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Imbalances in Cardiac Output

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...

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Related Experiment Video

Updated: Mar 10, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Hemodynamic coherence in critically ill pediatric patients.

Ö Erdem¹, J W Kuiper¹, D Tibboel¹

¹Intensive Care, Department of Paediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, P.O. 2040, 3000CA, Rotterdam, The Netherlands.

Best Practice & Research. Clinical Anaesthesiology

|December 10, 2016

Summary

Pediatric critical care is complex due to physiological differences. Monitoring microcirculation, not just macrocirculation, using hemodynamic coherence can optimize oxygen delivery in critically ill children.

Keywords:

hemodynamic coherence hemodynamic monitoring microcirculation pediatric critical care

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Last Updated: Mar 10, 2026

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Published on: August 19, 2020

Area of Science:

Pediatric critical care
Cardiovascular physiology
Hemodynamics

Background:

Treating critically ill children presents unique challenges compared to adults due to physiological and pathophysiological differences.
Neonatal and pediatric cardiovascular systems differ significantly in size, weight, proportions, and metabolism, requiring tailored monitoring.
Current hemodynamic monitoring focuses on macrocirculation, which may not reflect microcirculatory function.

Purpose of the Study:

To highlight the importance of microcirculatory monitoring in pediatric critical care.
To introduce the concept of hemodynamic coherence for assessing pediatric patients.
To explore the potential of hemodynamic coherence in guiding therapy for optimal oxygen delivery.

Main Methods:

Review of existing research on pediatric hemodynamics and microcirculation.
Analysis of the concept of hemodynamic coherence and its relevance to children.
Discussion of the limitations of current monitoring techniques.

Main Results:

Children can experience microcirculatory alterations (loss of hemodynamic coherence) even with normal systemic hemodynamics.
Normal macrocirculatory parameters do not guarantee adequate microcirculatory function.
Implementing hemodynamic coherence monitoring could improve therapeutic titration.

Conclusions:

Assessing microcirculation alongside macrocirculation is vital for pediatric critical care.
The concept of hemodynamic coherence offers a promising framework for optimizing oxygen delivery in children.
Further technical development and research are needed to validate bedside microcirculatory monitoring in pediatric patients.