• Evert Christiaan Boerma and Inge Tjitske Bootsma.
• Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
• Curr Opin Crit Care. 2019 Jun 1; 25 (3): 292-297.

Purpose Of ReviewTo focus on the missing link between accuracy and precision of monitoring devices and effective implementation of therapeutic strategies.Recent FindingsHaemodynamic monitoring is generally considered to be an essential part of intensive care medicine. However, randomized controlled trials fail to demonstrate improved outcome unequivocally as a result of hemodynamic monitoring. This absence of solid proof renders doctors to hesitance to apply haemodynamic monitoring in clinical practise. Profound understanding of the underlying mechanisms, adequate patient selection and timing, meaningful representation and software-supported interpretation of data all play an important role. Furthermore, protocol adherence and human behaviour seem to form the often missing link between a solid physiologic principle and clinically relevant outcome. Introduction of haemodynamic monitoring should therefore not be limited to theoretical and practical issues, but also involve integration strategies. By learning from others, we might be able to implement haemodynamic monitoring in such a way that it has potential to modify the course of a disease.SummaryThe clinical success of haemodynamic monitoring goes far beyond accuracy and precision of monitoring devices. Understanding of the factors influencing the effective implementation of therapeutic strategies plays an important role in the meaningful introduction of haemodynamic monitoring.

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