Here, Sara Crager takes a few minutes to discuss the hemodynamic interfaces with me. Over the next months, I’ll be picking the brains of my co-authors for the fantastic angles they can all bring to our “Trilogy in 4 Parts” (creative title by of course @EMnerd) which we all feel can be a really useful mental model for both learners and veterans and even better for patients!
Note that we are planning #HR25 around congestion and the hemodynamic interface model – so if you want to master the interfaces, be sure to come join us! https://thinkingcriticalcare.com/2024/06/05/hr2025-the-hospitalist-the-resuscitationist-montreal-may-21-24-2025-hr25/
cheers
Philippe
thinking critical care 
Philippe, when is the paper available? Do you have a link to it?
Its under review – so depends what reviewer 2 will say! 😉
Hi Philippe – Lovely to hear Sara’s voice – and I do agree that this model is something we have used implicitly for years. Do you think that it means we will revisit renal resistive index as an interface II measure? I was looking at hepatic artery RI but then got worried that it might be confounded by cirrhosis or the hepatic artery buffer system. Any thoughts so far?
Hey Kylie. In my opinion yes. The main obstical is systemic issues (along interface I) confound what you can Doppler in the high flow organs. However, there are multiple ways to find the confounding factors or mitigate them. For one example if the RRI is high and the SRI and HRI is ok, then there likely is an interface II problem isolated to the kidney. So we might focus on things that will improve kidney perfusion. However if all 3 RIs are high, then perhaps we should go look at interface I and adjust things.