Improving ICU quality and patient safety is crucial to building sustainable clinical programs and surviving the current reimbursement landscape. The growing population of older, sicker patients with multiple comorbidities represents an increasing challenge for critical care clinicians. Even a short 5-minute period of patient hemodynamic instability can lead to a cascade of complications, including inadequate tissue perfusion, multiple organ dysfunction, and prolonged length of stay and resource utilization (Zenati MS, et al. J Trauma).
A systematic approach to escalating hemodynamic management and guidance helps avoid gaps in care for the most critically ill ICU patients. Right Ventricular (RV) failure is most common in post-operative care as well as with patients diagnosed with sepsis and ARDS. The occurrence of RV dysfunction in the critically ill cardiac patient population has been reported as high as 33%. RV dysfunction is routinely underdiagnosed in ICU patients (Kaynar M, et al. UPMC, 2013), but leads to substantial patient complications. RV failure furthers patients high-risk profiles: RV failure is the leading cause of prolonged length of stay and significant cost. By providing a direct window into the RV, advanced hemodynamic ultrasound programs make it possible to identify RV dysfunction from its inception.
Time on Vent
40-50% of time on vent is dedicated to weaning (Esteban A, et al. JAMA, 2002). The primary cause of failure to wean is cardiac insufficiency. Proactive, hemodynamic management of patients who are at risk of prolonged time on vent improves ICU quality and translates into significant improvements in department quality standards overall. Hemodynamic ultrasound is continuously available, direct visualization of heart filling and function:
- Clinical: Guides faster, safer vent weaning
- Operational: Enables reduction in Time on Vent
- Adminstative: Helps achieve system-wide quality initiatives