The hemodynamic monitoring landscape is rapidly evolving from pressure-based and static parameters to more blood flow-based and dynamic parameters. Consensus guidelines for cardiac surgery state that the pulmonary artery catheter is neither required nor helpful in most patients. In the meantime, critical care has been searching for the alternatives to the pulmonary artery catheter and protocols for use. Best available evidence for any protocol developed suggests the inclusion of stroke volume optimization to determine fluid responsiveness. Additional strategies to using stroke volume to optimize hemodynamics, including case studies, are discussed.
Keywords: Cardiac output; Fluid management; Hemodynamics; Mean arterial pressure; Passive leg raise; Pulmonary artery catheter; Stroke volume; Stroke volume optimization.
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