Perioperative Cardiac Output Monitoring

Abstract

The hemodynamic status monitoring of high-risk surgical patients and critically ill patients is one of the main objectives of their therapeutic management. One of the mostimportant parameters for cardiac function monitoring is CO.

CO measurement has long been considered essential to the assessment and guidance of therapeutic decisions in critically ill patients, by providing an indirect indication of systemic DO2 and global tissue perfusion. Perioperative CO monitoring has become nearly routine for certain high-risk patients and in major surgeries, where large fluid shifts are expected.

There are multiple monitoring techniques which can be used for CO monitoring. The PACis the clinical standard for perioperative CO monitoring. Invasiveness and complications associated with PAC led to development of newer methods which are minimally or non-invasive.

An ideal CO monitor should becontinuous, cost effective,provide accurate and reproducible measurement of relevant haemodynamic variables, supposed to be easy to use, readily available, operator-independent, cause no harm (minimally or non-invasive) and reliable during various physiological statesand have fast response time. Advances in the computersoftware and hardware have led to development of newermethods of CO monitoring with minimal or no vascularaccess.