title: Less invasive hemodynamic monitoring in critically ill patients.
abstract: Over the last decade, the way to monitor hemodynamics at the bedside has evolved considerably in the intensive care unit as well as in the operating room. The most important evolution has been the declining use of the pulmonary artery catheter along with the growing use of echocardiography and of continuous, real-time, minimally or totally non-invasive hemodynamic monitoring techniques. This article, which is the result of an agreement between authors belonging to the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine, discusses the advantages and limits of using such techniques with an emphasis on their respective place in the hemodynamic management of critically ill patients with hemodynamic instability.
authors.affiliation: Service de réanimation médicale, Hôpital de Bicêtre, Hôpitaux universitaires Paris-Sud, AP-HP, 78, rue du Général Leclerc, 94 270, Le Kremlin-Bicêtre, France. jean-louis.teboul@aphp.fr.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Teboul
authors.affiliation: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Saugel
authors.affiliation: Anaesthesia and Intensive Care, St George's Hospital and Medical School, London, UK.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cecconi
authors.affiliation: Department of Intensive Care, CHIREC Hospitals (Université Libre de Bruxelles), Brussels, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: De Backer
authors.affiliation: Department of Transversal Medicine, Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital, Zurich, Switzerland.
authors.forename: Christoph K
authors.initials: CK
authors.lastname: Hofer
authors.affiliation: Service de réanimation médicale, Hôpital de Bicêtre, Hôpitaux universitaires Paris-Sud, AP-HP, 78, rue du Général Leclerc, 94 270, Le Kremlin-Bicêtre, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Monnet
authors.affiliation: Department of Anesthesiology and Intensive Care, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Azriel
authors.initials: A
authors.lastname: Perel
authors.affiliation: Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Pinsky
authors.affiliation: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Reuter
authors.affiliation: Anaesthesia and Intensive Care, St George's Hospital and Medical School, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Rhodes
authors.affiliation: Clinique Ambroise Paré, 92200, Neuilly-Sur-Seine, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Squara
authors.affiliation: Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Scheeren
mesh_terms: D002302:Cardiac Output / Q000502:physiology; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D008991:Monitoring, Physiologic / Q000379:methods* / Q000639:trends; D013318:Stroke Volume / Q000502:physiology; D013815:Thermodilution / Q000379:methods
keywords: Bioreactance; Esophageal Doppler; Hemodynamic monitoring; Pulse contour analysis; Pulse pressure variation; Transpulmonary thermodilution