• Curr Opin Crit Care · Aug 2012

    Review

    Less-invasive approaches to perioperative haemodynamic optimization.

    • Martin Geisen, Andrew Rhodes, and Maurizio Cecconi.
    • Department of Intensive Care Medicine, St George's Hospital NHS Trust, London, UK.
    • Curr Opin Crit Care. 2012 Aug 1;18(4):377-84.

    Purpose Of ReviewA number of less-invasive haemodynamic monitoring devices have been introduced in recent years, largely replacing the pulmonary artery catheter (PAC) as a standard monitoring tool. Apart from tracking cardiac output (CO), these monitors provide additional haemodynamic parameters. The aim of this article is to review the most widely used less-invasive monitoring modalities, their technical characteristics and limitations regarding their clinical performance.Recent FindingsThe utilization of CO monitoring in the perioperative setting has been shown to be associated with improved outcomes if integrated into a haemodynamic optimization strategy. These findings provide the basis of recent recommendations for perioperative monitoring.SummaryAn array of monitoring modalities have been introduced that can reliably track CO in the perioperative setting and make the PAC dispensable in most clinical situations. In order to be used safely and efficiently, knowledge regarding the inherent monitoring techniques and their limitations, their clinical validity and the utility of the parameters provided is crucial.

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