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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Functional hemodynamic monitoring. | Critical Care December 2005 Vol 9 No 6 Pinsky and Payen Review Functional hemodynamic monitoring Michael R Pinsky1 and Didier Payen2 1 Professor of Critical Care Medicine Bioengineering and Anesthesiology Department of Critical Care Medicine University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA 2Professor of Anesthesiology Department of Anesthesiology and Critical Care Medicine Lariboisière Hospital University of Paris VII Paris France Corresponding author Michael R Pinsky pinskymr@ccm.upmc.edu Published online 22 November 2005 This article is online at http ccforum.com content 9 6 566 2005 BioMed Central Ltd Critical Care 2005 9 566-572 DOI 10.1186 cc3927 Abstract Hemodynamic monitoring is a central component of intensive care. Patterns of hemodynamic variables often suggest cardiogenic hypovolemic obstructive or distributive septic etiologies to cardiovascular insufficiency thus defining the specific treatments required. Monitoring increases in invasiveness as required as the risk for cardiovascular instability-induced morbidity increases because of the need to define more accurately the diagnosis and monitor the response to therapy. Monitoring is also context specific requirements during cardiac surgery will be different from those in the intensive care unit or emergency department. Solitary hemodynamic values are useful as threshold monitors e.g. hypotension is always pathological central venous pressure is only elevated in disease . Some hemodynamic values can only be interpreted relative to metabolic demand whereas others have multiple meanings. Functional hemodynamic monitoring implies a therapeutic application independent of diagnosis such as a therapeutic trial of fluid challenge to assess preload responsiveness. Newer methods for assessing preload responsiveness include monitoring changes in central venous pressure during spontaneous inspiration and variations in arterial pulse pressure systolic pressure and aortic flow variation in response
