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

Siegenthaler N, Giraud R, Saxer T, Courvoisier DS, Romand JA, Bendjelid K - Biomed Res Int (2014)

Bottom Line: TPTD and PAC were frequently both available, although TPTD was the preferred technique.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.

View Article: PubMed Central - PubMed

Affiliation: 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.

ABSTRACT

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.

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Related in: MedlinePlus

The use of echocardiography by intensivists. The results are presented as the mean number of replies from Swiss intensivists (in %) to the total number of intensivists who replied to the question (n(Intensivists)/total replies).
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fig2: The use of echocardiography by intensivists. The results are presented as the mean number of replies from Swiss intensivists (in %) to the total number of intensivists who replied to the question (n(Intensivists)/total replies).

Mentions: Echocardiography was available in most ICUs (Figure 2) but was not routinely used, and in most cases, echocardiography was not performed by the intensivists themselves. In contrast to this result, a large majority of participating physicians considered that Swiss intensivists should be able to perform echocardiography in ICUs for haemodynamic management.


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

Siegenthaler N, Giraud R, Saxer T, Courvoisier DS, Romand JA, Bendjelid K - Biomed Res Int (2014)

The use of echocardiography by intensivists. The results are presented as the mean number of replies from Swiss intensivists (in %) to the total number of intensivists who replied to the question (n(Intensivists)/total replies).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016935&req=5

fig2: The use of echocardiography by intensivists. The results are presented as the mean number of replies from Swiss intensivists (in %) to the total number of intensivists who replied to the question (n(Intensivists)/total replies).
Mentions: Echocardiography was available in most ICUs (Figure 2) but was not routinely used, and in most cases, echocardiography was not performed by the intensivists themselves. In contrast to this result, a large majority of participating physicians considered that Swiss intensivists should be able to perform echocardiography in ICUs for haemodynamic management.

Bottom Line: TPTD and PAC were frequently both available, although TPTD was the preferred technique.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.

View Article: PubMed Central - PubMed

Affiliation: 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.

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus