Value of Non Invasive Hemodynamic Monitoring in Patients Admitted to Respiratory Intensive Care Unit

Mechanical ventilation MV is a life saving intervention in intensive care units. Access to lower airways is achieved either through tracheostomy or endotracheal intubation. More recently non invasive ventilation NIV techniques were introduced that do not require an endotracheal airway but using patient ventilator interfaces in the form of facial masks have been designed.

The haemodynamic consequences of MV are multiple and complex and may affect all the determinants of cardiac performance such as heart rate.preload.contractility .and afterload. These consequences affect both right and left ventricle and are also related to the biventricular interdependence .

Mechanically ventilated patients are considered Critically ill.and they are often hemodynamically unstable or at risk of becoming unstable owing to hypovolemia. cardiac dysfunction. or alterations of vasomotor function. leading to organ dysfunction.deterioration into multiorgan failure .and eventually death .Socardiopulmonary monitoring is crucial to ensure successful evaluation and management of these patients . With hemodynamic monitoring. The investigators aim to guide our medical management to prevent or treat organ failure and improve the outcomes of our patients. Therapeutic measures may include fluid resuscitation.vasopressors or inotropic agents .

Hemodynamic monitoring can be done by different techniques which ranges from invasive to less invasive and completely noninvasive methods to assess Cardiac output BP oxygen saturation. Some hemodynamic parameters are easy to be measured like blood pressure and heart rate but do not give a complete picture of a patient's hemodynamics .

Measuring CO and its components preload afterload and contractility will tell us if there is ongoing need for fluid resuscitation vasopressors or inotropic agents . It can be used as a diagnostic tool to determine the type of shock hypovolemic cardiogenic obstructive or distributive according to the hemodynamic profile .