Hemodynamic monitoring improves patient outcomes when coupled with appropriate, personalized, and process-specific resuscitation strategies, though its independent effectiveness remains difficult to quantify.
Does hemodynamic monitoring-linked resuscitation improve patient outcomes in acute care settings?
Hemodynamic monitoring is effective only when its data are coupled with appropriate, protocolized treatment algorithms to guide resuscitation and fluid management.
Hemodynamic monitoring is the centerpiece of patient monitoring in acute care settings. Its effectiveness in terms of improved patient outcomes is difficult to quantify. This review focused on effectiveness of monitoring-linked resuscitation strategies from: (1) process-specific monitoring that allows for non-specific prevention of new onset cardiovascular insufficiency (CVI) in perioperative care. Such goal-directed therapy is associated with decreased perioperative complications and length of stay in high-risk surgery patients. (2) Patient-specific personalized resuscitation approaches for CVI. These approaches including dynamic measures to define volume responsiveness and vasomotor tone, limiting less fluid administration and vasopressor duration, reduced length of care. (3) Hemodynamic monitoring to predict future CVI using machine learning approaches. These approaches presently focus on predicting hypotension. Future clinical trials assessing hemodynamic monitoring need to focus on process-specific monitoring based on modifying therapeutic interventions known to improve patient-centered outcomes.
Pinsky et al. (2022) conducted a review in Cardiovascular insufficiency in acute care settings. Hemodynamic monitoring-linked resuscitation strategies was evaluated. Hemodynamic monitoring improves patient outcomes when coupled with appropriate, personalized, and process-specific resuscitation strategies, though its independent effectiveness remains difficult to quantify.