Hemodynamic monitoring in the critically ill: an overview of current cardiac output monitoring methods.

Critically ill patients are often hemodynamically unstable (or at risk of becoming unstable) owing to hypovolemia, cardiac dysfunction, or alterations of vasomotor function, leading to organ dysfunction, deterioration into multi-organ failure, and eventually death. With hemodynamic monitoring, we aim to guide our medical management so as to prevent or treat organ failure and improve the outcomes of our patients. Therapeutic measures may include fluid resuscitation, vasopressors, or inotropic agents. Both resuscitation and de-resuscitation phases can be guided using hemodynamic monitoring. This monitoring itself includes several different techniques, each with its own advantages and disadvantages, and may range from invasive to less- and even non-invasive techniques, calibrated or non-calibrated. This article will discuss the indications and basics of monitoring, further elaborating on the different techniques of monitoring.
Competing Interests: Manu Malbrain is founding president and current Treasurer of the World Society of Abdominal Compartment Syndrome (WSACS, www.wsacs.org) and a member of the medical advisory board of Pulsion Medical Systems (Maquet Getinge Group). He is also co-founder of the International Fluid Academy (IFA, www.fluidacademy.org), a not-for-profit organization that is part of iMERiT (International Medical Education and Research Initiative) adhering to the FOAM (Free Open Access Medical Education) principles. The authors don’t have any financial disclosures with regard to writing this paper. Competing interests: Samir Sakka is a member of the Medical Advisory Board of Pulsion Medical Systems, Maquet Getinge Group. No competing interests were disclosed. No competing interests were disclosed.