Advances of hemodynamic monitoring and the current state of fluid resuscitation in clinical practice

Fluid resuscitation remains the most common and the most debated intervention for critically ill patients. Fluid resuscitation is recommended as a principal therapy in various critical care guidelines, despite the low quality of evidence backing its safety. Fluid overload may lead to a lot of adverse effects, necessitating a reliable method to predict the patient’s hemodynamic response to fluid resuscitation. This review summarizes various hemodynamic monitoring. techniques developed over the years and their role in guiding fluid resuscitation, such as the Swan-Ganz catheter, transpulmonary thermodilution, Doppler ultrasound, and impedance cardiography. Each of these techniques comes with differing advantages and shortcomings, as well the appropriate clinical settings in which these techniques can be applied. Existing protocols, which recommend fluid resuscitation as well as evidences pointing against its clinical safety are also discussed.