Critical Care Presence
Developing Tools for More Effective Bedside Care
The care of critically ill patients is complex and challenging with the outcome highly dependent on the skill set of the critical care team. In virtually any critical care setting, there is an abundance of information available, yet the ability to process data and provide effectively organized and meaningful information is limited.
An important example is the assessment of work of breathing (WOB). Unrecognized WOB increase leading to respiratory muscle fatigue is a frequent cause of hospital cardiac arrest. We have developed a simple clinical scale to assess WOB at the bedside enabling healthcare providers to recognize and treat early WOB increase.1,2
Our WOB scale was also useful to assess the need for intubation to initiate mechanical ventilation in patients with COVID-19 pneumonia2 and is now available through the MAPI Research Trust and a webinar discussing respiratory failure and the WOB scale’s clinical usefulness.
- Apigo M, Schechtman J, Dhliwayo N, Al Tameemi M, Gazmuri RJ. Development of a work of breathing scale and monitoring need of intubation in COVID-19 pneumonia. Crit Care. 2020 Jul 31;24(1):477. doi: 10.1186/s13054-020-03176-y. PMID: 32736637; PMCID: PMC7393620.
- Nadeem A, Fanapour P, Apigo M, Kim S, George S, Khan M, Shahid A, Patel C, Carnate R, Gazmuri RJ. COVID-19 pneumonia: Guiding the decision to intubate based on work of breathing assessment independent of oxygenation. Int J Crit Care Emerg Med 2021, 7:126. DOI: 10.23937/2474-3674/1510126.
Thus, there is an important unmet clinical need for more effective use of available data and for development of automated systems leveraging on the available data to implement repetitive tasks with faster response times and less prone to human error. Stay tuned…