Hemodynamic Monitoring in Critical Care

摘要: In the critically ill patient, hemodynamic monitoring is vital for determining a patient’s volume status and can assist clinician in potential therapeutic options, including intravenous fluid resuscitation or challenge. Incorrect determination of an ill-advised bolus have grave consequences. Moreover, there are number clinical scenarios where difficult to determine. As such, myriad tools been developed assessing responsiveness challenge, with ultimate objective optimizing tissues oxygenation organ perfusion. Hemodynamic rely on tenets basic human cardiovascular physiology, which characterized by relationship between cardiac output, systemic vascular resistance, mean arterial pressure. Because measuring stroke real time difficult, output (SV heart rate) also elusive. Unfortunately clinician, most relevant status. Newer dynamic measures, realtime measurements certain physiological parameters calculate responsiveness, replaced earlier static measures status, pulmonary artery occlusion pressure, central venous left ventricular end-diastolic area. The still widely used many ICUs be determined via transduction catheter internal jugular subclavian catheter. newer techniques analysis fluctuations signs during respiratory variation (as case pulse contour inferior vena cava diameter measurement) direct measurement blood flow through aorta thermodilution, transpulmonary thoracic electrical bioimpedance, esophageal Doppler analysis), determine output. Data benefit one method over another largely mixed, may more accurate feasible specific scenarios. Ultimately, sound judgment, proper interpretation measurements, appropriate responses analyses important aspects monitoring. Other facets critical care, such as surgical management, mechanical ventilation strategies, renal therapies, nutrition, all related hemodynamics dictated, some extent, Within whether feed hemodynamically unstable patient remains controversial, has use immune modulating nutritional therapies patients who various states shock. *Email: LWBusse@gmail.com bussel01@gmail.com Diet Nutrition Critical Care DOI 10.1007/978-1-4614-8503-2_36-1 # Springer Science+Business Media New York 2014