Hemodynamic Monitoring in the ICU

By: Raphael Giraud and Karim Bendjelid

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Synopsis: This book describes thepathophysiological significance of the hemodynamic monitoring parametersavailable to the clinician and their role in providing reliable andreproducible information on the cardiocirculatory status of a patient in shock. It is explained how measurements of these parameters enable the intensivist tounderstand the patient's condition and to make more informed treatmentdecisions in order to optimize the hemodynamic status and improve theprognosis. Full guidance is provided on measurement of intravascular bloodpressures, cardiac output, and derived variables. Methods of cardiac outputdetermination based on the classical pulmonary thermodilution, transpulmonarythermodilution, echocardiography, and Doppler techniques are reviewed. Techniquesbased on calibrated and non-calibrated pulse contour analysis are discussed,with attention to their limitations. Furthermore, the dynamic indices of fluidresponsiveness, their clinical applications, and issues related to their useare addressed. Care is also taken to explain the physiological conceptsunderlying various devices used by anesthesiologists and intensivists.