Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: A Hemodynamic monitoring over the past 10 years. | Available online http content 10 1 117 Commentary Hemodynamic monitoring over the past 10 years Michael R Pinsky University of Pittsburgh School of Medicine 606 Scaife Hall 3550 Terrace Street Pittsburgh PA15261 USA Corresponding author Michael R Pinsky pinsky@ Published 9 February 2006 This article is online at http content 10 1 117 2006 BioMed Central Ltd Critical Care 2006 10 117 doi cc3997 Abstract Changes in hemodynamic monitoring over the past 10 years have followed two paths. First there has been a progressive decrease in invasive monitoring most notably a reduction in the use of the pulmonary artery catheter because of a presumed lack of efficacy in its use in the management of critically ill patients with an increased use of less invasive monitoring requiring only central venous and arterial catheterization to derive the same data. Second numerous clinical trials have documented improved outcome and decreased costs when early goal-directed protocolized therapies are used in appropriate patient populations such as patients with septic shock presenting to Emergency Departments and high-risk surgical patients before surgery preoptimization and immediately after surgery post-optimization . Novel monitoring will be driven more by its role in improving outcomes than in the technical abilities of the manufacturers. Hemodynamic monitoring is a cornerstone in the care of the hemodynamically unstable patient. It serves as a monitor both of stability and acute deterioration and of response to therapy. Although hemodynamic monitoring is also both context specific and disease specific it is primarily driven by technology and offset by utility. Nothing underscores this concept better than the decline in the use of the pulmonary artery catheter PAC whose use has markedly decreased while its ability to measure increasingly more hemodynamic variables increased 1 . In its ultimate format the PAC continuously measures temperature heart
