Document Details Document Type : Article In Journal  Document Title : Cardiac output monitoring: an integrative perspective Cardiac output monitoring: an integrative perspective   Subject : Critical care  Document Language : English  Abstract : Cardiac output monitoring in the critically ill patient is standard practice in order to ensure tissue oxygenation [1] and has been traditionally accomplished using the pulmonary artery catheter (PAC). In recent years, however, the value of PAC has been questioned with some suggesting that its use might not only be unnecessary but also potentially harmful [1]. Th is notion, together with the availability of new less invasive cardiac output measuring devices, has markedly decreased the widespread use of the PAC [2]. Today, various devices are available to measure or estimate cardiac output using diff erent methods. Some of these less invasive devices track stroke volume (SV) continuously and provide dynamic indices of fl uid responsiveness, others allow assessment of volumetric preload variables, and some also provide continuous measurement of central venous saturation via the use of proprietary catheters that are attached to the same monitor. All these variables – together with cardiac output – may result in an improved hemodynamic assessment of the critically ill patient. However, it is important to appreciate that each device has its inherent limitations and that no cardiac output monitoring device can change patient outcome unless its use is coupled with an intervention that by itself has been associated with improved patient outcomes. Th erefore, the concept of hemodynamic optimization is increasingly recognized as a cornerstone in the management of critically ill patients and has been shown to be associated with improved outcome in the perioperative [3] and in the intensive care unit (ICU) [4] setting. Th e aim of this article is to provide a systematic update of the currently available and most commonly used cardiac output monitoring devices. In addition, an integrated approach for the use of these diff erent devices in critically ill patients will be presented taking into considera tion the devices’ technical characteristics, their perfor mance and typical limitations, and also any additional hemodynamic variables they may offer  ISSN : 1466-609X  Journal Name : Critical Care  Volume : 15  Issue Number : 2  Publishing Year : 1432 AH 2011 AD  Article Type : Article  Added Date : Monday, July 11, 2011  Researchers Researcher Name (Arabic) Researcher Name (English) Researcher Type Dr Grade Email جمال الهاشمي Al-Hashemi, Jamal Investigator Doctorate   Files File Name Type Description  29943.pdf pdf   Back To Researches Page