Monitoring

Abstract

Management of children with respiratory illness requires close monitoring for assessing clinical progress as well as to determine if any therapeutic adjustments are necessary. Pulse oximetry, capnography, and blood gas determinations are techniques to assess gas exchange. Monitoring of respiratory mechanics is helpful in determination of static and dynamic compliances, auto PEEP measurement and adjustments of ventilator settings. Patients with neuromuscular weakness should be monitored for effort dependent parameters to determine extubation readiness. Determination of arteriovenous oxygen difference is helpful in calculating either O₂ consumption or cardiac output by using Fick equation if one of these two entities can be measured. Mixed venous O₂ saturation is an indicator of cardiac output provided O₂ consumption and arterial O₂ content are constant. Measurements of intrapulmonary shunting, alveolar and anatomic dead spaces, work of breathing are useful in titrating ventilator settings. Measurements of intrapulmonary shunting, alveolar and anatomic dead spaces, work of breathing are useful in titrating ventilator settings.