Rethinking Resuscitation: Integrating Dynamic Hemodynamic Monitoring at the Bedside

Hemodynamic monitoring is essential for guiding resuscitation in critically ill patients, yet reliance on static indicators such as central venous pressure persists despite evidence of their poor predictive value. This evidence-based clinical review challenges outdated practices and highlights dynamic parameters to include pulse pressure variation, stroke volume variation, pleth variability index, and passive leg raise, as superior tools for assessing fluid responsiveness. Practical strategies for integrating these measures with bedside perfusion assessments, such as capillary refill time and mottling, are presented to help nurses implement evidence-based, multimodal monitoring and reduce iatrogenic harm.