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The Hemodynamic Puzzle: Solving the Impossible?

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Annual Update in Intensive Care and Emergency Medicine 2014

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM,volume 2014))

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Abstract

Development of multiorgan dysfunction is often the result of hypoperfusion, which severely affects outcomes of medical and surgical patients and substantially increases the utilization of resources and costs [1]. Therefore, the use of early and efficient strategies to detect tissue hypoperfusion and to treat the imbalance between oxygen consumption and delivery is of particular importance [2]. Traditional endpoints, such as heart rate, blood pressure, mental status and urine output, can be useful in the initial identification of inadequate perfusion, but are limited in their ability to identify ongoing, compensated shock [3]. Therefore, more detailed assessment of global macrohemodynamic indices, such as cardiac output and derived variables and measures of oxygen delivery and uptake, may be necessary to guide treatment [4–5]. Furthermore, after optimization of these parameters, indicators of tissue perfusion should also be assessed to verify the effectiveness of therapy [6]. This multimodal approach can be translated into the individualized use of target endpoints for hemodynamic stabilization instead of treating ‘normal’ values, and can help to achieve adequate oxygen supply and tissue oxygenation in order to avoid under- or over-resuscitation, which are equally harmful.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, University of Szeged, 6725, Szeged, Hungary

    K. Tánczos, M. Németh & Z. Molnár

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  1. K. Tánczos
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  2. M. Németh
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  3. Z. Molnár
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Correspondence to Z. Molnár .

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  1. Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent Prof.

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Tánczos, K., Németh, M., Molnár, Z. (2014). The Hemodynamic Puzzle: Solving the Impossible?. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2014. Annual Update in Intensive Care and Emergency Medicine, vol 2014. Springer, Cham. https://doi.org/10.1007/978-3-319-03746-2_27

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  • DOI: https://doi.org/10.1007/978-3-319-03746-2_27

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-03745-5

  • Online ISBN: 978-3-319-03746-2

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