Non-Invasive Continuous Measurement of Haemodynamic Parameters—Clinical Utility

Abstract

The evaluation and monitoring of patients’ haemodynamic parameters are essential in everyday clinical practice. The application of continuous, non-invasive measurement methods is a relatively recent solution. CNAP, ClearSight and many other technologies have been introduced to the market. The use of these techniques for assessing patient eligibility before cardiac procedures, as well as for intraoperative monitoring is currently being widely investigated. Their numerous advantages, including the simplicity of application, time- and cost-effectiveness, and the limited risk of infection, could enforce their further development and potential utility. However, some limitations and contradictions should also be discussed. The aim of this paper is to briefly describe the new findings, give practical examples of the clinical utility of these methods, compare them with invasive techniques, and review the literature on this subject.

Current Commonly Used Dynamic Parameters and Monitoring Systems for Perioperative Goal-Directed Fluid Therapy: A Review

“…Moreover, it is invasive and can lead to numerous complications such as thrombosis, pulmonary artery rupture, infection, and arrhythmia on insertion [51]. Therefore, other minimal or noninvasive hemodynamic monitoring systems have been developed [65,66]. In the section below, we will focus on common and popular monitoring systems which have been verified and used preoperatively for GDFT.…”

Intensivtherapie in der Herzchirurgie – alles anders?

“…Daneben stehen weitere, wenig bis nicht invasive Verfahren zur Verfügung. Wiewohl diese durch ihre geringe Invasivität und einfache Anwendung bestechen, scheinen sie hinsichtlich Präzision und somit Aussagekraft im kardiochirurgischen Patientenkollektiv noch Limitationen aufzuweisen [5] und sollten bei komplex erkrankten Patienten nur mit Vorbehalt eingesetzt werden.…”

“…Patienten sollten nach Auftreten von POAF während des Krankenhausaufenthalts therapeutisch antikoaguliert werden, wenn die Vorhofflimmerepisode > 48 h andauert [5]. Die Fortführung der Antikoagulation als Dauertherapie mittels Vitamin-K-Antagonisten oder DOAK sollte nach Nutzen-Risiko-Evaluation und abhängig vom Patientenwunsch erfolgen [23].…”

Current state of sepsis resuscitation in critical care

“…Despite its invasive nature and complexities, the PAC remains the most precise technique for monitoring hemodynamics. The use of PAC is recommended in patients with refractory shock, right ventricular dysfunction, and those with severe shock associated with ARDS given its capability to provide direct measurements in the right heart and pulmonary circulation 57,65 …”

“…The increase in blood volume in the thorax decreases the resistance of the passing electricity. A “phase shift” is measured via electrodes placed along the electricity current 65 . The higher the cardiac SV, the more significant the phase shift.…”