Hemodynamic Monitoring and Support

Critically ill patients are carefully and closely monitored to assess the nature and severity of their disease process and to assess the need for and impact of different therapies. All organs can be monitored, some more easily than others, with hemodynamic monitoring of the cardiovascular system being the most frequent. Hemodynamic monitoring techniques have progressed immensely since thevery early days of intensive care and perhaps particularly over the past 50 years, moving from the very earliest, bulky sphygmographs to measure arterial pressure, to invasive catheters to assess cardiac output, to the more recent development of noninvasive, digital monitors providing continuous values ofmultiple hemodynamic variables. Concepts have also changed as we move from global macrohemodynamic monitoring toward a more regional, microcirculatory perfusion approach and frommaximal monitoring for all, to a much more individualized approach. Here, we will briefly review these changes.