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The Use of Hemodynamic Monitoring to Improve Patient Outcomes

  • J. Wilson
  • M. Cecconi
  • A. Rhodes

Abstract

Hemodynamics is the physiology concerned with movements of blood and the forces involved in the circulation [1]. Hemodynamic monitoring involves the study of this physiology, with various forms of technology to understand these forces and the movement of blood, and put them into a clinical context that can be assessed and used to direct therapy. The main function of these hemodynamic forces is to transport substrates to, and clear metabolites from, the cells in order to allow adequate cellular function. The assessment of hemodynamics must, therefore, also take into account the metabolic status of the cell in particular in relation to its supply of oxygen. A relative lack of oxygen at the cellular level is known as tissue hypoxia. The identification and correction of tissue hypoxia remains one of the central facets of any protocol that aims to resuscitate patients from shock conditions. This is because tissue hypoxia has both pathological relevance in vitro [2] and an association with poor outcome [3]. When monitoring the circulation, therefore, an estimate must be made of the adequacy of the circulation with respect to the likelihood of there being underlying tissue hypoxia. With most currently available monitors for routine practice it is impossible to assess tissue hypoxia at either a local or a cellular level. An extrapolation is, therefore, made from a number of globally measured parameters that can provide an estimate of the likelihood of underlying disturbance. Clinicians can then use this information to direct therapeutic decisions in order to benefit their patients.

Keywords

Cardiac Output Central Venous Pressure Pulmonary Artery Catheter Tissue Hypoxia Hemodynamic Monitoring 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science + Business Media Inc. 2007

Authors and Affiliations

  • J. Wilson
    • 1
  • M. Cecconi
    • 1
  • A. Rhodes
    • 1
  1. 1.General Intensive Care UnitSt George’s HospitalLondonUK

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