RPHICUTeaching2016.1-Monitoring

BACKGROUND: Despite a previous meta-analysis that concluded that central venous pressure should not be used to make clinical decisions regarding fluid management, central venous pressure continues to be recommended for this purpose. AIM: To perform an updated meta-analysis incorporating recent studies that investigated indices predictive of fluid responsiveness. A priori subgroup analysis was planned according to the location where the study was performed (ICU or operating room)...

No abstract text is available yet for this article.

Monitoring plays an important role in the current management of patients with acute respiratory failure but sometimes lacks definition regarding which 'signals' and 'derived variables' should be prioritized as well as specifics related to timing (continuous versus intermittent) and modality (static versus dynamic). Many new techniques of respiratory monitoring have been made available for clinical use recently, but their place is not always well defined. Appropriate use of available monitoring techniques and correct interpretation of the data provided can help improve our understanding of the disease processes involved and the effects of clinical interventions...

Hemodynamic monitoring plays a fundamental role in the management of acutely ill patients. With increased concerns about the use of invasive techniques, notably the pulmonary artery catheter, to measure cardiac output, recent years have seen an influx of new, less-invasive means of measuring hemodynamic variables, leaving the clinician somewhat bewildered as to which technique, if any, is best and which he/she should use. In this consensus paper, we try to provide some clarification, offering an objective review of the available monitoring systems, including their specific advantages and limitations, and highlighting some key principles underlying hemodynamic monitoring in critically ill patients...

No abstract text is available yet for this article.

The hemodynamic monitoring of a surgical patient acquires a major relevance in high-risk patients and those suffering from surgical diseases associated with hemodynamic instability, such as hemorrhagic or septic shock. This article reviews the fundamental physiologic principles needed to understand hemodynamic monitoring at the bedside. Monitoring defines stability, instability, and response to therapy. The major hemodynamic parameters measured and derived from invasive hemodynamic monitoring, such as arterial, central venous, and pulmonary catheterization, are discussed, as are its clinical indications, benefits, and complications...