title: Hemodynamic monitoring in thoracic surgical patients.
abstract: OBJECTIVE
  This article reviews the technology and clinical data describing hemodynamic monitoring devices available to anesthesiologists and intensivists caring for patients undergoing thoracic surgical procedures, so that they may better utilize available technology to improve outcomes in this high-risk surgical population.
  
  
  RESULTS
  Noninvasive stroke volume monitors are based on several different technology platforms, all of which have distinct performance characteristics. Strong clinical outcomes data support the use of these devices in patients undergoing major surgical procedures although these studies generally do not target thoracic surgical procedures specifically. The predictive ability of respiratory variation (for measuring fluid responsiveness) is controversial in both one lung and low tidal volume ventilation. Extravascular lung water measurements are well validated, predict postoperative lung function, but require the use of transpulmonary thermodilution.
  
  
  CONCLUSIONS
  Technology that has been shown to improve clinical outcomes in major surgical procedures is likely applicable to patients undergoing thoracic surgical procedures; however, several unique features of these procedures limit or modify the way in which these devices can be used. Understanding the scientific basis of these devices is the key to using them effectively.
authors.affiliation: Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Raphael
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Regali
authors.forename: Robert H
authors.initials: RH
authors.lastname: Thiele
mesh_terms: D000074743:Hemodynamic Monitoring / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D013318:Stroke Volume / Q000502:physiology; D013815:Thermodilution; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*