Haemodynamic monitoring in the intensive care unit: results from a web-based Swiss survey. 2014

Nils Siegenthaler, and Raphael Giraud, and Till Saxer, and Delphine S Courvoisier, and Jacques-André Romand, and Karim Bendjelid
Intensive Care Unit, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland ; Faculty of Medicine, University of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.

BACKGROUND The aim of this survey was to describe, in a situation of growing availability of monitoring devices and parameters, the practices in haemodynamic monitoring at the bedside. METHODS We conducted a Web-based survey in Swiss adult ICUs (2009-2010). The questionnaire explored the kind of monitoring used and how the fluid management was addressed. RESULTS Our survey included 71% of Swiss ICUs. Echocardiography (95%), pulmonary artery catheter (PAC: 85%), and transpulmonary thermodilution (TPTD) (82%) were the most commonly used. TPTD and PAC were frequently both available, although TPTD was the preferred technique. Echocardiography was widely available (95%) but seems to be rarely performed by intensivists themselves. Guidelines for the management of fluid infusion were available in 45% of ICUs. For the prediction of fluid responsiveness, intensivists rely preferentially on dynamic indices or echocardiographic parameters, but static parameters, such as central venous pressure or pulmonary artery occlusion pressure, were still used. CONCLUSIONS In most Swiss ICUs, multiple haemodynamic monitoring devices are available, although TPTD is most commonly used. Despite the usefulness of echocardiography and its large availability, it is not widely performed by Swiss intensivists themselves. Regarding fluid management, several parameters are used without a clear consensus for the optimal method.

UI MeSH Term Description Entries
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D003422 Critical Care Health care provided to a critically ill patient during a medical emergency or crisis. Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D003935 Diagnostic Techniques, Cardiovascular Methods and procedures for the diagnosis of diseases or dysfunction of the cardiovascular system or its organs or demonstration of their physiological processes. Cardiovascular Diagnostic Technic,Cardiovascular Diagnostic Technics,Cardiovascular Diagnostic Technique,Cardiovascular Diagnostic Techniques,Diagnostic Technic, Cardiovascular,Diagnostic Technics, Cardiovascular,Diagnostic Technique, Cardiovascular,Technic, Cardiovascular Diagnostic,Technics, Cardiovascular Diagnostic,Technique, Cardiovascular Diagnostic,Techniques, Cardiovascular Diagnostic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012769 Shock A pathological condition manifested by failure to perfuse or oxygenate vital organs. Circulatory Collapse,Circulatory Failure,Hypovolemic Shock,Collapse, Circulatory,Failure, Circulatory,Shock, Hypovolemic
D013557 Switzerland A country in Europe. It is bordered by Austria, France, Italy, Liechtenstein, and Germany. The capital is Bern.
D014600 Utilization Review An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use. Review, Utilization,Reviews, Utilization,Utilization Reviews
D016638 Critical Illness A disease or state in which death is possible or imminent. Critically Ill,Critical Illnesses,Illness, Critical,Illnesses, Critical
D019538 Health Care Surveys Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care. Healthcare Surveys,National Ambulatory Medical Care Survey,National Hospital Discharge Survey,Care Survey, Health,Care Surveys, Health,Health Care Survey,Healthcare Survey,Survey, Health Care,Survey, Healthcare,Surveys, Health Care,Surveys, Healthcare

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