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Mini invasive hemodynamic monitoring: from arterial pressure to cardiac output

  • GIORGIO DELLA ROCCA 1
  • MAURIZIO CECCONI1
  • MARIA GABRIELLA COSTA1

1,Department of Anesthesia and Intensive Care Medicine Medical School of University of Udine

DOI: 10.22514/SV31.022008.1 Vol.3,Issue S1,February 2008 pp.7-9

Published: 01 February 2008

*Corresponding Author(s): GIORGIO DELLA ROCCA E-mail: anestesia.segr@aoud.sanita.fvg.it

Abstract

To evaluate the Cardiac Output (CO) the standard invasive pulmonary artery catheter (PAC) is considered today the gold standard. The major criticism to the PAC is that its level of invasiveness is not supported by an improvement in patient’s outcome. The interest to lesser and lesser invasive techniques is high. Therefore, the alternative techniques have been recently developed.

Cardiac Output can be monitored continuously by different devices that analyze the arterial waveform to track changes in stroke volume (SV) and CO. The analysis of the arterial pressure wave to determine cardiac output is classified as Pulse Contour analysis or Pulse Pressure Analysis. Starting from a similar principle three main devices are now available on the market, with different algorithms and features: • PiCCO System (Pulsion Medical System, Munich, Germany)

• LiDCOTMplus System (LidCO, Cambridge, UK)

• Flotrac technology and Vigileo Monitor (Edwards Lifesciences, Irvine, CA, USA).

The algorithm used by all these devices has been also implemented even with the analysis of the variation of stroke volume (SVV) and of the pulse pressure (PPV). SVV and PPV represent the variation of stroke volume and of the pulse pressure during the respiratory cycle. In sedated ventilated patients these indexes have proven to predict the response to a fluid challenge. A high variation (>10-12%) identifies with good sensitivity and specificity responders and not responders.

Keywords

cardiac output, arterial pressure, stroke volume variation, pulse pressure variation

Cite and Share

GIORGIO DELLA ROCCA ,MAURIZIO CECCONI,MARIA GABRIELLA COSTA. Mini invasive hemodynamic monitoring: from arterial pressure to cardiac output. Signa Vitae. 2008. 3(S1);7-9.

References

1. Jansen JR, Wesseling KH, Settels JJ, Schreuder JJ. Continuous cardiac output monitoring by pulse contour during cardiac surgery. Eur Heart J 1990;11:26-32.

2. Della Rocca G, Costa MG, Pompei L, Coccia C, Pietropaoli P. Continuous and intermittent cardiac output measurement: pulmonary artery catheter versus aortic transpulmonary technique. Br J Anaesth 2002;88:350-6.

3. Michard F, Teboul JL. Using heart-lung interactions to assess fluid responsiveness during mechanical ventilation. Crit Care 2000;4:282-9.

4. Hamilton TT, Huber LM, Jessen ME. PulseCO: a less-invasive method to monitor cardiac output from arterial pressure after cardiac surgery. Ann Thorac Surg 2002;74:1408-12.

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