Noninvasive cardiac output monitoring (NICOM): a clinical validation

Squara, Pierre; Denjean, Dominique; Estagnasié, Philippe; Brusset, Alain; Dib, Jean-Claude; Dubois, Claude

doi:10.1007/s00134-007-0640-0

Cited by 282 publications

(211 citation statements)

References 19 publications

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“…Transthoracic bioreactance is a recently introduced technology that allows for the noninvasive measurement of CO (NICOM1; Cheetah Medical Inc., Portland, OR, USA) [5,6]. The bioreactance signal is determined by measuring blood flow-dependent changes in the phase shifts between an oscillating electrical current applied across the thorax and the resulting voltage signal.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive cardiac output measurements in patients with pulmonary hypertension

2012

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Pulmonary hypertension (PH) is characterised by a progressive decline in cardiac output (CO) and right heart failure. NICOM1 (noninvasive cardiac output monitor) is a bioreactance-based technology that has been broadly validated, but its specific application in right heart failure and PH is unknown.Cardiac catheterisation was performed in 50 consecutive patients with PH. CO measurements were performed using three different methods (thermodilution, Fick and NICOM) at baseline and after vasodilator challenge. We compared the precision (coefficient of variation) and accuracy of NICOM compared to thermodilution and Fick.The mean CO (L?min -1 ) at baseline as measured by the three methods was 4.73¡1.15 (NICOM), 5.69¡1.74 (thermodilution) and 4.84¡1.39 (Fick). CO measured by NICOM was more precise than by thermodilution (3.5¡0.3% versus 9.6¡6.1%, p,0.001). Bland-Altman analyses comparing NICOM to thermodilution and Fick revealed bias and 95% limits of agreement that were comparable to those comparing Fick to thermodilution. All three CO methods detected an increase in CO in response to vasodilator challenge.CO measured via NICOM is precise and reliably measures CO at rest and changes in CO with vasodilator challenge in patients with PH. NICOM may allow for the noninvasive haemodynamic assessment of patients with PH and their response to therapy. @ERSpublications Cardiac output measurements allow for haemodynamic assessment of patients with PH and their response to therapy

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Section: Introductionmentioning

confidence: 99%

Noninvasive cardiac output measurements in patients with pulmonary hypertension

2012

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“…Reproducibility of haemodynamic measures at rest and their response to stress in heart failure using a non‐invasive gas rebreathing technology has been previously reported 19. In post‐cardiac surgery patients, the bioreactance method was validated against thermodilution with a strong relationship reported between the two methods 24. Myers et al .…”

Section: Discussionmentioning

confidence: 89%

A novel cardiac output response to stress test developed to improve diagnosis and monitoring of heart failure in primary care

et al. 2018

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AimsPrimary care physicians lack access to an objective cardiac function test. This study for the first time describes a novel cardiac output response to stress (CORS) test developed to improve diagnosis and monitoring of heart failure in primary care and investigates its reproducibility.Methods and resultsProspective observational study recruited 32 consecutive primary care patients (age, 63 ± 9 years; female, n = 18). Cardiac output was measured continuously using the bioreactance method in supine and standing positions and during two 3 min stages of a step‐exercise protocol (10 and 15 steps per minute) using a 15 cm height bench. The CORS test was performed on two occasions, i.e. Test 1 and Test 2. There was no significant difference between repeated measures of cardiac output and stroke volume at supine standing and Stage 1 and Stage 2 step exercises (all P > 0.3). There was a significant positive relationship between Test 1 and Test 2 cardiac outputs (r = 0.92, P = 0.01 with coefficient of variation of 7.1%). The mean difference in cardiac output (with upper and lower limits of agreement) between Test 1 and Test 2 was 0.1 (−1.9 to 2.1) L/min, combining supine, standing, and step‐exercise data.ConclusionsThe CORS, as a novel test for objective evaluation of cardiac function, demonstrates acceptable reproducibility and can potentially be implemented in primary care.

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“…These frequency changes correlate well with instantaneous changes in blood volume and blood flow in the aorta. Bioreactance was validated in various nonpregnant populations which manifested hemodynamic instability, [19][20][21] and it has been shown to produce hemodynamic profiles in the pregnant population consistent with other more invasive forms of monitoring. 22 Noninvasive CO monitoring provides continuous HR data, performs noninvasive blood pressure measurements at one-minute intervals, and records one-minute running averages of CO, stroke volume, SVV, and TPR.…”

Section: Discussionmentioning

confidence: 97%

“…22 Noninvasive CO monitoring provides continuous HR data, performs noninvasive blood pressure measurements at one-minute intervals, and records one-minute running averages of CO, stroke volume, SVV, and TPR. Noninvasive CO monitoring appears to report directional changes in CO well, 19,20 but the absolute values in pregnancy are not well validated. Therefore, in our view, the trends seen in this report may be of greater importance than the absolute CO values.…”

Section: Discussionmentioning

confidence: 99%