Hemodynamic Monitoring in the Intensive Care Unit

Abstract

Patients in the intensive care unit are often critically ill with inadequate tissue perfusion and oxygenation. This inadequate delivery of substrates at the cellular level is a common definition of shock. Hemodynamic monitoring is the observation of cardiovascular physiology. The purpose of hemodynamic monitoring is to identify abnormal physiology and intervene before complications, including organ failure and death, occur. The most common types of invasive hemodynamic monitors are central venous catheters, pulmonary artery catheters, and arterial pulse-wave analysis. Ultrasonography is a noninvasive alternative being used in intensive care units for hemodynamic measurements and assessments.

Radial artery cannulation in intensive care unit patients: Does distance from wrist joint increase catheter durability and functionality?

“…Reported arterial catheter use in United States ICU is 49.2% for patients undergoing mechanical ventilation and 51.7% for patients requiring vasopressors. [1][2][3] Radial artery is usually the most accessed site for cannulation due to a series of advantages and a reduced frequency of superficial and deep palmar arches joining radial and ulnar arteries in the distal forearm. A complete superficial palmar arch is reported to be present in between 43% and 97% of patients hands while complete deep palmar arch in 90% to 95%.…”

“…Reported arterial catheter use in United States ICU is 49.2% for patients undergoing mechanical ventilation and 51.7% for patients requiring vasopressors. 1–3 Radial artery is usually the most accessed site for cannulation due to a series of advantages and a reduced frequency of associated complications, mostly related to distal ischemia. 4 An adequate collateral flow to the hand is guaranteed by the superficial and deep palmar arches joining radial and ulnar arteries in the distal forearm.…”

Schockpatient Pferd – Schnell erkennen, richtig behandeln

“…Es handelt sich damit um eine Minderperfusion mit daraus resultierender Schädigung von Zellen und Organen aufgrund ungenügender Sauerstoff-und Nährstoffzufuhr [7, 17,19]. Anders ausgedrückt ist der Schockzustand gekennzeichnet durch ein Ungleichgewicht zwischen Sauerstoffverbrauch und Sauerstoffzufuhr, wodurch in den Geweben Störungen der metabolischen Funktion sowie der strukturellen Integrität auftreten können [7,20,26].…”

The Place of Nutrition in Critical Care of the Chest

“…Related to the use of pressors is the question of when and if the patient is no longer in shock. Muller et al 5 have reviewed hemodynamic monitoring. The basic information obtained is pulmonary artery occlusion pressure, which allows approximation of left ventricular end‐diastolic pressure, and cardiac output.…”

“…As Muller and colleagues point out, emphatically and correctly, the pulmonary artery catheter is only valuable if findings derived from it are incorporated into treatment, preferably through algorithms to guide therapy. Emerging technologies, notably arterial waveform analysis and ultrasonography, have a great deal of promise to obtain equivalent data, and it may be possible in the near future to obtain needed information without the indwelling pulmonary artery catheter 5 …”