Effective hemodynamic monitoring

Author:

Pinsky Michael R.,Cecconi Maurizio,Chew Michelle S.,De Backer Daniel,Douglas Ivor,Edwards Mark,Hamzaoui Olfa,Hernandez Glenn,Martin Greg,Monnet Xavier,Saugel Bernd,Scheeren Thomas W. L.,Teboul Jean-Louis,Vincent Jean-Louis

Abstract

AbstractHemodynamic monitoring is the centerpiece of patient monitoring in acute care settings. Its effectiveness in terms of improved patient outcomes is difficult to quantify. This review focused on effectiveness of monitoring-linked resuscitation strategies from: (1) process-specific monitoring that allows for non-specific prevention of new onset cardiovascular insufficiency (CVI) in perioperative care. Such goal-directed therapy is associated with decreased perioperative complications and length of stay in high-risk surgery patients. (2) Patient-specific personalized resuscitation approaches for CVI. These approaches including dynamic measures to define volume responsiveness and vasomotor tone, limiting less fluid administration and vasopressor duration, reduced length of care. (3) Hemodynamic monitoring to predict future CVI using machine learning approaches. These approaches presently focus on predicting hypotension. Future clinical trials assessing hemodynamic monitoring need to focus on process-specific monitoring based on modifying therapeutic interventions known to improve patient-centered outcomes.

Funder

NHLBI

Publisher

Springer Science and Business Media LLC

Subject

Critical Care and Intensive Care Medicine

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