title: Hemodynamic monitoring in the intensive care unit: a Brazilian perspective.
abstract: OBJECTIVE
  In Brazil, there are no data on the preferences of intensivists regarding hemodynamic monitoring methods. The present study aimed to identify the methods used by national intensivists, the hemodynamic variables they consider important, the regional differences, the reasons for choosing a particular method, and the use of protocols and continued training.
  
  
  METHODS
  National intensivists were invited to answer an electronic questionnaire during three intensive care events and later, through the Associação de Medicina Intensiva Brasileira portal, between March and October 2009. Demographic data and aspects related to the respondent preferences regarding hemodynamic monitoring were researched.
  
  
  RESULTS
  In total, 211 professionals answered the questionnaire. Private hospitals showed higher availability of resources for hemodynamic monitoring than did public institutions. The pulmonary artery catheter was considered the most trusted by 56.9% of the respondents, followed by echocardiograms, at 22.3%. Cardiac output was considered the most important variable. Other variables also considered relevant were mixed/central venous oxygen saturation, pulmonary artery occlusion pressure, and right ventricular end-diastolic volume. Echocardiography was the most used method (64.5%), followed by pulmonary artery catheter (49.3%). Only half of respondents used treatment protocols, and 25% worked in continuing education programs in hemodynamic monitoring.
  
  
  CONCLUSIONS
  Hemodynamic monitoring has a greater availability in intensive care units of private institutions in Brazil. Echocardiography was the most used monitoring method, but the pulmonary artery catheter remains the most reliable. The implementation of treatment protocols and continuing education programs in hemodynamic monitoring in Brazil is still insufficient.
authors.affiliation: Departamento de Cuidados Intensivos, Hospital Pompéia, Caxias do Sul, RS, Brasil.
authors.forename: Fernando Suparregui
authors.initials: FS
authors.lastname: Dias
authors.affiliation: Unidade de Terapia Intensiva, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brasil.
authors.forename: Ederlon Alves de Carvalho
authors.initials: EA
authors.lastname: Rezende
authors.affiliation: Unidade de Terapia Intensiva Adulto, Hospital Universitário, Universidade Federal da Paraíba, João Pessoa, PB, Brasil.
authors.forename: Ciro Leite
authors.initials: CL
authors.lastname: Mendes
authors.affiliation: Unidade de Terapia Intensiva Adulto, Hospital Universitário, Universidade Federal da Paraíba, João Pessoa, PB, Brasil.
authors.forename: João Manoel
authors.initials: JM
authors.lastname: Silva
authors.affiliation: Unidade de Terapia Intensiva, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brasil.
authors.forename: Joel Lyra
authors.initials: JL
authors.lastname: Sanches
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001938:Brazil; D002407:Catheterization, Swan-Ganz / Q000706:statistics & numerical data; D003422:Critical Care / Q000379:methods* / Q000706:statistics & numerical data; D004452:Echocardiography / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006439:Hemodynamics / Q000502:physiology; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011795:Surveys and Questionnaires