Takes a novel, practical approach to analyzing hemodynamic monitoring, focusing on the patient and outcomes based on disease, treatment options and relevance of monitoring to direct patient care
Will rapidly become a classic in the approach to patient monitoring and management during critical illness
Michael R. Pinsky, MD is a professor of Critical Care medicine, Bioengineering and Anaesthesiology at the University of Pittsburgh and Dr hc from the University of Paris (La Sorbonne). He is considered an expert in hemodynamic monitoring, cardiovascular and pulmonary physiology and the treatments of cardio-respiratory diseases, including septic shock, ARDS and transplantation.
Didier Payen, MD is a professor and chairman of Anaesthesiology and Critical Care Medicine at Laribosiere Hospital, Paris and the president of the European Society of Intensive care Medicine. He is considered an expert in hemodynamic monitoring, organ transplantation, nitric oxide metabolism and treatment and cardiovascular physiology.
Hemodynamic monitoring is one of the major diagnostic tools available in the acute care setting to diagnose cardiovascular insufficiency and monitor changes over time in response to interventions. However, the rationale and efficacy of hemodynamic monitoring to affect outcome has come into question. We now have increasing evidence that outcome from critical illness can be improved by focused resuscitation based on existing hemodynamic monitoring, whereas non-specific aggressive resuscitation impairs survival. Thus, this book frames hemodynamic monitoring into a functional perspective wherein hemodynamic variables and physiology interact to derive performance and physiological reserve estimates that themselves drive treatment. This philosophy, as well as the limitations and applications of common and evolving hemodynamic measures and their focused use in the care of critically ill patients are discussed, relevant to one underlying truth: No monitoring device, no matter how simple or sophisticated, will improve patient-centered outcomes useless coupled to a treatment which, itself, improves outcome.
IntroductionFunctional Hemodynamic Monitoring: Foundations and Future (M.R. Pinsky and D. Payen).-Therapeutic GoalsDefining Hemodynamic Instability (M. H. Weil).- Determinants of Blood Flow and Organ Perfusion (E. Calzia, Z. Iványi, and P. Radermacher).- Determining Effectiveness of Regional Perfusion (D. Payen).- Microcirculatory and Mitochondrial Distress Syndrome (MMDS): A New Look at Sepsis (P. E. Spronk, V. S. Kanoore-Edul, and C. Ince).- `Adequate´ Hemodynamics: A Question of Time? (L. Gattinoni, F. Valenza, and E. Carlesso).-Limits and Applications of Hemodynamic MonitoringArterial Pressure: A Personal View (D. Bennett).- Central Venous Pressure: Uses and Limitations (T. Smith, R.M. Grounds, and A. Rhodes).- Pulmonary Artery Occlusion Pressure: Measurement, Significance, and Clinical Uses (J.J. Marini and J. W. Leatherman).- Cardiac Output by Thermodilution and Arterial Pulse Contour Techniques (J. Jansen and P.C.M. van den Berg).- Clinical Value of Intrathoracic Volumes from Transpulmonary Indicator Dilution (J. Groeneveld, R.M. Breukers, and J. Verheij).- Methodology and Value of Assessing Extravascular Lung Water (J. Groeneveld and J. Verheij).- Arterial Pulse Contour Analysis: Applicability to Clinical Routine (D.A. Reuter and A. Goetz).- Arterial Pulse Power Analysis: The LiDCOTMplus System (A. Rhodes and R. Sunderland).- Esophageal Doppler Monitoring (M. Singer).- Splanchnic Blood Flow (J. Creteur).-Measurement of Oxygen Derived Variables and Cardiac PerformanceMicrocirculatory Blood Flow: Video Microscopy (D. De Backer).- Mixed Venous Oxygen Saturation (SvO2) (J. Hall).- Central Venous Oxygen Saturation (ScvO2) (K. Reinhart and F. Bloos).- VO2/DO2 Relationships (J.L. Vincent).- Cardiac Preload Evaluation Using Echocardiographic Techniques (M. Slama).- Right VentricularEnd-diastolic Volume (J. Boldt).-Assessment of Fluid ResponsivenessVolume Challenge in Tissue Hypoperfusion (P. Dellinger).- The Use of CVP in Critically Ill Patients (S. Magder).- Arterial Pressure Variation during Positive Pressure Ventilation (A. Perel, S. Preisman, and H. Berkenstadt).- Arterial Pulse Pressure Variation during Positive Pressure Ventilation and Passive Leg Raising (J.-L. Teboul, X Monnet, and C. Richard).-Development of Treatment AlgorithmsStandardization of Care by Defining End-points of Resuscitation (M. Mythen, H. Meeran, and M. Grocott).- Protocolized Cardiovascular Management based on Ventricular-arterial Coupling (M. R. Pinsky).- Cost-effectiveness of Monitoring Techniques (J. Wendon).- Index
Functional Hemodynamic Monitoring: Foundations and Future.- Therapeutic goals.- Defining Hemodynamic Instability.- Determinants of Blood Flow and Organ Perfusion.- Determining Effectiveness of Regional Perfusion.- Microcirculatory and Mitochondrial Distress Syndrome (MMDS): A New Look at Sepsis.- 'Adequate' Hemodynamics: A Question of Time?.- Limits and Applications of Hemodynamic Monitoring.- Arterial Pressure: A Personal View.- Central Venous Pressure: Uses and Limitations.- Pulmonary Artery Occlusion Pressure: Measurement, Significance, and Clinical Uses.- Cardiac Output by Thermodilution and Arterial Pulse Contour Techniques.- Clinical Value of Intrathoracic Volumes from Transpulmonary Indicator Dilution.- Methodology and Value of Assessing Extravascular Lung Water.- Arterial Pulse Contour Analysis: Applicability to Clinical Routine.- Arterial Pulse Power Analysis: The LiDCO? plus System.- Esophageal Doppler monitoring.- Splanchnic Blood Flow.- Measurement of Oxygen Derived Variables and Cardiac Performance.- Microcirculatory Blood Flow: Videomicroscopy.- Mixed Venous Oxygen Saturation (SvO2).- Central Venous Oxygen Saturation (ScvO2).- DO2/VO2 relationships.- Cardiac Preload Evaluation Using Echocardiographic Techniques.- Right Ventricular End-Diastolic Volume.- Assessment of Fluid Responsiveness.- Fluid Therapy of Tissue Hypoperfusion.- The Use of Central Venous Pressure in Critically Ill Patients.- Arterial Pressure Variation during Positive-pressure Ventilation.- Arterial Pulse Pressure Variation During Positive Pressure Ventilation and Passive Leg Raising.- Development of Treatment Algorithms.- Standardization of Care by Defining Endpoints of Resuscitation.- Protocolized Cardiovascular Management Based on Ventricular-arterial Coupling.- Cost Effectivenessof Monitoring Techniques.
Über den Autor
Michael R. Pinsky, MD is a professor of Critical Care medicine, Bioengineering and Anaesthesiology at the University of Pittsburgh and Dr hc from the University of Paris (La Sorbonne). He is considered an expert in hemodynamic monitoring, cardiovascular and pulmonary physiology and the treatments of cardio-respiratory diseases, including septic shock, ARDS and transplantation.nDidier Payen, MD is a professor and chairman of Anaesthesiology and Critical Care Medicine at Laribosiere Hospital, Paris and the president of the European Society of Intensive care Medicine. He is considered an expert in hemodynamic monitoring, organ transplantation, nitric oxide metabolism and treatment and cardiovascular physiology.
Inhaltsverzeichnis
Introduction
Functional Hemodynamic Monitoring: Foundations and Future (M.R. Pinsky and D. Payen).-
Therapeutic Goals
Defining Hemodynamic Instability (M. H. Weil).- Determinants of Blood Flow and Organ Perfusion (E. Calzia, Z. Iványi, and P. Radermacher).- Determining Effectiveness of Regional Perfusion (D. Payen).- Microcirculatory and Mitochondrial Distress Syndrome (MMDS): A New Look at Sepsis (P. E. Spronk, V. S. Kanoore-Edul, and C. Ince).- 'Adequate' Hemodynamics: A Question of Time? (L. Gattinoni, F. Valenza, and E. Carlesso).-
Limits and Applications of Hemodynamic Monitoring
Arterial Pressure: A Personal View (D. Bennett).- Central Venous Pressure: Uses and Limitations (T. Smith, R.M. Grounds, and A. Rhodes).- Pulmonary Artery Occlusion Pressure: Measurement, Significance, and Clinical Uses (J.J. Marini and J. W. Leatherman).- Cardiac Output by Thermodilution and Arterial Pulse Contour Techniques (J. Jansen and P.C.M. van den Berg).- Clinical Value of Intrathoracic Volumes from Transpulmonary Indicator Dilution (J. Groeneveld, R.M. Breukers, and J. Verheij).- Methodology and Value of Assessing Extravascular Lung Water (J. Groeneveld and J. Verheij).- Arterial Pulse Contour Analysis: Applicability to Clinical Routine (D.A. Reuter and A. Goetz).- Arterial Pulse Power Analysis: The LiDCOTMplus System (A. Rhodes and R. Sunderland).- Esophageal Doppler Monitoring (M. Singer).- Splanchnic Blood Flow (J. Creteur).-
Measurement of Oxygen Derived Variables and Cardiac Performance
Microcirculatory Blood Flow: Video Microscopy (D. De Backer).- Mixed Venous Oxygen Saturation (SvO2) (J. Hall).- Central Venous Oxygen Saturation (ScvO2) (K. Reinhart and F. Bloos).- VO2/DO2 Relationships (J.L. Vincent).- Cardiac Preload Evaluation Using Echocardiographic Techniques (M. Slama).- Right VentricularEnd-diastolic Volume (J. Boldt).-
Assessment of Fluid Responsiveness
Volume Challenge in Tissue Hypoperfusion (P. Dellinger).- The Use of CVP in Critically Ill Patients (S. Magder).- Arterial Pressure Variation during Positive Pressure Ventilation (A. Perel, S. Preisman, and H. Berkenstadt).- Arterial Pulse Pressure Variation during Positive Pressure Ventilation and Passive Leg Raising (J.-L. Teboul, X Monnet, and C. Richard).-
Development of Treatment Algorithms
Standardization of Care by Defining End-points of Resuscitation (M. Mythen, H. Meeran, and M. Grocott).- Protocolized Cardiovascular Management based on Ventricular-arterial Coupling (M. R. Pinsky).- Cost-effectiveness of Monitoring Techniques (J. Wendon).-
Index
Klappentext
This is the newest volume in the softcover series "Update in Intensive Care Medicine".
It takes a novel, practical approach to analyzing hemodynamic monitoring, focusing on the patient and outcomes based on disease, treatment options and relevance of monitoring to direct patient care.
It will rapidly become a classic in the approach to patient monitoring and management during critical illness.
Hemodynamic monitoring is one of the major diagnostic tools available in the acute care setting to diagnose cardiovascular insufficiency and monitor changes over time in response to interventions. However, the rationale and efficacy of hemodynamic monitoring to affect outcome has come into question. We now have increasing evidence that outcome from critical illness can be improved by focused resuscitation based on existing hemodynamic monitoring, whereas non-specific aggressive resuscitation impairs survival. Thus, this book frames hemodynamic monitoring into a functional perspective wherein hemodynamic variables and physiology interact to derive performance and physiological reserve estimates that themselves drive treatment. This philosophy, as well as the limitations and applications of common and evolving hemodynamic measures and their focused use in the care of critically ill patients are discussed, relevant to one underlying truth: No monitoring device, no matter how simple or sophisticated, will improve patient-centered outcomes useless coupled to a treatment which, itself, improves outcome.
