Traditional, static measures of resuscitation, such as vital signs, central venous pressure, and pulmonary arterial pressure, provide momentary glimpses evolving hemodynamic states. In patients with shock, these measures of resuscitation are poor indicators of response to therapy. As a result, dynamic assessments of cardiovascular status are now used in critically ill patients to facilitate resuscitation. Some of these approaches focus on fluid responsiveness. These assessments allow care to be tailored to each patient’s response to interventions. An evolving aspect of hemodynamic monitoring is evaluation of the adequacy of tissue perfusion and oxygen delivery. In this review, we consider the use of arterial, central venous, and pulmonary arterial blood pressure monitoring; echocardiography; transesophageal Doppler technology; pulse contour analysis; bioimpedance and bioreactance; and partial rebreathing monitoring modalities to assess hemodynamic status in critically ill patients.
This review contains 22 figures, 5 tables, and 38 references.
Key words: echocardiography, esophageal Doppler technology, invasive and noninvasive hemodynamic monitoring, pulse contour analysis, shock
Fluid removal in critically ill patients during hemodialysis: is there a role for functional hemodynamic monitoring?
