Rationale for cardiovascular monitoring

Current Opinion in Critical Care

Volumn 9, Issue 3, 2003, Pages 222-224

  Pinsky, Michael R ^a,b  

^a UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^b 606 Scaife Hall ^*  (United States)

Author keywords

Circulatory shock; Clinical trials; Hemodynamic monitoring; Intensive care; Resuscitation

Indexed keywords

ARTERIAL OXYGEN SATURATION; ARTERIAL PRESSURE; BLOOD ANALYSIS; BODY WEIGHT; CATHETERIZATION; CENTRAL VENOUS PRESSURE; DIURESIS; ELECTROCARDIOGRAPHY; EXPIRED AIR; HEART AFTERLOAD; HEART FAILURE; HEART RATE; HEMODYNAMIC MONITORING; HUMAN; INTENSIVE CARE; INTRAVASCULAR CATHETER; MEAN ARTERIAL PRESSURE; PLETHYSMOGRAPHY; PULSE OXIMETRY; SHORT SURVEY; TECHNIQUE; TITRIMETRY; URINE VOLUME;

BLOOD PRESSURE DETERMINATION; CATHETERIZATION, SWAN-GANZ; CENTRAL VENOUS PRESSURE; CRITICAL CARE; DIAGNOSTIC TECHNIQUES, CARDIOVASCULAR; HEMODYNAMIC PROCESSES; HUMANS; MONITORING, PHYSIOLOGIC;

EID: 0038542127     PISSN: 10705295     EISSN: None     Source Type: Journal    
DOI: 10.1097/00075198-200306000-00009     Document Type: Short Survey

References (13)

1. Michard F, Boussat S, Chemla D, et al.: Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 2000, 162:134-138.
2. Gunn SR, Pinsky MR: Implications of arterial pressure variation in patients in the intensive care unit. Curr Opin Crit Care 2001, 7:212-217.
3. Tavernier B, Makhotine O, Lebuffe G, et al.: Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 1998, 89:1313-1321.
4. Wesseling K, Wit BD, Weber J, et al.: A simple device for the continuous measurement of cardiac output. Adv Cardiovasc Physiol 1983, 5:16-52.
5. Feissel M, Michard F, Mangin I, et al.: Respiratory changes in aortic blood velocity as an indicator of fluid responsiveness in ventilated patients with septic shock. Chest 2001, 119:867-873.
6. Reuter DA, Felbinger TW, Schmidt C, et al.: Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med 2002, 28:392-398. This prospective clinical trial was one of the first to apply arterial pulse contour technology to stroke volume variation and then to use it to manage patients. The paper should be read along with its accompanying editorial (see [9]).
7. Reuter DA, Felbinger TW, Kilger E, et al.: Optimising fluid therapy in mechanically ventilated patients after cardiac surgery by on-line monitoring of left ventricular stroke volume variations. Comparison with aortic systolic pressure variations. Br J Anaesth 2002, 88:124-126.
8. Berkenstadt H, Margalit N, Hadani M, et al.: Stroke volume variation as a predictor of fluid responsiveness in patients undergoing brain surgery. Anesth Analg 2001, 92:984-989.
9. Pinsky MR: Functional hemodynamic monitoring: asking the right question. Intensive Care Med 2002, 28:386-388.
10. Jellinek H, Krafft P, Fitzgerald RD, et al.: Right atrial pressure predicts hemodynamic response to apneic positive airway pressure. Crit Care Med 2000, 28:672-678. A solid body of work attempting to identify threshold values for CVP that could be used for all ventilator-dependent patients.
11. Magder S, Lagonidis D, Erice F: The use of respiratory variations in right atrial pressure to predict the cardiac output response to PEEP. J Crit Care 2001, 16:108-114.
12. Rivers E, Nguyen B, Havstad S, et al.: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001, 345:1368-1377. The clinical study that put close titration of care based on sound physiologic principals back on the map. A very well-conducted and well-documented study that has become the focus point of numerous discussions, new clinical trials, and reengineering of emergency department triage procedures.
13. Sandham JD, Hull RD, Brant RF, et al.: A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 2003, 348:5-14. The definitive clinical trial of PAC use in a defined group of patients at risk for untoward events. The accompanying editorial places these data in a pulmonary perspective. However, the real message is that the use of the pulmonary artery catheter in the nonspecifically ill patient cannot be defended.