Cardiovascular monitoring in the medical intensive care unit

The need for and development of computer-based monitoring in medical intensive care are discussed. The critical care ward system at the University of Southern California's Center for the Critically Ill is described. Basic monitoring routines include measurement of heart rate; arterial, venous, and pulmonary pressures; core and peripheral temperature; and urine output. Other application programs handle cardiac output determinations, laboratory tests, narrative data entry, and process control. Data retrieval provides for tabular, textual, and graphic displays both at the bedside and in hard copy, as well as data printouts for research purposes. Computer control covers the vascular interface, automated pressure calibration, peristaltic pumps for fluid infusion and blood sampling, and urine collection and disposal. Using automated fluid challenge as a prototype, servo operations should be extended to mechanical ventilation and fluid therapy.