Introduction

Many of us were raised with the concept of giving (large amounts of fluid) guided by blood pressure, heart rate, may be diuresis or peripheral temperature. The same counts for starting inotropic or vasopressor support. May be some us would use central venous pressure or capillary refill time, but that was it. Nowadays we know that volume resuscitation should be guided and aimed at limitation not only in the ICU but also in the OR. The same counts for starting vasoactive medication.

Blood pressure, the most commonly used resuscitation goal hardly correlates with the need for volume resuscitation (fluid responsiveness) or fluid status. In the past, Swan-Ganz catheter was used to guide resuscitation but now has run out of favor.

Now we have to re-evaluate our ancient ways of haemodynamic monitoring. Some of the components might still be used, and especially be valuable in low resource environment. On the other hand, there are new ways of haemodynamic monitoring, including PiCCO technology and Cardiopulmonaty Ultrasound. We may even bring back the Swan-Ganz catheter into favor.

Objectives

1. Use of haemodynamic monitoring in ICU, OR, ER and in the ward.

2. Hemodynamic monitoring tools in low resource settings

3. Tailoring monitoring to patients, especially with diseases that are more prevalent in East Africa

Who can attend?

Any practitioner dealing with hemodynamically unstable patients