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Hemodynamic Monitoring in the Critical Care Environment

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1 Hemodynamic Monitoring in the Critical Care Environment
Laurence Busse, Danielle L. Davison, Christopher Junker, Lakhmir S. Chawla  Advances in Chronic Kidney Disease  Volume 20, Issue 1, Pages (January 2013) DOI: /j.ackd Copyright © 2013 National Kidney Foundation, Inc. Terms and Conditions

2 Figure 1 Patient A has a steeper starling curve than patient B. Both patients have identical changes in preloads. Administration of a volume challenge will yield different changes in stroke volume. Patient A is more “volume responsive” than patient B. Advances in Chronic Kidney Disease  , 21-29DOI: ( /j.ackd ) Copyright © 2013 National Kidney Foundation, Inc. Terms and Conditions

3 Figure 2 Schematic of the distal portion of a PA catheter and corresponding pressure tracings as the catheter travels through the heart. The PAoP reflects left atrial pressure. RA, right atrium; RV, right ventricle; PA, pulmonary artery. Advances in Chronic Kidney Disease  , 21-29DOI: ( /j.ackd ) Copyright © 2013 National Kidney Foundation, Inc. Terms and Conditions

4 Figure 3 Illustration of pulse pressure variation. PA, arterial pressure; PAW, airway pressure; PPmax, maximum pulse pressure; PPmin, minimum pulse pressure. Note that tracing occurs during positive = pressure ventilation. Reprinted with permission from Gunn SR, Pinsky MR. Implications of arterial pressure variation in patients in the intensive care unit. Curr Opin Crit Care. 2001;7(3): Advances in Chronic Kidney Disease  , 21-29DOI: ( /j.ackd ) Copyright © 2013 National Kidney Foundation, Inc. Terms and Conditions

5 Figure 4 A PLR in a semirecumbent patient.
Reproduced with permission from Teboul JL, Monnet X. Prediction of volume responsiveness in critically ill patients with spontaneous breathing activity. Curr Opin Crit Care. 2008;14(3): Advances in Chronic Kidney Disease  , 21-29DOI: ( /j.ackd ) Copyright © 2013 National Kidney Foundation, Inc. Terms and Conditions

6 Figure 5 A schematic of a TPTD setup.
Reproduced with permission from Pulsion Medical Inc., 2445 Gateway Drive, Suite 110, Irving TX, 75063, USA. Advances in Chronic Kidney Disease  , 21-29DOI: ( /j.ackd ) Copyright © 2013 National Kidney Foundation, Inc. Terms and Conditions

7 Figure 6 Schematic of an external electrode thoracic electrical bioimpedance setup. Impedance is tracked on a recording device (not shown). Reprinted with permission from Tang WH, Tong W. Measuring impedance in congestive heart failure: Current options and clinical applications. Am Heart J. 2009;157(3): Advances in Chronic Kidney Disease  , 21-29DOI: ( /j.ackd ) Copyright © 2013 National Kidney Foundation, Inc. Terms and Conditions


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