Invasive and Noninvasive Hemodynamic Monitoring

Abstract

The focus of this chapter is the added value of an optimized hemodynamic monitoring system. Hemodynamic indexes can give valuable information about patient tissue perfusion and therefore guide medical therapy, improving outcome. Over the years many techniques have been developed in order to optimize hemodynamic status, but currently none have proven to be even close to the ideal one. The perfect hemodynamic index is the one that provides a cheap, continuous, noninvasive, and yet accurate measurement of tissue perfusion. The optimal monitoring system should be tailored on patient clinical status, balancing efficacy and invasiveness. Furthermore, many efforts have been made to better understand patient volemic status and fluid responsiveness, which are important determinants of cardiac output and tissue perfusion. Many studies have proven that in different settings, establishing patient cardiac output still remains a challenge. The following pages will revise the state of the art.