Multicomponent noninvasive physiologic monitoring of circulatory function

Shoemaker, William C.; Appel, Paul L.; Kram, Harry B.; Nathan, Ragu C.; Thompson, Jeffrey L.

doi:10.1097/00003246-198805000-00004

Cited by 66 publications

(25 citation statements)

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“…Results from comparative studies have been poor, with reported limits of agreement of 40-60% [29][30][31]. This failure is probably caused by excessive lung fluid [9].…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…In patients who have suffered acute myocardial infarction [26], undergoing cardiac catheterisation [27] or neurosurgery [20,28], agreement with thermodilution has been acceptable (Ϯ 20-30%). However, unacceptable limits of agreement of Ϯ 40-60% have been repeatedly found in critically ill patients [29][30][31]. In general, results from studies in critically ill patients have shown that TEB cardiac output, when compared to thermodilution, over-estimates at low cardiac outputs and under-estimates at high cardiac outputs [32].…”

Section: A Summary Of Evaluation Studiesmentioning

confidence: 99%

“…In general, results from studies in critically ill patients have shown that TEB cardiac output, when compared to thermodilution, over-estimates at low cardiac outputs and under-estimates at high cardiac outputs [32]. This effect appears to be worse in severe sepsis and during positive pressure ventilation [30,31,33].…”

Section: A Summary Of Evaluation Studiesmentioning

confidence: 99%

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Impedance cardiographyThe impact of new technology

Critchley

1998

Anaesthesia

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SummaryThe 1990s have witnessed major advances in impedance cardiography technology. Problems existed with the methods used to calculate cardiac output. Excessive lung fluid, as often found in critically ill patients, may also invalidate measurements. The signal processing and measurement techniques used in older systems were deficient. The newer systems, of which there are at least six, incorporate novel and improved signal processing techniques. They also offer analog visual displays, personal computer interfacing, sophisticated analytical software and haemodynamic patient management systems. Evaluation of these systems is difficult because no true 'gold standard' method of cardiac output measurement exists. When compared with thermodilution techniques, limits of agreement of Ϯ 20-30% seem acceptable. These limits can be achieved in normal subjects but not in critically ill patients. Validation data are available for only half of the new systems. Until recently, the main application for impedance cardiography has been research but improved accuracy should lead to increased clinical usage.

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“…Results from comparative studies have been poor, with reported limits of agreement of 40-60% [29][30][31]. This failure is probably caused by excessive lung fluid [9].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Section: A Summary Of Evaluation Studiesmentioning

confidence: 99%

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Impedance cardiographyThe impact of new technology

Critchley

1998

Anaesthesia

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“…23,24 In general, the ICG measurement can be used to put the findings of the traditional vital signs into a more complete systems-analysis perspective. 25 Clinical Monitoring. Evaluating and monitoring patients for hemodynamic stability are an important part of the practice of emergency medicine.…”

Section: Clinical Applications In Emergency Medicinementioning

confidence: 99%

“…21,[29][30][31][32][33][34][35][36] Invasive hemodynamic parameters obtained by pulmonary artery (PA) catheterization, and other methods to define survivors' patterns, have been reported to provide criteria for therapeutic goals in critically ill patients. 25,29,32,33 When noninvasive hemodynamic measurements have been used in the ED to guide early shock management, there is a significant impact on the progression to organ failure and mortality. 33,34 Similar measurements and calculated endpoints derived from ICG monitoring have been used to improve management, outcomes, and survival in patients with shock, congestive heart failure, and hypertension.…”

Section: Outcomes Studiesmentioning

confidence: 99%

Bench to Bedside: Electrophysiologic and Clinical Principles of Noninvasive Hemodynamic Monitoring Using Impedance Cardiography

Summers

Shoemaker

Peacock

et al. 2003

Academic Emergency Medicine

Self Cite

114

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The evaluation of the hemodynamic state of the severely ill patient is a common problem in emergency medicine. While conventional vital signs offer some insight into delineating the circulatory pathophysiology, it is often impossible to determine the true clinical state from an analysis of blood pressure and heart rate alone. Cardiac output measurements by thermodilution have been the criterion standard for the evaluation of hemodynamics. However, this technology is invasive, expensive, time-consuming, and impractical for most emergency department environments. Impedance cardiography (ICG) is a noninvasive method of obtaining continuous measurements of hemodynamic data such as cardiac output that requires little technical expertise. ICG technology was first developed by NASA in the 1960s and is based on the idea that the human thorax is electrically a nonhomogeneous, bulk conductor. Variation in the impedance to flow of a high-frequency, low-magnitude alternating current across the thorax results in the generation of a measured waveform from which stroke volume can be calculated by a modification of the pulse contour method. To adequately judge the possible role of this technology in the practice of emergency medicine, it is important to have a sufficient understanding of the basic scientific principles involved as well as the clinical validity and limitations of the technique.

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Noninvasive monitoring of peripheral perfusion

Lima¹,

Bakker²

Applied Physiology in Intensive Care Medicine

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Multicomponent noninvasive physiologic monitoring of circulatory function

Cited by 66 publications

References 0 publications

Impedance cardiographyThe impact of new technology

Impedance cardiographyThe impact of new technology

Bench to Bedside: Electrophysiologic and Clinical Principles of Noninvasive Hemodynamic Monitoring Using Impedance Cardiography

Noninvasive monitoring of peripheral perfusion

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