Az ICON® elektromos kardiometrián alapuló nem invazív hemodinamikai monitor használata a klinikumban

Abstract

Establishment of a proper hemodynamic monitoring system in order to achieve optimal care among critically ill patients is fundamental. In contrast to invasive patient-checking systems, which were introduced decades ago and used in both adult and pediatric intensive care, the non-invasive methods have become more popular in recent years due to technical advancements in intensive care and patient monitoring. This increase in popularity can be attributed to the higher degree of safety and reduced complication rates as well as to its being more economical. Our summary focuses on the ICON® patient monitoring system. This newly engineered, non-invasive tool is based on electrical cardiometry, and uses hemodynamic parameters in both neonatal and pediatric care as well as in adults. The operating principle is simple: the conductivity of the blood in the aorta shows time-dependent changes. Prior to the opening of the aortic valve, the orientation of the red blood cells (RBCs) is random, and it is not until the contraction of the aorta that the RBCs and the opening of the aortic valve achieve a parallel position. The tool senses the conductivity between four placed electrodes, and measures the stroke volume (SV) and cardiac output (CO), before calculating other additional parameters (eg.: systemic vascular resistance) by tracing the variation of bioimpedance according to changes in the heart cycle. The most important advantages of ICON® are the measurements that are made available immediately as well as continuously, and the low complication rate that originates from its non-invasive operation. ICON® is a new, promising hemodynamic device in the tool belt of intensive care. Due to the nature of the device, it is possible to evaluate the status of the patient on a continuous basis, allowing for optimal care. To identify the more accurate clinical indications further measures will be necessary. Orv Hetil. 2018; 159(44): 1775–1781.

Neonatal Hemodynamics: Relevance to Research and Clinical Comprehension Review

“…This tool senses the cardiac output, stroke volume, systemic vascular resistance and other parameters continuously and immediately, thereby becoming the advantageous device in the monitoring belt of the neonatal intensive care. 28 It is found to be helpful in reporting hemodynamic instability before clinical worsening of the critical patients, thereby helping in taking decisions before time. 29 Gatelli et al presented a case of preterm male infant (1,475 g) born via caesarean section due to prolonged premature membrane rupture induced labor.…”

“…Abbreviations: IVC= Inferior vena cava; POCUS= Point of care ultrasound. 28 It is found to be helpful in reporting hemodynamic instability before clinical worsening of the critical patients, thereby helping in taking decisions before time. 29 Gatelli et al presented a case of preterm male infant (1,475 g) born via caesarean section due to prolonged premature membrane rupture induced labor.…”

Assessing Passive Leg Raise Test in Pediatric Shock Using Electrical Cardiometry

“…In doing so, indices of hemodynamic function such as SV and CO (among others) can be estimated while minimizing the risk associated with more invasive monitoring modalities. 21,22 EC has shown increasing promise in its accuracy and reliability in both critically ill and perioperative populations. [23][24][25] Though previously our team had explored the use of EC in determining hemodynamic changes following fluid bolus in children with shock, 16 we wanted to assess PLR using EC in the pediatric cohort.…”

“…In doing so, indices of hemodynamic function such as SV and CO (among others) can be estimated while minimizing the risk associated with more invasive monitoring modalities. 21 22 EC has shown increasing promise in its accuracy and reliability in both critically ill and perioperative populations. 23 24 25…”