الصفحة 1
الصفحة 1
Functional Hemodynamic Monitoring
Hemodynamic monitoring is one of the major diagnostic tools available in the acute care setting to diagnose cardiovascular insufficiency and monitor changes over time in response to interventions. However, the rationale and efficacy of hemodynamic monitoring to affect outcome has come into question. We now have increasing evidence that outcome from critical illness can be improved by focused resuscitation based on existing hemodynamic monitoring, whereas non-specific aggressive resuscitation impairs survival. Thus, this book frames hemodynamic monitoring into a functional perspective wherein hemodynamic variables and physiology interact to derive performance and physiological reserve estimates that themselves drive treatment. This philosophy, as well as the limitations and applications of common and evolving hemodynamic measures and their focused use in the care of critically ill patients are discussed, relevant to one underlying truth: No monitoring device, no matter how simple or sophisticated, will improve patient-centered outcomes useless coupled to a treatment which, itself, improves outcome.
Les techniques de monitorage hémodynamique en réanimation = Hemodynamic monitoring techniques in intensive care
The hemodynamic monitoring of intensive care patients is undergoing major changes. Technological advances such as computerization and miniaturization have made it possible to considerably expand the range of assessment tools available at the bedside. Thus, the approach to cardiovascular monitoring - which was once readily "invasive" and global - is gradually becoming non-invasive and locoregional or even tissue. At the same time, the combined evolution of technology and physiological and pathophysiological concepts now provides the clinician with access to a variety of "functional hemodynamic monitoring". The aim of this book is to provide a better understanding of the interest and the limits of the hemodynamic parameters accessible by current hemodynamic monitoring techniques. It thus aims to ensure that the use of these techniques is perfectly mastered by resuscitators and anesthetists-resuscitators so that patient care is ultimately optimal.
