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Minimally invasive cardiac output technologies in the ICU: putting it all together

Clement, Ramon P.a; Vos, Jaap J.b; Scheeren, Thomas W.L.b

Current Opinion in Critical Care: August 2017 - Volume 23 - Issue 4 - p 302–309
doi: 10.1097/MCC.0000000000000417
CARDIOVASCULAR SYSTEM: Edited by Thomas W.L. Scheeren

Purpose of review Haemodynamic monitoring is a cornerstone in the diagnosis and evaluation of treatment in critically ill patients in circulatory distress. The interest in using minimally invasive cardiac output monitors is growing. The purpose of this review is to discuss the currently available devices to provide an overview of their validation studies in order to answer the question whether these devices are ready for implementation in clinical practice.

Recent findings Current evidence shows that minimally invasive cardiac output monitoring devices are not yet interchangeable with (trans)pulmonary thermodilution in measuring cardiac output. However, validation studies are generally single centre, are based on small sample sizes in heterogeneous groups, and differ in the statistical methods used.

Summary Minimally and noninvasive monitoring devices may not be sufficiently accurate to replace (trans)pulmonary thermodilution in estimating cardiac output. The current paradigm shift to explore trending ability rather than investigating agreement of absolute values alone is to be applauded. Future research should focus on the effectiveness of these devices in the context of (functional) haemodynamic monitoring before adoption into clinical practice can be recommended.

aDepartment of Critical Care

bDepartment of Anaesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

Correspondence to Thomas W.L. Scheeren, MD, PhD, Department of Anaesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, The Netherlands. Tel: +31 50 3616161; fax: +31 50 361 9986; e-mail:

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