Cardiac Hemodynamic Monitoring

Cardiac and hemodynamic monitoring are the cornerstones of modern-day critical care. Previous groundwork has characterized cardiac physiology and the pathophysiology that occurs during shock and other disorders disrupting homeostasis. Fundamental to this understanding is the need to monitor cardiac and hemodynamic indices to provide point-of-care data that can be incorporated into the care of patients with physiologic compromise. This chapter will review the goals of resuscitation, recognition of shock in the elderly patient, and briefly review the cardiac and hemodynamic changes that occur with aging. Additionally, we will review standard and advanced hemodynamic techniques of monitoring and evaluate their strengths and limitations in the elderly ICU patient. Lastly, we will offer paradigms for hemodynamic and cardiac monitoring in the critically ill elderly patient with a focus on risk/benefit assessment and fluid responsiveness and finish with an individualized, patient centered approach to resuscitation and physiologic support during recovery from critical illness.