Accuracy of non-invasive and minimally invasive hemodynamic monitoring: where do we stand?

Abstract

One of the most important variables in assessing hemodynamic status in the intensive care unit (ICU) is the cardiac function and blood pressure. Invasive methods such as pulmonary artery catheter and arterial line allow monitoring of blood pressure and cardiac function accurately and reliably. However, their use is not without drawbacks, especially when the invasive nature of these procedures and complications associated with them are considered. There are several newer methods of noninvasive and minimally invasive hemodynamic monitoring available. In this manuscript, we will review these different methods of minimally invasive and non-invasive hemodynamic monitoring and will discuss their advantages, drawbacks and limitations.

Implementation and Calibration of a Deep Neural Network to Predict Parameters of Left Ventricular Systolic Function Based on Pulmonary and Systemic Arterial Pressure Signals

“…With respect to ventricular ejection fraction, it is worth mentioning that its measurement by standard modern techniques (cardiac computerized tomography, radionucleotide and invasive ventriculography, echocardiography or magnetic resonance imaging) presents a bias of less than 5% (Pickett et al, 2015 ), which reinforces the relevance of our model, which leads to a relative error smaller than 2%. Finally, new devices and non-invasive approaches for continuous pressure measurement may broaden the applicability of the presented framework (Proena et al, 2016 ), while new methods for haemodynamic monitoring could provide innovative perspectives (Pour-Ghaz et al, 2019 ).…”

Blood Pressure Sensors: Materials, Fabrication Methods, Performance Evaluations and Future Perspectives

“…Minimally-invasive blood pressure measurement is based on nonvascular implantable miniaturized sensors that are compatible with body tissues, and these devices can provide real-time monitoring of the cardiac cycle [69], including intravascular [70], intraocular [71] and intracranial [72] using different MEMS-based implantable blood pressure sensors including Au-PI diaphragms [73] and Si nanomembranes [74]. The accuracy of a minimally invasive approach, in contrast to the invasive, is still controversial, and it may be due to the drift in sensitivity over a long time that affects long-term accuracy [75].…”

Comparison of cardiac output estimates by echocardiography and bioreactance at rest and peak dobutamine stress test in heart failure patients with preserved ejection fraction

“…5,13 However, their acceptability has been limited by inaccuracy and unreliability. 12,14 An ideal cardiac output monitor should be easy to use, valid, reliable, reproducible, noninvasive, cheap with fast response time. 12,15 Recently, there has been a lot of clinical and research focus on two-dimensional echocardiography and bioreactance derived cardiac output monitoring in various clinical scenario.…”

“…12,14 An ideal cardiac output monitor should be easy to use, valid, reliable, reproducible, noninvasive, cheap with fast response time. 12,15 Recently, there has been a lot of clinical and research focus on two-dimensional echocardiography and bioreactance derived cardiac output monitoring in various clinical scenario. [16][17][18] Echocardiography has emerged as an important tool in the diagnosis, management, and prognostication of patients of heart failure and is the most utilized noninvasive tool in clinical and research setting.…”

“…Since the discovery of invasive cardiac output measurement by Adolf Fick in 1870, 10 and the subsequent introduction a century later, of the Swan Ganz pulmonary artery catheterization based on bolus thermodilution, 11 other newer minimally invasive and noninvasive techniques have been discovered. These newer techniques are such as pulse contour analysis, esophageal Doppler, inert gas rebreathing, thoracic bioimpedance, thoracic bioreactance, and echo Doppler method 12 limit risks associated with infections, arrhythmia, complications of central line insertion, and also cost 5,13 …”