Hemodynamic monitoring in the intensive care unit

Hemodynamic monitoring is a diagnostic tool. Because it often requires invasive procedures, hemodynamic monitoring is associated with an increased incidence of untoward events. Like any diagnostic tool, its ability to improve outcome is primarily related to the survival benefit that is enjoyed by specific therapies that can only be given without complications based on their use. Presently, few specific treatment plans fit into this category. The diagnostic accuracy of preload responsiveness is markedly improved by the use of arterial pulse pressure or stroke volume variation, neither of which require pulmonary arterial catheterization. The field of hemodynamic monitoring is rapidly evolving and will probably continue to evolve at this rapid pace over the next 5 to 10 years as new technologies, information management systems, and our understanding of the pathophysiology of critical illness progresses.