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Hemodynamic Monitoring in Surgical Critical Care

  • Brett M. Howard
  • D. Benjamin ChristieIII
Chapter

Abstract

Hemodynamic monitoring has been an essential element of medical care and arguably the corner stone of patient care delivery in any acute clinical setting. However, despite medicine’s modern evolution and technological advancements, hemodynamic monitoring continues to be a much debated topic with polarized differences of opinion. The debate has existed, and continues to exist, due in part to the historic difficulty that researchers and clinicians have had in identifying a universally acceptable modality to obtain accurate and reproducible data regarding cardiovascular performance, responsiveness to therapeutic interventions, appropriate end points of resuscitation, or therapeutic efforts.

Methods of hemodynamic assessment include indirect and direct perfusion (pressure and flow) measurements and the more recently acknowledged, direct visualization methods. While all modalities have advantages, disadvantages, and some degree of imprecision, no single technique is inadequate or useless nor has any one modality proven to be a stand-alone solution to complex resuscitation scenarios. While research is unceasing in establishing a gold standard for hemodynamic monitoring and an accompanied end point of resuscitation, a thorough understanding of existing and evolving hemodynamic monitoring strategies and concepts is a necessary prerequisite for the practicing intensivist.

Keywords

Echocardiography Central venous pressure Arterial pressure Peripheral perfusion Venous oxygen saturation 

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Authors and Affiliations

  1. 1.Department of SurgeryMedical Center of Navicent HealthMaconUSA
  2. 2.Department of Trauma/Critical CareMedical Center Navicent Health/Mercer University School of MedicineMaconUSA

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