title: Hemodynamic monitoring in the era of evidence-based medicine.
abstract: Hemodynamic instability frequently occurs in critically ill patients. Pathophysiological rationale suggests that hemodynamic monitoring (HM) may identify the presence and causes of hemodynamic instability and therefore may allow targeting therapeutic approaches. However, there is a discrepancy between this pathophysiological rationale to use HM and a paucity of formal evidence (as defined by the strict criteria of evidence-based medicine (EBM)) for its use. In this editorial, we discuss that this paucity of formal evidence that HM can improve patient outcome may be explained by both the shortcomings of the EBM methodology in the field of intensive care medicine and the shortcomings of HM itself.
authors.affiliation: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. bernd.saugel@gmx.de.
authors.forename: Bernd
authors.initials: B
authors.lastname: Saugel
authors.affiliation: Department of Intensive Care, Ziekenhuis Netwerk Antwerpen, Campus ZNA Stuivenberg, Antwerp, Belgium.
authors.forename: Manu L N G
authors.initials: ML
authors.lastname: Malbrain
authors.affiliation: Department of Anesthesiology and Critical Care, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Azriel
authors.initials: A
authors.lastname: Perel
mesh_terms: D016638:Critical Illness / Q000628:therapy; D019317:Evidence-Based Medicine / Q000379:methods*; D000074743:Hemodynamic Monitoring / Q000379:methods*; D006801:Humans