoring Instrumental monitoring Assessment scales Bed monitoring 


  1. 1.
    Nič M, Jirát J, Košata B, Jenkins A, McNaught A. IUPAC compendium of chemical terminology—the gold book. Research Triagle Park, NC: International Union of Pure and Applied Chemistry; 2009.CrossRefGoogle Scholar
  2. 2.
    Patient Care and Monitoring Systems. 2013. Accessed 12 May 2016.
  3. 3.
    Welch JR, Theaker C. Ruolo infermieristico in terapia intensiva. In: Bersten AD, Soni N, editors. Oh Manuale di terapia intensiva. sesta edizione ed. Milano: Elsevier Health Sciences Italy; 2010. p. 3197–647.Google Scholar
  4. 4.
    Vincent JL, Singer M. Critical care: advances and future perspectives. Lancet. 2010;376(9749):1354–61. Scholar
  5. 5.
    Schallom M. Monitoring and support devices in the Intensive Care Unit. Support Line. 2014;36(6):20–5. 10.21037/jtd.2016.05.37.CrossRefGoogle Scholar
  6. 6.
    Ciccone A, Celani MG, Chiaramonte R, Rossi C, Righetti E. Continuous versus intermittent physiological monitoring for acute stroke. Cochrane Database Syst Rev 2013;(5):CD008444. doi:
  7. 7.
    Adams HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation. 2007;115(20):e478–534.CrossRefPubMedGoogle Scholar
  8. 8.
    Imhoff M, Kuhls S. Alarm algorithms in critical care monitoring. Anesth Analg. 2006;102(5):1525–37.CrossRefPubMedGoogle Scholar
  9. 9.
    ECRI Institute. Top 10 technology hazards for 2012. The risks that should be at the top of your prevention list. Health Devices. 2011;40(11):358–73.Google Scholar
  10. 10.
    Tomasi CD, Grandi C, Salluh J, Soares M, Giombelli VR, Cascaes S, et al. Comparison of CAM-ICU and ICDSC for the detection of delirium in critically ill patients focusing on relevant clinical outcomes. J Crit Care. 2012;27(2):212–7. Scholar
  11. 11.
    Christakou A, Papadopoulos E, Patsaki E, Sidiras G, Nanas S. Functional Assessment Scales in a general intensive care unit. Hosp Chron. 2013;8(4):164.Google Scholar
  12. 12.
    Gentili A. Il paziente critico. Clinica e assistenza infermieristica in anestesia e rianimazione. Milano: CEA; 1993.Google Scholar
  13. 13.
    Besso J, Lumb PD, Williams G. Intensive and critical care medicine. WFSICCM World Federation of Societies of Intensive and Critical Care Medicine. Milano: Springer; 2009.Google Scholar
  14. 14.
    Bersten AD, Soni N. Oh Manuale di terapia intensiva. London: Elsevier Health Sciences Italy; 2010.Google Scholar
  15. 15.
    Citerio G, Oddo M, Taccone FS. Recommendations for the use of multimodal monitoring in the neurointensive care unit. Curr Opin Crit Care. 2015;21(2):113–9. Scholar
  16. 16.
    Schomer AC, Hanafy K. Neuromonitoring in the ICU. Int Anesthesiol Clin. 2015;53(1):107–22. Scholar
  17. 17.
    Barr J, Fraser GL, Puntillo K, Ely EW, Gelinas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41(1):263–306. Scholar
  18. 18.
    Stammet P, Collignon O, Werer C, Sertznig C, Devaux Y. Bispectral index to predict neurological outcome early after cardiac arrest. Resuscitation. 2014;85(12):1674–80. Scholar
  19. 19.
    Kipnis E, Ramsingh D, Bhargava M, Dincer E, Cannesson M, Broccard A, Vallet B, Bendjelid K, Thibault R. Monitoring in the intensive care. Crit Care Res Pract. 2012;2012:473507. Scholar
  20. 20.
    Bulleri E, Fusi C. Manuale di monitoraggio grafico della ventilazione meccanica. Guida pratica alla rilevazione delle asincronie. FareLibri; 2015.Google Scholar
  21. 21.
    Poulia KA, Yannakoulia M, Karageorgou D, Gamaletsou M, Panagiotakos DB, Sipsas NV, Zampelas A. Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly. Clin Nutr. 2012;31(3):378–85. Scholar
  22. 22.
    Berni G, Francois C, Tonelli L. National Early Warning Score (NEWS) Misurazione standardizzata della gravità della malattia. 2016. Accessed 16 Jun 2016.
  23. 23.
    Rando K, Niemann CU, Taura P, Klinck J. Optimizing cost-effectiveness in perioperative care for liver transplantation: a model for low- to medium-income countries. Liver Transpl. 2011;17(11):1247–78. Scholar
  24. 24.
    Odell M, Victor C, Oliver D. Nurses’ role in detecting deterioration in ward patients: systematic literature review. J Adv Nurs. 2009;65(10):1992–2006.CrossRefPubMedGoogle Scholar
  25. 25.
    Cabrera D, Thomas JF, Wiswell JL, Walston JM, Anderson JR, Hess EP, et al. Accuracy of ‘My Gut Feeling:’ comparing system 1 to system 2 decision-making for acuity prediction, disposition and diagnosis in an Academic Emergency Department. West J Emerg Med. 2015;16(5):653–7. Scholar
  26. 26.
    Adhikari NKJ, Fowler RA, Bhagwanjee S, Rubenfeld GD. Critical care and the global burden of critical illness in adults. Lancet. 2010;376(9749):1339–46. Scholar
  27. 27.
    Kisiel M. Nursing observations: knowledge to help prevent critical illness. Br J Nurs. 2006;15(19):1052–6. 10.12968/bjon.2006.15.19.22105.CrossRefPubMedGoogle Scholar
  28. 28.
    Moller JT, Johannessen NW, Espersen K, Ravlo O, Pedersen BD, Jensen PF, et al. Randomized evaluation of pulse oximetry in 20,802 patients; II. Perioperative events and postoperative complications. J Am Soc Anesthesiol. 1993;78(3):445–53.CrossRefGoogle Scholar
  29. 29.
    Forsyth RJ, Raper J, Todhunter E. Routine intracranial pressure monitoring in acute coma. Cochrane Database Syst Rev. 2015;(11):CD002043. doi:
  30. 30.
    Cannesson M, Broccard A, Vallet B, Bendjelid K. Monitoring in the intensive care unit: its past, present, and future. Crit Care Res Pract. 2012;2012:452769. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Matteo Manici
    • 1
  • Claudio Torbinio
    • 2
  1. 1.Anesthesia, Intensive Care and Hub Pain ServiceUniversity Hospital of ParmaParmaItaly
  2. 2.Trauma Centre, Emergency DepartmentAncona HospitalProvince of AnconaItaly

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