Clinical Assessment of Cardiac Output (Co) vs Lidcotm Indicator Dilution (Id) Measurement: Are Clinical Estimates of Cardiac Output and Oxygen Delivery Reliable Enough to Manage Critically Ill Patients?

Noninvasive Hemodynamic Monitoring in Heart Failure: Utilization of Impedance Cardiography

“…Stevenson 6 reported a sensitivity of 58% for clinical signs indicative of elevated pulmonary capillary wedge pressures. Jonas 7 reported only a 30% correct estimation of cardiac index by physical examination when compared with the less‐invasive lithium dilution method. These shortcomings in clinical assessment relegate treatment decisions to poorly guided empiricism.…”

Pro-Con Debate: We should not Measure Cardiac output in Critical Care

“…Whilst few would dispute the value of these parameters, they are neither sensitive nor specific indicators of low cardiac output. 38 For each alternative parameter, there are a number of confounding factors that may explain a given abnormality. Along with the clinical history, many alternative parameters play an important role in the identification of the patient at risk of tissue hypoperfusion.…”

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“…Any data provided by a monitoring device should be interpreted with care and used in conjunction with other physiological and biochemical parameters. Clinical estimation of cardiac output, even by an experienced physician, is unreliable [59], whereas the use of flow monitoring has proved beneficial in various patient groups both with [60,61] and without the use of targets for oxygen flux [62-65]. …”