Hemodynamic measurement in the operating room: a review of conventional measures to identify hypovolemia.
Direct measurement of physiologic systems is often impractical. To overcome these obstacles, indirect physiologic measures have been developed. Indirect physiologic measures such as heart rate, blood pressure, and many others are surrogates that are believed to accurately represent the function of a physiologic system. Although a powerful tool, physiologic measurement has several potential limitations and errors. This can result in erroneous instrument data. For that reason, it is the responsibility of the clinician to question and interpret monitor output and to ultimately correctly assess validity of the measurement. This article reviews commonly used intraoperative monitoring techniques and discusses their potential limitations as they relate to hypovolemia and hemorrhagic shock.
D'Angelo
Matthew R
MR
R Adams Cowley Shock Trauma Center, Division of Trauma Anesthesiology, University of Maryland Medical Center, Baltimore, Maryland, USA. mdangelo@umaryland.edu
Dutton
Richard P
RP
D015982:Bias; D001795:Blood Pressure Determination; D001811:Blood Volume Determination; D002302:Cardiac Output; D002496:Central Venous Pressure; D003244:Consciousness Disorders / Q000209:etiology; D017548:Echocardiography, Transesophageal; D006339:Heart Rate; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D020896:Hypovolemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D016343:Monitoring, Intraoperative / Q000379:methods*; D009730:Nursing Assessment; D012720:Severity of Illness Index; D012771:Shock, Hemorrhagic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D014563:Urodynamics