Minimally invasive hemodynamic monitoring and goal-directed therapy

To the extent possible, hemodynamic monitoring should be non-invasive, continuous and reflect metabolic qualities, such as tissue blood flow and oxygen delivery. Recent advances in technologies have created new opportunities to switch from more invasive and risky monitoring to less invasive eons. However, degradation of signal quality and understanding of the relation between these newer minimally invasive and non-invasive measures with more traditional invasive ones is central to their effective use. Finally, since no monitoring device improves patient outcome unless coupled to a treatment that improves patient outcome, finding common pathways to integrate these newer monitoring devices into proven treatment algorithms will be an essential part of their integration into clinical practice.