TY  - CHAP
M1  - Book, Section
TI  - Chapter 41. Noninvasive Cardiac Output Monitoring
A1  - Smith, Sarah C.
A2  - Atchabahian, Arthur
A2  - Gupta, Ruchir
PY  - 2013
T2  - The Anesthesia Guide
AB  - Table  Graphic  Jump  Location|Download  (.pdf)|PrintComparison  of  Available  Noninvasive  Cardiac  Output  MonitorsAdvantagesLimitationsTruly  noninvasive?CO2  Fick  principle,  for  example,  NICO®Good  agreement  between  NICO®  and  ultrasound  transit  timePatient  may  be  breathing  spontaneously  or  on  a  ventilatorAccuracy  adversely  affected  by  hyperventilation  and  V/Q  mismatch  (preexisting  lung  disease  or  postoperative  atelectasis)Yes;  however,  patient  must  be  intubatedEsophageal  Doppler,  for  example,  CardioQ  (single  use),  WAKIe  TO  (reusable)High  validity  for  monitoring  changes  in  cardiac  output  in  critically  ill  patientsUsing  esophageal  Doppler  to  optimize  fluid  management  has  been  shown  to  improve  outcomesPatient  must  be  intubated  and  sedatedSmall  risk  of  injury  to  the  esophagusLimited  agreement  with  thermodilutionNo,  requires  placement  of  probe  in  the  esophagusTranspulmonary  lithium  dilution,  for  example,  LiDCOHigh  signal-to-noise  ratioGood  agreement  with  thermodilutionLow  risk  of  toxicityNot  approved  for  patients  15%  indicating  fluid  responsivenessEasy  to  useAdversely  affected  by  a  poor  arterial  waveform  (arrhythmia,  intra-aortic  balloon  pump)Older  devices  may  not  adequately  compensate  for  changes  in  vascular  toneNewer  devices  have  good  agreement  with  thermodilution  and  esophageal  DopplerNo,  requires  an  intra-arterial  lineBioimpedance,  for  example,  Cheetah  NICOM®,  BioZ  Dx®Completely  noninvasiveImpedance  to  high-frequency  current  between  electrodes  on  chest;  estimates  thoracic  blood  volumeRelative  hemodynamic  stability  requiredAccuracy  reduced  by  arrhythmias,  aortic  insufficiency,  intra-aortic  balloon  pumpContraindicated  in  patients  with  pacemakersYes,  adhesive  surface  electrodes  only  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=57260834
ER  -