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Postgraduate Education Corner: Contemporary Reviews in Critical Care Medicine |

Hemodynamic MonitoringHemodynamic Monitoring

Steven M. Hollenberg, MD, FCCP
Author and Funding Information

From the Cooper Medical School of Rowan University; and Coronary Care Unit, Cooper University Hospital, Camden, NJ.

Correspondence to: Steven M. Hollenberg, MD, FCCP, Divisions of Cardiovascular Disease and Critical Care Medicine, Cooper University Hospital, One Cooper Plaza, 366 Dorrance, Camden, NJ 08103; e-mail: Hollenberg-Steven@cooperhealth.edu.


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(5):1480-1488. doi:10.1378/chest.12-1901
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Published online

Hemodynamic assessment is a key component of the evaluation of the critically ill patients and has both diagnostic and prognostic utility. This review outlines a general approach to assessment of hemodynamics and perfusion, and then discusses various hemodynamic parameters: heart rate, BP, intravascular (central venous and pulmonary artery) pressures, cardiac output, and myocardial performance, within the context not only of how they are best measured but also how they should be used in a clinical context. Hemodynamics are best assessed using a combination of not only different hemodynamic parameters but also those with the inclusion of clinical indices of perfusion. The benefits of these techniques, as with all medical testing and interventions, must be weighed against any potential risks. Although what to measure and how to measure it is important, what is most important is how to use the information. Evaluating the response to therapeutic interventions is frequently the most useful way to employ hemodynamic monitoring techniques. For the practitioner, learning how to select from a robust set of hemodynamic tools and how to tailor their use to individual clinical settings will allow for optimal patient care.

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