Update on minimally invasive hemodynamic monitoring in thoracic anesthesia

Abstract

Many different minimally invasive hemodynamic monitoring devices have been developed and clinically introduced in the last years. They offer the advantage of being less invasive and easier to use. However, these techniques have several limitations and data are scarce in patients undergoing thoracic anesthesia, preventing their widespread use so far.

Introductory Chapter: Hemodynamic Management. The Problem of Monitoring Choice

“…As a consequence, several reports tried to suggest guidelines for hemodynamic monitoring in specific conditions, like for example, circulatory shock [9], sepsis [10], or patients under thoracic anesthesia [11].…”

Perioperative Cardiac Output Monitoring Utilizing Non-pulse Contour Methods

“…Similarly, the major complication rate associated with TEE is less than 1% [16], while no complications have been reported for TED [17]. Finally, the least invasive techniques, also known as non-invasive or minimally invasive methods [18][19][20], include the bioimpedance/bioreactance method, partial CO 2 rebreathing method, inert gas rebreathing (IGR) method, transthoracic echocardiography (TTE)/Doppler (TTD) method, and non-invasive pulse contour method.…”

Advanced bioimpedance signal processing techniques for hemodynamic monitoring during anesthesia

“…The partial CO2 rebreathing technique evaluates respiratory CO2 and applies the Fick principle to calculate CO [37], [62], [63]. Pulmonary blood flow can be calculated by relating the content of alveolar gas in pulmonary capillary blood to the quantity of gas passing to the lung.…”

“…The transthoracic Doppler (USCOM, Sidney, Australia) determines CO via flow measurements at the aortic or pulmonary valve but it requires a considerable level of experience for its usage and is not suitable for thoracic surgery [40], [63].…”

“…A large quantity of studies evaluating and comparing different cardiac output monitors have been published [2], [25], [26], [34], [35], [39], [61], [63], [64], [67], [68], [70]- [79]. The new qCO monitor, by Quantium Medical, seeks to learn from past experiences and introduce new, advanced processing techniques to improve the cardiac output calculations.…”