title: Multimodal individualized concept of hemodynamic monitoring.
abstract: OBJECTIVE
  To discuss the pathophysiological rationale of advanced hemodynamic monitoring in the critically ill and also to highlight the importance of a multimodal, individualized approach.
  
  
  RESULTS
  There are several clinical studies and animal experiments evaluating, which hemodynamic endpoint should be the best target during fluid management. Recent systematic reviews and meta-analyses also investigated the effects of advanced hemodynamic endpoints targeted hemodynamic management on outcome mainly in high-risk surgical patients. Although most of these studies report positive results, this knowledge does not seem to affect our everyday practice. According to large international surveys, most physicians still rely on inappropriate indices. One of the reasons could be that target values applied in these studies can be misleading in the individual patient. Therefore, we describe the concept of an individualized approach, in which normalizing the components of oxygen delivery are put in the context of the patients' individual response by evaluating components of oxygen consumption, and organ perfusion.
  
  
  CONCLUSIONS
  Advanced hemodynamic monitoring-based management provides a number of benefits, which could be better tailored for the patients' actual needs by putting this into a multimodal, individualized approach.
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Molnar
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Szabo
authors.forename: Marton
authors.initials: M
authors.lastname: Nemeth
mesh_terms: D001794:Blood Pressure; D002302:Cardiac Output; D016638:Critical Illness / Q000628:therapy*; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D012151:Resuscitation; D013318:Stroke Volume
chemical_list: D010100:Oxygen