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CAN NURSES USE CONTINUOUS CENTRAL VENOUS OXYGEN SATURATION MONITORING TO DICTATE HOW AND WHEN TO PROVIDE CARE?
  1. C Young1
  1. 1Pediatric Nurse Consultant, Global Critical Care, Edwards Lifesciences, LLC, Irvine, CA, USA

Abstract

Can pediatric critical care nurses adequately evaluate the effects of routine care using traditional hemodynamic monitoring tools? Is the care and procedures beneficial or potentially harmful to children following surgical repair of congenital heart defects? How can this be assessed in “real-time”? Can newly advanced monitoring tools besides traditional vital signs; heart rate, blood pressure, pulse oximetry, respiratory rate and central venous pressure; help determine the optimal time to change inotropes, suction, bathe or reposition the child, rather than performing these tasks on certain shifts or time of day? Can these “real-time” monitoring tools guide nurses’ clinical decision making for when and how to provide care?

Continuous monitoring of global and/or regional oxygen saturation can provide “real-time” information of the balance between oxygen delivery and consumption. Many seemingly innocuous procedures can drastically increase oxygen consumption needs, beyond oxygen delivery capabilities.

Nurses have knowledge of physiological causes and exogenous interventions that can lead to increases in oxygen consumption. While most of these interventions are a necessity, continuous monitoring of global and/or regional oxygen saturation can help nurses at the bedside determine when the best time is to provide care, when an intervention is necessary and how the patient tolerates it.

In a time of soaring health care costs, a worldwide nursing shortage, and children undergoing increasingly complex cardiac repairs, there exists an obligation to decrease mortality and morbidity as much as possible. The best and most advanced technology providing an early warning is extremely vital in the crucial recovery period.

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