Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Oct 2016
Review[Hemodynamic monitoring in intensive care and emergency medicine : Integration of clinical signs and ultrasound findings].
Hemodynamic monitoring is required in critically ill patients presenting with circulatory shock. Besides the clinical evaluation, noninvasive technologies can be used. ⋯ To differentiate the cause of circulatory shock and monitor the effects of therapies, hemodynamic monitoring is necessary. This review discusses possibilities of the different invasive and noninvasive monitoring tools with a focus on the integration of clinical and sonographic parameters.
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Med Klin Intensivmed Notfmed · Oct 2016
Review[Hemodynamic monitoring of critically ill patients : Bedside integration of data].
Hemodynamic monitoring of critically ill patients is a key issue in intensive care medicine. Indication and application of invasive hemodynamic monitoring is a highly complex matter and requires thorough professional education and training. ⋯ All information gathered through medical history, physical examination, imaging, and hemodynamic monitoring help to form an overall picture and should be reevaluated regularly and in individual cases very closely depending on the hemodynamic instability of the patient. Target values are strictly indicative and are not binding taking into account that each patient has its unique pathophysiological profile.
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Med Klin Intensivmed Notfmed · Oct 2016
[Cardiac hemodynamics during shock : Management in daily clinical routine].
In caring for critically ill patients, a sophisticated approach to treating hemodynamic instability in acute circulatory failure is a major concern of modern critical care. Depending on the form of shock-distributive, cardiogenic, hypovolemic or obstructive, with the possibility of overlapping forms of shock-preload, afterload, cardiac output, and contractility are altered in various ways. ⋯ Fluid therapy taking volume responsiveness and need for volume into account, vasopressor therapy taking microcirculatory derangement into account, and therapy using inotropes, sometimes in combination with vasodilators are the cornerstones of critical care treatment in this regard. Preload, afterload, cardiac output, and contractility must thereby be evaluated and treated in a patient- and situation-specific manner.