Although the need to properly assess and monitor the hemodynamic status of a critically ill patient appears self-evident, the plethora of information in the published literature over the past two decades has resulted in complexity rather than clarity. Factors contributing to the complexity include uncertainty as to which patient advanced monitoring should be used in, doubt about the underlying principles on which decisions are made, confusion over an ever-expanding array of available devices, and individual physician behaviour.

This article explores the Why, When, Which and What of Hemodynamic Monitoring.

Here are the main points:

1. Why hemodynamic status should be measured is linked to the belief that it results in improved patient care.
2. When to apply more advanced monitoring?
3. Which technique to use once the decision has been made to escalate the level of monitoring.
4. What the physician actually does with the information after obtaining data from the chosen device or technique is a field demanding further study.

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