- Poster presentation
- Open Access
Change of therapeutic plan following advanced cardiopulmonary monitoring in critically ill patients: a multicenter study
© BioMed Central Ltd. 2007
- Published: 22 March 2007
- Respiratory Failure
- Clinical Judgment
- Cardiogenic Shock
- Systemic Vascular Resistance
- Therapeutic Decision
Many therapeutic decisions are made in the ICU on the basis of clinical judgment and conventional monitoring alone, although these may be inadequate for a reliable estimate of hemodynamic status. We therefore measured the effects of more advanced cardiopulmonary parameters (ACP) on major therapeutic decisions.
Cardiopulmonary assessment was done in critically ill patients from 12 European ICUs independently by one to four physicians per patient just before the use of the PiCCO monitor (Pulsion, Germany). Following cardiopulmonary evaluation and prediction of ACP (reported elsewhere), each physician suggested a therapeutic plan before and after the first set of PiCCO measurements (cardiac output, systemic vascular resistance, global end-diastolic volume, stroke volume variation, and extravascular lung water), and then self-rated the accuracy of his original therapeutic plan.
The measurement of advanced cardiopulmonary parameters caused both specialists and residents to make considerable changes in therapeutic decisions that were previously made based on clinical judgment and conventional monitoring alone.
The authors of this unsupported study are members of Pulsion's medical advisory board.