title: Haemodynamic monitoring in the intensive care unit: results from a web-based Swiss survey.
abstract: BACKGROUND
  The aim of this survey was to describe, in a situation of growing availability of monitoring devices and parameters, the practices in haemodynamic monitoring at the bedside.
  
  
  METHODS
  We conducted a Web-based survey in Swiss adult ICUs (2009-2010). The questionnaire explored the kind of monitoring used and how the fluid management was addressed.
  
  
  RESULTS
  Our survey included 71% of Swiss ICUs. Echocardiography (95%), pulmonary artery catheter (PAC: 85%), and transpulmonary thermodilution (TPTD) (82%) were the most commonly used. TPTD and PAC were frequently both available, although TPTD was the preferred technique. Echocardiography was widely available (95%) but seems to be rarely performed by intensivists themselves. Guidelines for the management of fluid infusion were available in 45% of ICUs. For the prediction of fluid responsiveness, intensivists rely preferentially on dynamic indices or echocardiographic parameters, but static parameters, such as central venous pressure or pulmonary artery occlusion pressure, were still used.
  
  
  CONCLUSIONS
  In most Swiss ICUs, multiple haemodynamic monitoring devices are available, although TPTD is most commonly used. Despite the usefulness of echocardiography and its large availability, it is not widely performed by Swiss intensivists themselves. Regarding fluid management, several parameters are used without a clear consensus for the optimal method.
authors.affiliation: Intensive Care Unit, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland ; Faculty of Medicine, University of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.
authors.forename: Nils
authors.initials: N
authors.lastname: Siegenthaler
authors.affiliation: Intensive Care Unit, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Giraud
authors.affiliation: Intensive Care Unit, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.
authors.forename: Till
authors.initials: T
authors.lastname: Saxer
authors.affiliation: Division of Clinical Epidemiology (Biostatistics), University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil 1211 Geneva 14, Switzerland.
authors.forename: Delphine S
authors.initials: DS
authors.lastname: Courvoisier
authors.affiliation: Faculty of Medicine, University of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.
authors.forename: Jacques-André
authors.initials: JA
authors.lastname: Romand
authors.affiliation: Intensive Care Unit, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland ; Faculty of Medicine, University of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.
authors.forename: Karim
authors.initials: K
authors.lastname: Bendjelid
mesh_terms: D003422:Critical Care / Q000706:statistics & numerical data*; D016638:Critical Illness / Q000453:epidemiology; D003935:Diagnostic Techniques, Cardiovascular / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D020407:Internet / Q000706:statistics & numerical data*; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data*; D012769:Shock / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D013557:Switzerland; D014600:Utilization Review