ABSTRACT
Bedside hemodynamic monitoring can provide beneficial clinical information when patients are carefully selected, if the resulting data are interpreted accurately, and if the procedure is properly performed. When the above criteria are met, hemodynamic monitoring provides precise and quantitative information that can help confirm what was clinically suspected, help select appropriate therapeutic interventions and assist in following-up patients’ response to treatment. With hemodynamic monitoring, variables such as preload, afterload, contractility, and heart rate can be altered by various therapeutic interventions. The clinical value of invasive hemodynamic monitoring has been generally accepted for numerous clinical conditions including shock associated with myocardial infarction, sepsis, major trauma, acute respiratory failure, cardiogenic or noncardiogenic pulmonary edema, and management of perioperative patients (Table 5.1). The purpose of this chapter is to review and illustrate the detailed physiologic information that can be obtained from both pulmonary artery catheterization (PAC) and central venous pressure (CVP) monitoring. We will also consider limitations inherent in pulmonary artery monitoring, and address risk versus benefit.
