Toward Intelligent Hemodynamic Monitoring: A Functional Approach

Abstract

Technology is now available to allow a complete haemodynamic analysis; however this is only used in a small proportion of patients and seems to occur when the medical staff have the time and inclination. As a result of this, significant delays occur between an event, its diagnosis and therefore, any treatment required. We can speculate that we should be able to collect enough real time information to make a complete, real time, haemodynamic diagnosis in all critically ill patients. This article advocates for “intelligent haemodynamic monitoring”. Following the steps of a functional analysis, we answered six basic questions. (1) What is the actual best theoretical model for describing haemodynamic disorders? (2) What are the needed and necessary input/output data for describing this model? (3) What are the specific quality criteria and tolerances for collecting each input variable? (4) Based on these criteria, what are the validated available technologies for monitoring each input variable, continuously, real time, and if possible non-invasively? (5) How can we integrate all the needed reliably monitored input variables into the same system for continuously describing the global haemodynamic model? (6) Is it possible to implement this global model into intelligent programs that are able to differentiate clinically relevant changes as opposed to artificial changes and to display intelligent messages and/or diagnoses?