Editorial for the series on hemodynamic monitoring in critically ill patients
This series of Annals of Translational Medicine presents a collection of review articles on hemodynamic monitoring in the critically ill patient. The limits and scopes of hemodynamic monitoring has broadened over the last decades with the incorporation of new less invasive techniques such as bedside point-of-care echocardiography. On the other hand, resuscitation concepts have changed and moved from a cardiac output centered approach to perfusion-driven strategies.
The relation between macrocirculation and end-organ or microcirculatory perfusion has been deeply explored and lead to define hemodynamic coherence as a state where an improvement of cardiac output or perfusion pressure is associated with improvement in regional and microcirculatory flow. This status is lost in advanced septic shock or other conditions where further efforts to maximize systemic hemodynamics will increase the risk of over-resuscitation without improving perfusion at the tissue level. This further reinforces the fact that hemodynamic monitoring cannot be addressed as an isolated topic without including the window of perfusion.
Therefore, this series includes in-depth reviews of key physiological topics such as fluid responsiveness, ventricular-arterial coupling, perfusion monitoring, and microcirculatory flow. In addition, advanced techniques such as echocardiography in different settings, monitoring of complex procedures such as VA-ECMO, and the impact of fluids and vasoactive drugs on hemodynamics and perfusion.
We are extremely thankful for the great contributions of all authors in the series. We hope you enjoy these interesting reviews as well as the editorials and related-originals included in the series. We believe the series will provide new insights and inspirations for readers in the future research.
Acknowledgments
Funding: None.
Footnote
Provenance and peer review: This article was commissioned by the editorial office, Annals of Translational Medicine for the series “Hemodynamic Monitoring in Critically Ill Patients”. The article did not undergo external peer review.
Conflicts of interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm.2020.04.36). The authors have no conflicts of interest to declare. The series “Hemodynamic Monitoring in Critically Ill Patients” was commissioned by the editorial office without any funding or sponsorship. GH served as the unpaid Guest Editor of the series. GWT served as the unpaid Guest Editor of the series and serves as an unpaid Section Editor of Annals of Translational Medicine from Oct 2019 to Sep 2020.
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