Chapter 14 - Comprehensive, real-time hemodynamic monitoring and data acquisition: An essential component of the development of individualized neonatal intensive care

Abstract

Understanding the cardiovascular physiology and pathophysiology in a neonate during transition and beyond requires the availability of objective data that reflects both systemic and regional blood flow and oxygen balance at a given time. Complementing conventional hemodynamic parameters such as heart rate, blood pressure, and arterial oxygen saturation, this additional information can provide insights into complex physiologic interactions between the key components of circulation that determine oxygen demand-delivery coupling and potentially reveal preclinical indicators and trends that identify patients at risk for cardiovascular compromise. Comprehensive hemodynamic monitoring systems enable continuous and simultaneous acquisition of physiometric data in real time for subsequent analysis and processing utilizing various applications including predictive mathematical modeling. While still being used primarily in research settings, increasing usage of such monitoring systems is the first step toward individualized hemodynamic management of high-risk patient subpopulations that could be identified early and would most likely benefit from a given intervention. To further enhance the capabilities of these systems, inclusion of genomic data potentially opens an entirely new era in hemodynamic research with implications for patient care in the near future.