• Michael R Pinsky, Maurizio Cecconi, Michelle S Chew, Daniel De Backer, Ivor Douglas, Mark Edwards, Olfa Hamzaoui, Glenn Hernandez, Greg Martin, Xavier Monnet, Bernd Saugel, ScheerenThomas W LTWLAnesthesiology, University Medical Center Groningen, Groningen, Netherlands., Jean-Louis Teboul, and Jean-Louis Vincent.
• Critical Care Medicine, Bioengineering, Cardiovascular Diseases, Anesthesiology and Clinical & Translations Medicine, University of Pittsburgh, Pittsburgh, PA, USA. pinsky@pitt.edu.
• Crit Care. 2022 Sep 28; 26 (1): 294.

AbstractHemodynamic monitoring is the centerpiece of patient monitoring in acute care settings. Its effectiveness in terms of improved patient outcomes is difficult to quantify. This review focused on effectiveness of monitoring-linked resuscitation strategies from: (1) process-specific monitoring that allows for non-specific prevention of new onset cardiovascular insufficiency (CVI) in perioperative care. Such goal-directed therapy is associated with decreased perioperative complications and length of stay in high-risk surgery patients. (2) Patient-specific personalized resuscitation approaches for CVI. These approaches including dynamic measures to define volume responsiveness and vasomotor tone, limiting less fluid administration and vasopressor duration, reduced length of care. (3) Hemodynamic monitoring to predict future CVI using machine learning approaches. These approaches presently focus on predicting hypotension. Future clinical trials assessing hemodynamic monitoring need to focus on process-specific monitoring based on modifying therapeutic interventions known to improve patient-centered outcomes.© 2022. The Author(s).

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