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Less invasive hemodynamic monitoring in critically ill patients

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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.

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Authors and Affiliations

  1. 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 & Xavier Monnet

  2. Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany

    Bernd Saugel & Daniel A. Reuter

  3. Anaesthesia and Intensive Care, St George’s Hospital and Medical School, London, UK

    Maurizio Cecconi & Andrew Rhodes

  4. Department of Intensive Care, CHIREC Hospitals (Université Libre de Bruxelles), Brussels, Belgium

    Daniel De Backer

  5. Department of Transversal Medicine, Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital, Zurich, Switzerland

    Christoph K. Hofer

  6. Department of Anesthesiology and Intensive Care, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel

    Azriel Perel

  7. Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    Michael R. Pinsky

  8. Clinique Ambroise Paré, 92200, Neuilly-Sur-Seine, France

    Pierre Squara

  9. Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent

  10. Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Thomas W. Scheeren

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  1. Jean-Louis Teboul
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  2. Bernd Saugel
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  3. Maurizio Cecconi
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  4. Daniel De Backer
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  5. Christoph K. Hofer
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  6. Xavier Monnet
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  7. Azriel Perel
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  8. Michael R. Pinsky
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  9. Daniel A. Reuter
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  10. Andrew Rhodes
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  11. Pierre Squara
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Correspondence to Jean-Louis Teboul.

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Conflicts of interest

JLT is a member of the medical advisory board of Pulsion Medical Systems and received honoraria from Edwards Lifesciences and Masimo Inc. for consulting. BS is a member of the medical advisory board of Pulsion Medical Systems and a received institutional research grants, unrestricted research grants, and refunds of travel expenses from Tensys Medical Inc. BS received honoraria for giving lectures for CNSystems Medizintechnik AG. MC consulted and lectured for Edwards Lifesciences and LiDCO. He received support from Edwards Lifesciences, LiDCO, Deltex Medical, Applied Physiology, Masimo, Bmeye, Cheetah Medical, Imacor (travel expenses, honoraria, advisory board, unrestricted educational grant, and research material). DDB received honoraria for lectures for Edwards Lifesciences and Nihon Kohden. DDB received grant/material for studies for Edwards Lifesciences, Maquet, Vytech, Cheetah, Imacor, and Nihon Kohden. XM is a member of the medical advisory board of Pulsion Medical systems and received honoraria from Cheetah Medical for consulting. AP is a member of the medical advisory board of Pulsion Medical Systems and is a consultant for Masimo Inc. MRP is a consultant for Edwards Lifesciences, Masimo Inc., and LiDCO and has stock options in LiDCO and Cheetah Medical companies. DAR is a member of the medical advisory board of Pulsion Medical Systems and gave lectures for Edwards Lifesciences. AR has no conflict of interest to declare. PS was a consultant for Cheetah Medical and for Edwards Lifesciences. TS received honoraria from Edwards Lifesciences and Masimo Inc. for consulting. TS received honoraria from Pulsion Medical Systems for lecturing. JLV has no conflict of interest to declare.

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On behalf of the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine (ESICM).

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Teboul, JL., Saugel, B., Cecconi, M. et al. Less invasive hemodynamic monitoring in critically ill patients. Intensive Care Med 42, 1350–1359 (2016). https://doi.org/10.1007/s00134-016-4375-7

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