Abstract

One of the most critical insights required for the management of a critically ill patient is to know the hemodynamic parameters. Over years, hemodynamic monitoring has evolved from simple bedside clinical examination to invasive monitoring techniques such as pulmonary artery catheterization, pulse contour analysis and is advancing into non-invasive methods improving the safety profile of the patient. Traditional invasive techniques such as pulmonary artery catheterization and transpulmonary thermodilution have provided detailed physiological insights but are associated with procedural risks and intermittent data acquisition. Over the past two decades, point-of-care ultrasound (POCUS) has emerged as an advanced bedside monitoring modality enabling real-time, repeatable, and non-invasive hemodynamic assessment. POCUS allows integrated evaluation of cardiac output, ventricular function, preload, afterload, pulmonary congestion, and systemic venous congestion. By facilitating rapid shock phenotyping and guiding individualized resuscitation strategies, it represents a paradigm shift from static pressure-based monitoring toward dynamic, physiology-oriented multiorgan assessment. This review synthesizes current evidence regarding the clinical application of cardiac, vascular, pulmonary, and venous Doppler ultrasound in hemodynamic monitoring, discusses limitations, and outlines future directions in precision cardiac critical care

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