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Cardiothoracic and Vascular Anesthesia
Anesthesia and Pain Medicine 2014;9(2):87-92.
Published online April 30, 2014.
Recent trend in cardiac output monitoring and trans-cardiopulmonary thermodilution-derived hemodynamic parameters
Gyu Sam Hwang
Department of Anesthesiology and Pain Medicine, Laboratory for Cardiovascular Dynamics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kshwang@amc.seoul.kr
Received: 10 March 2014   • Revised: 20 March 2014
Abstract
Currently, hemodynamic monitoring system is developing rapidly, with many different devices now available, which makes anesthesiologists feel somewhat confused by the various possibilities and issue of noninvasiveness. By the order of degree of invasiveness, these devices can be classified into the highly invasive pulmonary artery catheter and the completely noninvasive bioimpedance/bioreactance technique and Doppler echocardiography. Recently, trans-cardiopulmonary thermodilution-derived hemodynamic parameters, such as global end-diastolic volume, global ejection fraction, cardiac function index, extravascular lung water, pulmonary vascular permeability index and its cardiac output, are available in anesthetic practice by PiCCO(R)(Pulsion Medical Systems) and VolumeView(R) (Edwards Life Sciences). This article provides objective review of the monitoring systems, as well as the advantages and limitations, in order to offer better management of the critically ill patients undergoing surgery.
Key Words: Cardiac output, Extravascular lung water index, Transpulmonary thermodilution
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