Functional Hemodynamic Monitoring
Hemodynamic monitoring is one of the major diagnostic tools available in the acute care setting to diagnose cardiovascular insufficiency and monitor changes over time in response to interventions. However, the rationale and efficacy of hemodynamic monitor
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Update in Intensive Care and Emergency Medicine
Edited by J.-L. Vincent
M.R. Pinsky D. Payen (Eds.)
Functional Hemodynamic Monitoring
With 78 Figures and 35 Tables
Series Editor Prof. Jean-Louis Vincent Head, Department of Intensive Care Erasme University Hospital Route de Lennik 808, 1070 Brussels Belgium [email protected] Volume Editors Michael R. Pinsky, MD, CM, FCCM, FCCP, Dr. hc. Department of Critical Care Medicine University of Pittsburgh School of Medicine 606 Scaife Hall, 3550 Terrace Street Pittsburgh, PA 15261, USA Didier Payen, MD, PhD Department of Anesthesiology and Critical Care Lariboisière University Hospital University of Paris VII 2, rue Ambroise Paré 75475 Paris Cedex 10, France
ISSN 0933-6788 ISBN 3-540-22349-5 Springer-Verlag Berlin Heidelberg NewYork Library of Congress Control Number: 2004110192 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. Springer-Verlag Berlin Heidelberg New York a member of Springer Science+Business Media springeronline.com © Springer-Verlag Berlin Heidelberg 2005 Printed in Germany The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Editor: Dr. Ute Heilmann, Heidelberg, Germany Desk Editor: Hiltrud Wilbertz, Heidelberg, Germany Typsetting: Satz-Druck-Service, Leimen, Germany Production: Pro Edit GmbH, Heidelberg, Germany Cover design: design & production GmbH, 69126 Heidelberg, Germany Printed on acid-free paper 21/3150/Re – 5 4 3 2 1 0
Contents
Introduction Functional Hemodynamic Monitoring: Foundations and Future . . . . . . . . . . . . . . . . . . . . . . . . . M. R. Pinsky and D. Payen
3
Therapeutic Goals Defining Hemodynamic Instability . . . . . . . . . . . . . . . . . . M. H. Weil
9
Determinants of Blood Flow and Organ Perfusion . . . . . . . . . . 19 E. Calzia, Z. Iványi, and P. Radermacher Determining Effectiveness of Regional Perfusion . . . . . . . . . . 33 D. Payen Microcirculatory and Mitochondrial Distress Syndrome (MMDS): A New Look at Sepsis . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 P. E. Spronk, V. S. Kanoore-Edul, and C. Ince ‘Adequate’ Hemo
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