[Functional hemodynamic monitoring]

Abstract

Background: Critically ill patients in the intensive care unit require intensified monitoring to control the treatment with volume and/or vasoactive substances.

Research question: What role does functional hemodynamic monitoring play in controlling treatment and what techniques are used to manage this?

Material and methods: Review of the current literature.

Results and discussion: Precise knowledge of the physiology of the cardiovascular system as well as the pathophysiology of individual clinical pictures and the possibilities of invasive and noninvasive monitoring are the prerequisites for the indications, implementation and interpretation of functional hemodynamic monitoring. An understanding of the heart-lung interaction and the influence of invasive ventilation on the volumetric target parameters, such as stroke volume variation, systolic pressure variation and pulse pressure variation as well as sonography of the inferior vena cava are indispensable prerequisites for the question of volume responsiveness. Other maneuvers, such as the passive leg raising test, can be very helpful when deciding on volume administration in everyday clinical practice. Static parameters such as central venous pressure generally play no role and if any only a subordinate one.

Keywords: Heart-lung interaction; Intensive care; Multiple organ failure; Preload dependency; Volume responsiveness.