Physician, Department of Anesthesiology and Intensive Care, University Hospital in Pilsen, Czech Republic
Hemodynamic monitoring is one of the basic monitored parameters in patients under general anesthesia. Non-invasive blood pressure monitoring (time interval <5 min.) and continuous ECG recording are considered to be the minimum standard. However, in many cases this level of monitoring is insufficient, especially in fragile patients and/or extensive surgeries where rapid changes in hemodynamics can be expected, eg. large vascular procedures, liver resections, etc. In these cases it makes sense to use continuous blood pressure monitoring, whether non-invasive (good peripheral blood supply is precondition) or invasive. It has been shown that even short episode of hypotension in the order of minutes can have negative effects. In the case of fragile patients and risky procedures, it is appropriate to use one of the minimally invasive hemodynamic monitorings, which provide us not only with information on blood pressure, but also cardiac output and parameters that affect it (preload, afterload, contractility). Such a measurement is the basis of the so-called early goal directed therapy, which has proven its benefit for patients in a number of studies.