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Monitoring During Anesthesia
Adel Mohamad Alansary, MD
Why?
• Alert for potential incidents and errors.
• Guide medical, fluid and blood
therapy.
• Replace patient homoeostatic system.
• Guide surgical therapy.
Who?
Anesthesiologist.
What?
• Oxygenation:
• Oxygen analyzer.
• Oximetry.
• Clinical observation.
What?
• Ventilation:
• Clinical observation.
• Stethoscope.
• EtCO2.
What?
• Circulation:
• ECG
•HR.
•Arrhythmia.
What?
•ST analysis.
• BP
•Non-Invasive.
• Invasive
Anesthesia Machine
• Airway pressure.
• Flow meter.
• ETT.
• Oxygen supply pressure.
• IN OUT valves.
• Bellows.
What?
• CVS: Precordial stethoscope, IBP, PAP, CVP, Processed ECG, TEE, SVV, PPV, CO.
• Respiratory: expired gas, inhalational anesthetic, lung water, mixed venous Oximetry.
• Neurological: Processed EEG, CSF pressure, Evoked potentials, JVB Oximetry, cerebral Oximetry.
What?
• Neuromuscular monitoring.
• Renal: UOP, pH.
• Coagulation monitors.
• Bleeding.
HEMODYNAMIC MONITORING
Joseph T.
Clover (1825–
1882).
Cope DK. Monitoring in the 19th century:from blood-letting to
blood-flow measurements.ASA Newsl 2002;66(9):6–8.
ABP
• Non- invasive
• Auscultatory.
• Oscillemetry.
• Invasive
• Indications.
• Sites.
• Complications.
• Technical factors.
Normal Arterial Wave
What?
• Vitals.
• Anesthesia machine.
• Specific systems: