Second annual SCCM lecture. The role of hemodynamic monitoring in the management of the critically ill.

Critical Care Medicine
H J Swan

Abstract

Balloon flotation catheterization of the central circulation provides data which may be most meaningful and important to the management of critically ill patients. It allows the measurements of the filling pressures of the right and left ventricle as well as the cardiac output. These data combined with information concerning cardiac rhythm, heart rate, arterial pressure and other variables place the principal determinants of cardiac function at the disposal of the critical care personnel. In particular, the physician may optimize left ventricular filling pressure and then after other functional determinants of cardiac performance so as to optimize the relationship of cardiac output to the metabolic needs of the body tissues and systmes. Continued hemodynamic monitoring also provides prompt objective information as to success or failure of therapeutic interventions. It thereby allows for the most rational decision making and effective alteration in the therapy applied to the individual critically ill patient. Much still needs to be done to establish completely the impact of such monitoring techniques upon patient management. However, experience thus far has been most promising. Large numbers of physicians and health care personn...Continue Reading

Citations

Aug 8, 1997·International Journal of Cardiology·B Pohar, M Horvat
Jan 1, 1983·Journal of the American College of Cardiology·H J Swan, W Ganz
Feb 3, 1983·The New England Journal of Medicine·J A Shaver
Nov 21, 1997·Critical Care Medicine·M J Popovich, W D Hoffman
May 1, 1979·Intensive Care Medicine·G C CarlonW S Howland
Oct 1, 1980·American Journal of Obstetrics and Gynecology·T D Rafferty, R L Berkowitz
Mar 1, 1991·The Annals of Thoracic Surgery·M E WardA Zidulka

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