{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T04:23:12Z","timestamp":1793593392081,"version":"4.5.0"},"reference-count":25,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Advanced hemodynamic monitoring is fundamental in the management of the critically ill. Blood pressure and cardiac function are key markers of cardiovascular system function;, thus, having accurate measurements of these parameters in critically ill patients is essential. Currently, there are various methods available to choose from, as well as a greater understanding of the methods and criteria to be able to compare devices and select the best option for our patients\u2019 needs. Cardiac ultrasound and transpulmonary thermodilution help tailor the therapy for a patient\u2019s individual needs by putting the results of a thorough hemodynamic assessment into context. Both these hemodynamic monitoring techniques have their advantages, drawbacks and limitations. Cardiac ultrasound is a safe, non-invasive, less expensive, efficient bedside tool for diagnosing, monitoring and guiding critically ill patients\u2019 therapy management. It is recommended in the consensus guidelines as the first-choice method, especially when it comes to identifying different types of shock or the various factors involved. Pulse index contour continuous cardiac output (PiCCO) is a minimally invasive hemodynamic monitoring technique, integrating various static and hemodynamic parameters through a combination of trans-cardiopulmonary thermodilution and pulse contour analysis. The PiCCO method provides guidance to fluid and vasoactive therapy in critically ill patients and is also used for intraoperative and postoperative fluid management and monitoring in cardiac surgery. While invasive methods such as PiCCO are recommended for hemodynamic monitoring and can provide accurate information, they are not always necessary and are contraindicated in some cases.<\/jats:p>","DOI":"10.3390\/medicina60111884","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T05:36:45Z","timestamp":1731908205000},"page":"1884","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["PiCCO or Cardiac Ultrasound? Which Is Better for Hemodynamic Monitoring in ICU?"],"prefix":"10.3390","volume":"60","author":[{"given":"Maria","family":"Andrei","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Emergency County Hospital of Craiova, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoleta Alice","family":"Dragoescu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Emergency County Hospital of Craiova, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea","family":"Stanculescu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Emergency County Hospital of Craiova, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luminita","family":"Chiutu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Emergency County Hospital of Craiova, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavian","family":"Dragoescu","sequence":"additional","affiliation":[{"name":"Department of Urology, Emergency County Hospital of Craiova, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavian","family":"Istratoaie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Emergency County Hospital of Craiova, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1186\/s13054-016-1401-7","article-title":"Echocardiography in shock management","volume":"20","author":"McLean","year":"2016","journal-title":"Crit. Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"797","DOI":"10.21037\/atm.2020.04.11","article-title":"Continuous cardiac output assessment or serial echocardiography during septic shock resuscitation?","volume":"8","author":"Vignon","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3949\/ccjm.87a.18143","article-title":"Sepsis and septic shock: Guideline-based management","volume":"87","author":"Dugar","year":"2020","journal-title":"Clevel. Clin. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jointm.2022.09.003","article-title":"How to integrate hemodynamic variables during resuscitation of septic shock?","volume":"3","author":"Teboul","year":"2023","journal-title":"J. Intensive Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"789","DOI":"10.21037\/atm-20-1120","article-title":"Optimal target in septic shock resuscitation","volume":"8","author":"Kattan","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1007\/s10741-021-10140-7","article-title":"Risk stratification in cardiogenic shock: A focus on the available evidence","volume":"27","author":"Sciaccaluga","year":"2022","journal-title":"Heart Fail. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Zhang, Y., McCurdy, M.T., and Ludmir, J. (2023). Sepsis Management in the Cardiac Intensive Care Unit. J. Cardiovasc. Dev. Dis., 10.","DOI":"10.3390\/jcdd10100429"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"421","DOI":"10.21037\/atm.2019.07.06","article-title":"Accuracy of non-invasive and minimally invasive hemodynamic monitoring: Where do we stand?","volume":"7","author":"Manolukas","year":"2019","journal-title":"Ann. Transl. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1177\/0310057X1204000304","article-title":"The PiCCO monitor: A review","volume":"40","author":"Litton","year":"2012","journal-title":"Anaesth Intensive Care"},{"key":"ref_10","first-page":"67","article-title":"Sepsis definition: What\u2019s new in the treatment guidelines","volume":"61","year":"2022","journal-title":"Acta Clin. Croat."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"255","DOI":"10.15441\/ceem.23.065","article-title":"Hemodynamic management of septic shock: Beyond the Surviving Sepsis Campaign guidelines","volume":"10","author":"Suh","year":"2023","journal-title":"Clin. Exp. Emerg. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Vir\u00e1g, M., Leiner, T., Rottler, M., Ocskay, K., and Molnar, Z. (2021). Individualized Hemodynamic Management in Sepsis. J. Pers. Med., 11.","DOI":"10.3390\/jpm11020157"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1186\/s13054-022-04255-y","article-title":"A plea for personalization of the hemodynamic management of septic shock","volume":"26","author":"Cecconi","year":"2022","journal-title":"Crit. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jointm.2022.10.003","article-title":"Hemodynamic monitoring in cardiogenic shock","volume":"3","author":"Hamzaoui","year":"2023","journal-title":"J. Intensive Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zhang, H., Zhang, D., Lian, H., Zhang, Q., Chen, X., and Wang, X. (2024). Echocardiographic features of right ventricle in septic patients with elevated central venous pressure. BMC Anesthesiol., 24.","DOI":"10.1186\/s12871-024-02515-8"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2022-5-8","DOI":"10.7573\/dic.2022-5-8","article-title":"Emerging concepts in heart failure management and treatment: Focus on point-of-care ultrasound in cardiogenic shock","volume":"12","author":"Ruben","year":"2023","journal-title":"Drugs Context"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/ehjci\/jeu210","article-title":"The use of echocardiography in acute cardiovascular care: Recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association","volume":"16","author":"Lancellotti","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1007\/s00134-014-3525-z","article-title":"Consensus on circulatory shock and hemodynamic monitoring. Task force of the European society of Intensive Care Medicine","volume":"40","author":"Cecconi","year":"2014","journal-title":"Intensive Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1016\/j.crvasa.2017.11.007","article-title":"The use of echocardiography in acute cardiovascular care. Summary of the document prepared by the Czech Society of Cardiology","volume":"60","author":"Hutyra","year":"2018","journal-title":"Cor Et Vasa"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1745-6215-14-32","article-title":"Use of the PiCCO system in critically ill patients with septic shock and acute respiratory distress syndrome: A study protocol for a randomized controlled trial","volume":"14","author":"Zhang","year":"2013","journal-title":"Trials"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"R82","DOI":"10.1186\/cc6933","article-title":"Assessment of stroke volume variation for prediction of fluid responsiveness using the modified FloTrac\u2122 and PiCCOplus\u2122 system","volume":"12","author":"Hofer","year":"2008","journal-title":"Crit. Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s10877-024-01161-2","article-title":"Haemodynamic monitoring during noncardiac surgery: Past, present, and future","volume":"38","author":"Kouz","year":"2024","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"175","DOI":"10.5114\/ait.2022.115368","article-title":"Methods of assessing fluid responsiveness in septic shock patients: A narrative review","volume":"54","author":"Weigl","year":"2022","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"699","DOI":"10.4103\/0971-9784.191554","article-title":"Global end-diastolic volume an emerging preload marker vis-a-vis other markers\u2014Have we reached our goal?","volume":"19","author":"Kapoor","year":"2016","journal-title":"Ann. Cardiac. Anaesth."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.medin.2017.03.007","article-title":"The accuracy of PiCCO in measuring cardiac output in patients under therapeutic hypothermia: Comparison with transthoracic echocardiography","volume":"42","author":"Germano","year":"2018","journal-title":"Med. Intensiv."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/11\/1884\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:34:03Z","timestamp":1760114043000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/11\/1884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,17]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["medicina60111884"],"URL":"https:\/\/doi.org\/10.3390\/medicina60111884","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,17]]}}}