Empfehlungen zum hämodynamischen Monitoring in der internistischen Intensivmedizin

Hemodynamic monitoring of critically ill cardiovascular patients consists of basic monitoring and extended monitoring measures. Basic monitoring should be used in all patients and consists of electrocardiography, body temperature, transcutaneous oxygen saturation, non-invasive blood pressure, measurement of urine production and clinical assessment. Multiple modalities of extended monitoring measures are available that can supplement basic monitoring, especially when the patient does not respond to the applied treatment. They are useful for experienced physicians in selected cases but when used in an undifferentiated way most modalities induce harm rather than benefits; therefore, extended monitoring has to be individually tailored to each patient. This article gives recommendations for the use of the various modalities available. The use of bedside echocardiography is a central tool in diagnostics and surveillance of critically ill cardiovascular patients and can be used to guide fluid management and hemodynamic support. Thus, training and expertise in cardiovascular intensive care and echocardiographic imaging are indispensable prerequisites for the treatment of critically ill patients. This underscores the important role of trained personnel in cardiovascular intensive care.