الفهرس 
PHYSIOLOGY OF CARDIAC OUTPUTOnly 14 pages are availabe for public view
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Abstract
The aim of cardiovascular monitoring is to warn the
anesthesiologist in the OR and ICU about any early hemodynamic
instability or impending circulatory failure. Cardiac output monitoring is
the most reliable technique for assessing cardiovascular system.
Many methods developed for cardiac output measurements, which
are either invasive, minimally invasive or non-invasive. Thermodilution
technique was used for many years for cardiac output monitoring as it is
accurate and more popular since Swan and Ganz introduced the
pulmonary artery catheter. However, this technique showed many
complications, some of which may be fatal (eg. Pulmonary artery
rupture).
Many non-invasive methods of cardiac output monitoring have
been developed in the last few years especially in advances in technology,
sensor designs and interpretation of data giving these methods the
advantage of being non-invasive, providing online, continuous
measurements with trends to follow disease progression.
Most of these techniques had been discussed during the study
including:
(1) Minimally Invasive monitors:
a- Transesophageal Doppler
b- Pulse contour and pulse power analysis
c- Transesophageal echocardiography
d- Partial CO2 rebreathing technique
(2) Non-invasive monitors
a- USCOM
Summary
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b- Thoracic Electric Bioimpedance
c- Non-invasive arterial pressure analysis
d- Electrical velocimetry.
It is clear from this review of literature that the PAC is too invasive
and carries a lot of risks and potential for serious complications. The
minimally invasive and the non-invasive devices carry a much lower risk
of complications but still suffer from inaccuracies and shortcomings and
similar to the PAC, they still lack the impact on patients’ outcome.
Unfortunately, the ideal cardiac output monitor is still illusive. Hopefully,
in the near future the advances in technology will help the ideal cardiac
output monitor to materialize.