Hemodynamic Monitoring in Intensive Care Unit:Where we are Today?

A significant alteration of attitude towards hemodynamic monitoring in clinical setting happened during the last half of 1970.This occurred as a consequence towards the relative insensitivity and unresponsiveness of clinical methods to diagnose the rapid physiologic changes, especially in the critical care settings. During the 1980s the principles of hemodynamic monitoring allowed the basic physiological measurements to be applied in a consistent and meaningful manner for the management of a cardiovascular aspect of critical illness. The first paradigm shift in the hemodynamic monitoring can be traced back to the development of cardiac catheterization by Werner Forssmann in 19291. The idea of advanced hemodynamic monitoring was developed by HJC Swan, who developed balloon-tipped Swan-Ganz catheter from his observation of motion of sailboats on the Santa-Monica Bay in 19672. For more than 30 years, the pulmonary catheterization method has generally been accepted and is still the clinical standard to which the other methods are compared. Recent advances in technology have led to the development of minimally invasive (Flo-tracVigileo and transesophageal echocardiography) and noninvasive methods (impedance cardiography) for hemodynamic monitoring in critical care unit. The current narrative review is an attempt to highlight the present perspectives in hemodynamic monitoring in the Intensive Care Unit (ICU).