Monitoring: from cardiac output monitoring to echocardiography

Current Opinion in Critical Care
Mathieu JozwiakJean-Louis Teboul

Abstract

Hemodynamic exploration is mandatory in patients with shock to identify the type of shock, to select the best therapeutic strategy, and to assess the efficacy of the selected therapy. In this review, we summarize the characteristics of the main available hemodynamic monitoring systems and emphasize on how to select the most appropriate ones in patients with circulatory shock. Over the past decade, hemodynamic monitoring techniques have progressively evolved from intermittent toward real-time measurements and from invasive toward less invasive approaches. Nowadays, echocardiography is recommended as the first-line modality of hemodynamic evaluation in patients with shock. Current guidelines recommend reserving advanced hemodynamic monitoring systems for patients not responding to the initial therapy and/or for complex conditions such as combination of shock with acute respiratory distress syndrome. Invasive and noninvasive uncalibrated cardiac output monitors, as well as esophageal Doppler, could find their place in the perioperative context rather than in patients with shock. The use of echocardiography should be encouraged at the initial period of shock to identify main involved mechanisms and to select the appropriate therapy...Continue Reading

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Citations

May 9, 2016·Intensive Care Medicine·Jean-Louis TeboulThomas W Scheeren
Oct 6, 2016·BioMed Research International·Bernd SaugelJulia Y Wagner
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Oct 7, 2017·Current Opinion in Critical Care·Hitesh Gidwani, Hernando Gómez
Apr 26, 2020·Current Opinion in Critical Care·Thomas KaufmannThomas W L Scheeren
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Mar 17, 2021·AACN Advanced Critical Care·Shannon Gaasch

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