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Table 1 Cardiac output monitors

From: Applications of minimally invasive cardiac output monitors

 

Advantages

Disadvantages

PAC

 

Pulmonary infarction

 

Measure CVP

Rupture of pulmonary artery

 

Intermittent and continuous

Arrhythmias

 

SVR can be obtained

Need right heart catheterization

Pulse wave

Analysis

A. PICCO

  
 

Intermittent and continuous

Need a central venous access

 

Measures GEDV/EVLW

 
 

Estimate preload

 

B. LIDCO

  
 

Intermittent and continuous

Cannot be used if patient on lithium or NDM

 

SVR can be obtained

Need frequent blood drawing

  

Does not estimate preload

C. Flo-trac

SVR can be obtained

Not reliable in very high CO state

 

Measure PPV/SVV

Perform poorly with tachyarrhythmia

 

Many validation studies

Valvular pathology prevents accurate reading of CO

Esophageal Doppler

Less invasive

Needs intubated patient

 

Simple to use

Only measure descending aortic flow

  

Not good in AR

Echocardiography

Provides detailed cardiac information

Needs additional training

 

Estimate preload

Inability to image patient

Bioreactance

Non-invasive

Numerous mathematical assumptions

 

Continuous

Signal stability fails after 24 h

 

Sensors can be placed anywhere in thorax and back

 

Bioimpedence

Continuous

Numerous mathematical assumptions

 

Difficult to set up

Signal stability fails after 24 h

Flick's Principle

Easy set up

Not suitable for unstable patient

 

Provides additional ventilatory parameters

Shunt can affect CO estimation

  1. CVP central venous pressure, BP blood pressure, CO cardiac output, PCA pulse contour analysis, ICU intensive care unit, SVV stroke volume variation, PPV pulse pressure variation, GEDV global end diastolic volume, EVLW extravascular lung water, SVR systemic vascular resistance, CO cardiac output, AR aortic regurgitation, NDM non-depolarizing muscle relaxant, PAC pulmonary artery catheter