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DOI 10.1007/s10877-012-9375-8
Received: 2 October 2011 / Accepted: 30 May 2012 / Published online: 14 June 2012
The Author(s) 2012. This article is published with open access at Springerlink.com
1 Introduction
The primary evaluation of the hemodynamic condition is
done by assessing heart rate (HR) and mean blood pressure
(BP) as a surrogate of tissue perfusion. When these
parameters change rapidly, a single measurement conveys
insufficient information, making continuous measurement
desirable [1]. For continuous measurement of BP, cannulation of an artery is the primary approach. However,
noninvasive and continuous monitoring of BP has several
advantages, particularly if intra-arterial measurement of BP
is not warranted while intermittent measurements do not
have the required time resolution [2]. Finger cuff technology can provide such continuous and noninvasive
monitoring of BP and other hemodynamics parameters.
Although giving vital information, BP and HR due to
their regulated nature frequently do not respond to substantial changes in intravascular volume, e.g. fluid administration or blood loss. Age and pre-existing cardiovascular
morbidity complicate interpretation of these parameters
further [39]. In supine adults hypotension and tachycardia
are frequently absent even after blood loss of more than 1 l
[38, 10, 11]. Therefore, fluid administration to optimize
cardiac preload guided by BP is not straightforward. In
contrast, cardiac output (CO) and especially cardiac stroke
volume (SV) are sensitive to deviations in preload [7, 8].
Also, when arterial pressure is being restored by administering sympathomimetic drugs, it is at the expense of
regional flow possibly including that to the brain [12].
Moreover, there is growing evidence that a patients
cumulative fluid balance as well as strategy to guide fluid
administration have an impact on patient morbidity and
hospital stay. This has stimulated the development of
methods that immediately detect changes in cardiac preload
and output. With techniques like trans-esophageal and
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Method
Company
CO
BP
Nexfin
BMEYE
___
___
Finometer
FMS
___
___
LIFEGARD ICG
___
BioZ Monitor
Impedance cardiography
CardioDynamics International
Corporation
___
Cheetah reliant
Bioreactance
Cheetah Medical
___
Cardioscreen/Niccomo
___
__
AESCULON
Electrical velocimetry
___
HIC-4000
Impedance cardiography
___
NICaS
Regional impedance
NImedical
___
IQ2
3-dimensional impedance
___
ICON
Electrical velocimetry
___
___
PHYSIO FLOW
Manatec biomedical
Vasamed
AcQtrac
___
esCCO
Nihon Kohden
___
TEBCO
___
NCCOM 3
Impedance cardiography
___
RheoCardioMonitor
Impedance cardiography
Rheo-Graphic PTE
___
HemoSonicTM 100
ECOM
transesophageal Doppler
Endotracheal bioimpedance
?
?
___
___
CardioQ-ODMTM
Oesophageal Doppler
Deltex
___
TECO
Transesophageal Doppler
Medicina
___
ODM II
Transesophageal Doppler
Abbott
___
HDI/PulseWaveTM CR2000
__
USCOM 1A
Transthoracic Doppler
Uscom
__
NICO
Rebreathing Fick
Philips Respironics
Innocor
Rebreathing Fick
Innovision A/S
Vigileo/FloTrac
Edwards Lifesciences
___
___
LiDCOplus PulseCO
LiDCO Ltd
___
___
PiCCO2
___
___
MOSTCARE PRAM
Vytech
___
___
Vigilance
Edwards Lifesciences
___
DDG
Dye-densitogram analyzer
Nihon Kohden
Truccom
COstatus
Ultrasound dilution
CNSystems Medizintechnik AG
___
SphygmoCor CPV
System
Applanation tonometry
AtCor Medical
__
TL-200 T-LINE
Applanation tonometry
__
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b Fig. 2 The cZ pulse contour method, Modelflow and Nexfin CO-trek.
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during the optimization of atrioventricular delay in cardiac resynchronization therapy and a good agreement was
found [107]. The second study compared, during exercise, the CO of Nexfin CO-trek with inert gas rebreathing
method for CO estimation [108]. A good correlation was
found and values actually converged for large CO values
[109].
8.1 Anesthesiology
8.3 Cardiology
123
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