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Keywords

critical care nursing, evidence-based practice, functional hemodynamic indicators, fluid responsiveness, physiologic monitoring, pulse pressure, stroke volume, systolic blood pressure

 

Authors

  1. Bridges, Elizabeth PhD, RN, CCNS

Abstract

Overview: Hemodynamic monitoring has traditionally relied on such static pressure measurements as pulmonary artery occlusion pressure and central venous pressure to guide fluid therapy. Over the past 15 years, however, there's been a shift toward less invasive or noninvasive monitoring methods, which use "functional" hemodynamic indicators that reflect ventilator-induced changes in preload and thereby more accurately predict fluid responsiveness. The author reviews the physiologic principles underlying functional hemodynamic indicators, describes how the indicators are calculated, and discusses when and how to use them to guide fluid resuscitation in critically ill patients.