Minimally invasive cardiac output monitors

Drummond, Kate E.; Murphy, Edward

doi:10.1093/bjaceaccp/mkr044

Cited by 31 publications

(17 citation statements)

References 12 publications

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“…Because of its reported accuracy, the USCOM monitor is useful for diagnosing circulatory abnormalities and guiding the standard interventions of fluid inotropes and vaso-active therapies [21]. However, it may be unsuitable for patients with significant valvular stenosis [1].…”

Section: Discussionmentioning

confidence: 99%

“…The thermodilution technique, via the pulmonary artery catheter (PAC), remains the gold standard for measuring CO in critical patients. However, it does entail many risks such as infection, arrhythmias on insertion, cardiac valve damage during prolonged use, catheter knotting, pulmonary artery rupture and pulmonary embolism [1]. The ideal system for cardiac output monitoring would be non-invasive, easy to use, reliable and compatible from patient to patient [1].…”

Section: Introductionmentioning

confidence: 99%

“…Non-invasive cardiac output monitoring is a subject of great interest to the emergency medicine community [2,3]. While less invasive techniques (in comparison to the PAC) such as pulse contour analysis, transpulmonary thermodilution, lithium dilution and central venous oxygen saturation exist, they all require placement of a venous / arterial line [1,4].…”

Section: Introductionmentioning

confidence: 99%

“…Oesophageal Doppler and the Fick Principle gas rebreathing techniques provide technically simple alternatives, yet could still be considered invasive and come with inherent risks [1].…”

Section: Introductionmentioning

confidence: 99%

“…The only truly non-invasive techniques for measuring CO currently consist of transthoracic electrical bioimpedance, Nexfin finger arterial pulse contour analysis, and transthoracic continuous wave Doppler ultrasound [1]. Transthoracic electrical bioimpedance is limited by interference from arrhythmias, patient movement, patient body size variation and electric conductivity between the electrodes [5].…”

Section: Introductionmentioning

confidence: 99%

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In vitro evaluation of an ultrasonic cardiac output monitoring (USCOM) device

Gregory

Cooney

Diab

et al. 2015

J Clin Monit Comput

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Non-invasive cardiac output monitoring techniques provide high yield, low risk mechanisms to identify and individually treat shock in the emergency setting. The non-invasive ultrasonic cardiac output monitoring (USCOM) device uses an ultrasound probe applied externally to the chest; however limitations exist with previous validation strategies. This study presents the in vitro validation of the USCOM device against calibrated flow sensors and compares user variability in simulated healthy and septic conditions. A validated mock circulation loop was used to simulate each condition with a range of cardiac outputs (2-10 l/min) and heart rates (50-95 bpm). Three users with varying degrees of experience using the USCOM device measured cardiac output and heart rate by placing the ultrasound probe on the mock aorta. Users were blinded to the condition, heart rate and cardiac output which were randomly generated. Results were reported as linear regression slope (β). All users estimated heart rate in both conditions with reasonable accuracy (β = 0.86-1.01), while cardiac output in the sepsis condition was estimated with great precision (β = 1.03-1.04). Users generally overestimated the cardiac output in the healthy simulation (β = 1.07-1.26) and reported greater difficulty estimating reduced cardiac output compared with higher values. Although there was some variability between users, particularly in the healthy condition (P < 0.01), all estimations were within a clinically acceptable range. In this study the USCOM provided a suitable measurement of cardiac output and heart rate when compared with our in vitro system. It is a promising technique to assist with the identification and treatment of shock.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Oesophageal Doppler and the Fick Principle gas rebreathing techniques provide technically simple alternatives, yet could still be considered invasive and come with inherent risks [1].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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