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Understand complex hemodynamic conditions

The life of your critically ill patient depends on the right decision for the next therapeutic step. Therapeutic conflicts often arise at the critical care bedside, where you need dependable information you can trust. A set of reliable hemodynamic parameters can help determine the best individual treatment for your patients.[1] 

Hemodynamic questions to ask

Monitoring does not lower patient mortality or morbidity, per se - however, it provides valuable information that should be used to set up a treatment plan and apply individualized goal-directed therapy to the patient as early as possible. In order to ensure a broad foundation of information, a range of parameters can be provided and used as a basis for therapy decisions.

Is the patient's blood flow adequate?

Check CI, SVI

Is the patient's preload optimal?

Check GEDI

Is the patient's afterload optimal?

Check SVRI

Is the patient's cardiac contractility optimal?

Check GEF/CFI, CPI, dPmx

Is the patient volume responsive?

Check SVV/PPV

Is the patient in risk of pulmonary edema?

Check ELWI

What is the origin of pulmonary edema?

Check PVPI

Individualized hemodynamic monitoring shows following advantages [1], [3]

Better outcomes through individualized hemodynamic management
Better outcomes through individualized hemodynamic management

Careful management of cardiac output and it’s determinants can guide physicians through the resuscitative process of critically ill patients. Adapting individualized hemodynamic monitoring protocols leads to optimized therapeutic interventions and has the potential to improve outcomes.[3] 

  1. 1. Goepfert M, et al., Individually Optimized Hemodynamic Therapy Reduces Complications and Length of Stay in the Intensive Care Unit: A Prospective, Randomized Controlled Trial. Anesthesiology 013;119(4):824-836.

  2. 2. Busse L, Davison D, Junker C, Chawla L. Hemodynamic Monitoring in the Critical Care Environment, Advances in Chronic Kidney Disease 2013

    https://doi.org/10.1053/j.ackd.2012.10.006
  3. 3. Yuanbo Z, Jin W, Fei S. et al. ICU management based on PiCCO parameters reduces duration of mechanical ventilation and ICU length of stay in patients with severe thoracic trauma and acute respiratory distress syndrome. Ann. Intensive Care 6, 113 (2016). https://doi.org/10.1186/s13613-016-0217-6

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