Hemodynamic Monitoring: Requirements of Less Invasive Intensive Care — Quality and Safety

  • A. Vieillard-Baron
Conference paper


Monitoring is rather a general term which defines the set of techniques used to analyze, check, and monitor the quality of a recording in electronics, or the pathophysiologic reactions of a patient in medicine [1]. The definition of monitoring does not necessarily imply the notion of continuity. Applied to hemodynamics, monitoring records the main parameters of cardiac function, such as cardiac output, right and left filling pressures, contractility of the left ventricle, and systolic function of the right ventricle. Hemodynamic monitoring can be used to check filling requirements and also to assess how cardiovascular function impacts on metabolism, by determining venous oxygen saturation, lactate, and base deficit.


Cardiac Output Septic Shock Pulmonary Artery Catheter Hemodynamic Monitoring Circulatory Failure 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Centre National de Ressources Textuelles and Lexicales. Scholar
  2. 2.
    Definition of invasive. Available at: Accessed Dec 2007Google Scholar
  3. 3.
    Swan HJ, Ganz W, Forrester J, Marcus H, Diamond G, Chonette D (1970) Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med 283:447–451PubMedGoogle Scholar
  4. 4.
    Marino PL (1997) The ICU Book. 2nd ed. Lippincott, Williams & Wilkins, PhiladelphiaGoogle Scholar
  5. 5.
    Jardin F, Farcot JC, Boisante L, Curien N, Margairaz A, Bourdarias JP (1981) Influence of positive end-expiratory pressure on left ventricular performance. N Engl J Med 304: 387–392PubMedGoogle Scholar
  6. 6.
    Lemaire F, Regnier B, Simoneau G, Harf A (1980) Positive end-expiratory pressure (PEEP) ventilation suppresses the increase of shunting caused by dopamine infusion. Anesthesiology 52: 376–377PubMedCrossRefGoogle Scholar
  7. 7.
    Colice GL (2006) Historical perspective on the development of mechanical ventilation. In: Tobin MJ (ed) Principles and Practice of Mechanical Ventilation. McGraw-Hill, New-York, pp 1–36Google Scholar
  8. 8.
    Robin ED (1983) A critical look at critical care. Crit Care Med 11:144–148PubMedCrossRefGoogle Scholar
  9. 9.
    Spodick DH (1980) Physiologic and prognostic implications of invasive monitoring: undetermined risk/benefit ratios in patients with heart disease. Am J Cardiol 46:173–175PubMedCrossRefGoogle Scholar
  10. 10.
    Hickling K, Henderson S, Jackson R (1990) Low mortality associated with low volume/pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med 16:372–377PubMedCrossRefGoogle Scholar
  11. 11.
    Ronco C, Bellomo R, Homel P, et al (2000) Effects of different doses in continuous venovenous haemofiltration on outcomes of acute renal failure: a prospective randomized trial. Lancet 355:26–30CrossRefGoogle Scholar
  12. 12.
    Connors AF, Speroff TS, Dawson NV, et al (1996) The effectiveness of right-heart catheterization in the initial care of critically ill patients. JAMA 276:889–897PubMedCrossRefGoogle Scholar
  13. 13.
    Richard C, Warszawski J, Anguel N, et al (2003) Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA 290: 2713–2720PubMedCrossRefGoogle Scholar
  14. 14.
    The ESCAPE Investigators and ESCAPE Study Coordinators (2005) Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness. The ESCAPE trial. JAMA 294:1625–1633CrossRefGoogle Scholar
  15. 15.
    Sandham JD, Hull RD, Brant RF, et al (2003) A randomized, controlled trial of the use of the pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 348:5–14PubMedCrossRefGoogle Scholar
  16. 16.
    Annane D, Aegerter P, Jars-Guincestre MC, Guidet B (2003) Current epidemiology of septic shock: the CUB-Réa Network. Am J Respir Crit Care Med 168:165–172PubMedCrossRefGoogle Scholar
  17. 17.
    Eisenberg PR, Jaffe AS, Schuster DP (1984) Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients. Crit Care Med 12: 549–553PubMedCrossRefGoogle Scholar
  18. 18.
    Jardin F (2005) Acute leftward septal shift by lung recruitment maneuver. Intensive Care Med 31:1148–1149PubMedCrossRefGoogle Scholar
  19. 19.
    Antonelli M, Levy M, Andrews PJ, et al (2007) Hemodynamic monitoring in shock and implications for management. International Consensus Conference, Paris, France, 27–28 April 2006. Intensive Care Med 33:575–590PubMedCrossRefGoogle Scholar
  20. 20.
    Pinsky MR, Vincent JL (2005) Let us use the pulmonary artery catheter correctly and only when we need it. Crit Care Med 33:1119–1122PubMedCrossRefGoogle Scholar
  21. 21.
    Rivers E, Nguyen B, Havstad S, et al (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock N Engl J Med 345:1368–1377PubMedCrossRefGoogle Scholar
  22. 22.
    Hadian M, Pinsky MR (2007) Functional hemodynamic monitoring. Curr Opin Crit Care 13:318–323PubMedCrossRefGoogle Scholar
  23. 23.
    Charron C, Prat G, Caille V, et al (2007) Validation of a skills assessment scoring system for transesophageal echocardiographic monitoring of hemodynamics. Intensive Care Med 33: 1712–1718PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • A. Vieillard-Baron
    • 1
  1. 1.Department of Intensive CareHôpital Ambroise ParéBoulogneFrance

Personalised recommendations