Invasive Hemodynamic Monitoring

Invasive hemodynamic monitoring is an important component in the effective management of critically ill patients, especially those in shock states. This type of surveillance is accomplished through the use of pulmonary artery catheters, central venous catheter, and arterial pulse wave analysis and is used to assess the performance of the cardiovascular system, including perfusion pressure and oxygen delivery, and to determine correct therapeutic intervention to optimize end-organ oxygen delivery while monitoring responses to therapeutic interventions to guide continued management. Invasive hemodynamic monitoring may be particularly useful in shock states, right ventricular infarction, ruptured ventricular septum, mitral regurgitation, low cardiac output syndrome, cardiac tamponade, and pulmonary embolism (Laher et al, 2017). Invasive hemodynamic monitoring is indicated in acute and complex conditions including in the concomitant use of an LVAD or ECMO. It is not indicated in for stable heart failure patients and for those with chronic conditions for which the response to medical therapy has been appropriate. It may be used in the perioperative setting in those that are high risk for complications to attenuate respiratory and hemodynamic deterioration, especially during anesthetic induction (Hernandez-Monfort et al, 2022).