A 77-year-old man is admitted to the intensive care unit (ICU) of a university hospital from the operating room with fecal peritonitis caused by a perforated sigmoid colon. The patient’s medical history includes treated hypertension and hypercholesterolemia, previous heavy alcohol intake, and mild cognitive impairment.
Having been given 4 liters of crystalloid perioperatively, the patient arrives in the ICU hypotensive and tachycardic. He is mechanically ventilated. After a further 1 liter of Hartmann’s solution and 500 ml of 5% human albumin solution he remains hypotensive and tachycardic with a central venous pressure is 9 mm Hg.
At this point the poll asks what monitoring strategies would you use to guide hemodynamic support for this patient?