Non-invasive assessment of hemodynamics
Forrtová, M.
Rozhledy V Chirurgii Mesicnik Ceskoslovenske Chirurgicke Spolecnosti 81(12): 609-612
2002
ISSN/ISBN: 0035-9351 PMID: 12666472 Document Number: 548543
The objective of the work is to present different ways of haemodynamic monitoring, in particular assessment of the cardiac output (CO). Quantitative evaluation of haemodynamic functions is the basic prerequiste of successful treatment of critically ill patients. The extension of haemodynamic monitoring is associated above all with the use a catheter of the pulmonary artery since the seventies of the 20th century. Assessment of CO serves evaluation of the state of the cardiovascular system, assessment of systemic and pulmonary vascular resistance and is one of the basic determinants of oxygen supply to tissues. Ideal technology of CO assessment should be non-invasive, the assessment should be continuous, accurate and safe. At present none of the methods meet all these criteria. The author mentions first invasive techniques of CO assessment, intermittent as well as continuous ones. These methods are either based on Fick's method or on analysis of the pulse wave. The main part of the paper is devoted to non-invasive CO assessment. It deals with the principles of these methods, their development and use in contemporary therapy of critically ill patients. Great attention is paid to one of the most recent methods of CO monitoring by means of a NICO2 apparatus. There the calculation of CO is based on gas analyses and uses the differential form of Fick's equation. Individual haemodynamic data help us to assess the patient's haemodynamic profile. Monitoring facilitates the selection of suitable therapy and the follow up of its success during treatment. Recently non-invasive techniques are applied more extensively in particular because of their safety. Major development is recorded in particular in the sphere of electrocardiography, the NICO2 apparatus is also promising.