INVASIVE HEMODYNAMIC MONITORING IN CARDIAC SURGERY
Keywords:
Swan–Ganz catheter, transpulmonary thermodilution, hemodynamic monitoring, acquired heart diseaseAbstract
A large number of clinical studies have shown the benefits of early goal-directed therapy of hemodynamic disorders in anesthesiology and in critically ill patients. Methods, which evaluate the parameters of hemodynamics, play an important role in the diagnostic process both in the operation room and during intensive care. Our review describes the basic technologies for cardiovascular monitoring that are widely used in clinical practice and provides detailed comparative evaluation of methods for measuring cardiac output by Swan–Ganz catheter and by using transpulmonary thermodilution and pulse contour analysis. The article presents the hemodynamic algorithms obtained during pulmonary artery catheterization and transpulmonary thermodilution and the most common complications arising from the use of these techniques. The paper demonstrates advantages and disadvantages of each method of monitoring in relation to cardiac surgery and other categories of crtically ill patients, and describes alternative ways of assessing the adequacy of oxygen transport during perioperative period and intensive care. It shows the possibilities for using obtained data during early goal-directed therapy of hemodynamic disturbances during and after cardiac surgery. The authors analyzed both own data and results of studies, published in this field in the international peer-reviewed medical literature.
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