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Review
. 2022 Sep 28;26(1):294.
doi: 10.1186/s13054-022-04173-z.

Effective hemodynamic monitoring

Michael R Pinsky  1 , Maurizio Cecconi  2   3 , Michelle S Chew  4 , Daniel De Backer  5 , Ivor Douglas  6 , Mark Edwards  7 , Olfa Hamzaoui  8 , Glenn Hernandez  9 , Greg Martin  10 , Xavier Monnet  11 , Bernd Saugel  12 , Thomas W L Scheeren  13 , Jean-Louis Teboul  14 , Jean-Louis Vincent  15
Affiliations
Review

Effective hemodynamic monitoring

Michael R Pinsky et al. Crit Care. .

Abstract

Hemodynamic monitoring is the centerpiece of patient monitoring in acute care settings. Its effectiveness in terms of improved patient outcomes is difficult to quantify. This review focused on effectiveness of monitoring-linked resuscitation strategies from: (1) process-specific monitoring that allows for non-specific prevention of new onset cardiovascular insufficiency (CVI) in perioperative care. Such goal-directed therapy is associated with decreased perioperative complications and length of stay in high-risk surgery patients. (2) Patient-specific personalized resuscitation approaches for CVI. These approaches including dynamic measures to define volume responsiveness and vasomotor tone, limiting less fluid administration and vasopressor duration, reduced length of care. (3) Hemodynamic monitoring to predict future CVI using machine learning approaches. These approaches presently focus on predicting hypotension. Future clinical trials assessing hemodynamic monitoring need to focus on process-specific monitoring based on modifying therapeutic interventions known to improve patient-centered outcomes.

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Conflict of interest statement

Michael R. Pinsky, MD, Dr hc Scientific advisor and honoraria from Baxter (Deerfield, IL,USA), Edwards Lifescieinces (Irvine, CA USA) and Masimo (Irvine, CA, USA). Maurizio Cecconi, MD. PhD. Consult for Edwards Lifesciences (Irvine, CA, USA) and Directed Systems (Cambridge, UK). Michelle S. Chew, MD, PhD. Consultant and honoraria from Edwards Lifesciences (Irvine, CA, USA). Honoraria from Braun AB. Daniel De Backer, MD, PhD Honoraria from Baxter (Deerfiled, IL, USA, USA). Edwards Lifesciences (Irvine, CA, USA) and Philips (Amsterdam, Netherlands). Ivor Douglas, MD Honoraria and research grant Baxter (Deerfield, IL, USA) paid to institution. Mark Edwards, BMS, BMBS, MD (Res), Honorarium from Edwards Lifesciences (Irvine, CA, USA). Deputy Chief Investigator of Edwards Lifesciences and NIHR-funded OPTIMISE II trial, Chief Investigator of NIHR-funded FLO-ELA trial with research supported by Edwards, LiDCO, Masimo Inc. (Irvine, CA, USA)) and Deltex Medical (Chichester, UK) paid to institution. Olfa Hamzaoui, MD, Hororaria for lectures from Baxter (Deerfield, IL USA). Glenn Hernandez, MD, PhD, None. Greg Martin, MD, MSc. Scientific advisor and honoraria from Genentech (San Francisco, CA, USA) and Grifols Youngstown, OH, USA). Xavier Monnet, MD, PhD Scientific advisor and honoraria from Baxter (Deerfield, IL, USA) and Getinge (Solna, Sweden). Bernd Saugel, MD, PhD Consultant and honoria from Baxter (Deerfield, IL, USA), CNSystems Medizintechnik GmbH (Graz, Austria), Edwards Lifesiciens (Irvine, CA, USA), GE Healthcare (Chicago, IL, USA), Getinge AB (Gothenburg, Sweden), Philips Medizin Systeme Böblingen GmbH (Böblingen, Germany) and Vygon (Aachen, Germany); institutional restricted research grants from GE Healthcare (Chicago, IL, USA), Osypka Medical (Berlin, Germany) and Retia Medical LLC. (Valhalla, NY, USA). Thomas WL Scheeren, MD, PhD Research grants and honoraria from Edwards Lifesciences (Irvine, CA, USA) and Masimo Inc. (Irvine, CA, USA) paid to institution. Jean-Louis Teboul, MD, PhD, Member of the Medical Advisory Board of Getinge (Solna, Sweden). Jean-Louis Vincent, MD, PhD, None.

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