Pulmonary Carbon Dioxide Elimination for Cardiac Output Monitoring in Peri-operative and Critical Care Patients: History and Current Status

Peyton, Philip J.

doi:https://doi.org/10.1260/2040-2295.4.2.203

Journal of Healthcare Engineering

On this page

Abstract References Copyright Related Articles

Research Article | Open Access

Volume 4 | Article ID 632925 | https://doi.org/10.1260/2040-2295.4.2.203

Pulmonary Carbon Dioxide Elimination for Cardiac Output Monitoring in Peri-operative and Critical Care Patients: History and Current Status

Philip J. Peyton¹

Received01 Sept 2012

Accepted01 Dec 2012

Abstract

Minimally invasive measurement of cardiac output as a central component of advanced haemodynamic monitoring has been increasingly recognised as a potential means of improving perioperative outcomes in patients undergoing major surgery. Methods based upon pulmonary carbon dioxide elimination are among the oldest techniques in this field, with comparable accuracy and precision to other techniques. Modern adaptations of these techniques suitable for use in the perioperative and critical are environment are based on the differential Fick approach, and include the partial carbon dioxide rebreathing method. The accuracy and precision of this approach to cardiac output measurement has been shown to be similar to other minimally invasive techniques. This paper reviews the underlying principles and evolution of the method, and future directions including recent adaptations designed to deliver continuous breath-by-breath monitoring of cardiac output.

References

A. Donati, S. Loggi, J. C. Preiser et al., “Goal-directed introperative therapy reduces morbidity and length of hospital stay in high-risk surgical patients,” Chest, vol. 132, no. 6, pp. 1817–24, 2007.
View at: Google Scholar
M. Bundgaard-Nielsen, K. Holte, N. H. Secher, and H. Kehlet, “Monitoring of peri-operative fluid administration by individualized goal-directed therapy,” Acta Anaesthesiol Scand, vol. 51, pp. 331–340, 2007.
View at: Google Scholar
D. Chappell, M. Jacob, K. Hofmann-Kiefer, P. Conzen, and M. Rehm, “A Rational Approach to Perioperative Fluid management,” Anesthesiology, vol. 109, no. 4, pp. 723–40, 2008.
View at: Google Scholar
N. N. Rahbari, J. B. Zimmermann, T. Schmidt, M. Koch, M. A. Weigand, and J. Weitz, “Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery,” British Journal of Surgery, vol. 96, pp. 331–41, 2009.
View at: Google Scholar
I. Chytra, R. Pradl, R. Bosman, P. Pelnář, E. Kasal, and A. Židková, “Esophageal Doppler-guided fluid management decreases blood lactate levels in multiple-trauma patients: a randomized controlled trial,” Critical Care, vol. 11: R24, 2007.
View at: Google Scholar
S. M. Abbas and A. G. Hill, “Systematic review of the literature for the use of oesophageal Doppler monitor for fluid replacement in major abdominal surgery,” Anaesthesia, vol. 63, pp. 44–51, 2008.
View at: Google Scholar
A. M. Roche, T. E. Miller, and T. J. Gan, “Goal-directed fluid management with trans-oesophageal Doppler,” Best Practice & Research Clinical Anaesthesiology, vol. 23, pp. 327–334, 2009.
View at: Google Scholar
S. T. Gurgel and P. do Nascimento, “Maintaining Tissue Perfusion in High-Risk Surgical Patients: A Systematic Review of Randomized Clinical Trials,” Anesth Analg, vol. 112, pp. 1384–91, 2011.
View at: Google Scholar
M. A. Hamilton, M. Cecconi, and A. Rhodes, “A systematic review and meta-analysis on the use of preemptive hemodynamic intervention to improve postoperative outcomes in moderate- and high-risk surgical patients,” Anesth Analg, vol. 112, pp. 1392–402, 2011.
View at: Google Scholar
T. Corcoran, J. E. Rhodes, S. Clarke, P. S. Myles, and K. M. Ho, “Perioperative fluid management strategies in major surgery: a stratified meta-analysis,” Anesth Analg, vol. 114, no. 3, pp. 640–51, 2012.
View at: Google Scholar
A. F. Connors Jr, T. Speroff, N. V. Dawson et al., “The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators,” JAMA, vol. 18, 276, no. 11, pp. 889–97, 1996.
View at: Google Scholar
R. S. Wiener and H. G. Welch, “Trends in the use of the pulmonary artery catheter in the United States, 1993-2004,” JAMA, vol. 298, no. 4, pp. 423–9, Jul 25, 2007.
View at: Google Scholar
B. S. Cowie, “Does the pulmonary artery catheter still have a role in the perioperative period?” Anaesth Intensive Care, vol. 39, pp. 345–355, 2011.
View at: Google Scholar
D. J. Funk, E. W. Moretti, and T. J. Gan, “Minimally Invasive Cardiac Output Monitoring in the Perioperative Setting,” Anesth Analg, vol. 108, pp. 887–97, 2009.
View at: Google Scholar
A. Fick, “Uber die messung des Blutquantums in den Hertzventrikeln,” Sitzber Physik Med Ges, Wurzburg July 9th, 36: 1870.
View at: Google Scholar
A. Krogh and J. ALindhard, “Measurements of the blood flow through the lungs of man,” Scand Arch Physiol, vol. 27, pp. 100–125, 1912.
View at: Google Scholar
G. Laszlo, “Respiratory measurements of cardiac output: from elegant idea to useful test,” J Appl Physiol, vol. 96, pp. 428–437, 2004.
View at: Google Scholar
T. S. Kim, H. Rahn, and L. E. Farhi, “Estimation of true venous and arterial PCO₂ by gas analysis of a single breath,” J Appl Physiol, vol. 21, pp. 1338–1344, 1966.
View at: Google Scholar
C. Collier, “Determination of mixed venous CO₂ tensions by rebreathing,” J Appl Physiol, vol. 9, pp. 25–29, 1956.
View at: Google Scholar
J. G. Defares, “Determination of PvCO₂ From the exponential CO₂ Rise During Rebreathing,” J Appl Physiol, vol. 13, no. 2, pp. 159–64, 1958.
View at: Google Scholar
K. Espersen, E. W. Jensen, D. Rosenborg et al., “Comparison of cardiac output measurement techniques: thermodilution, Doppler, CO₂-rebreathing and direct Fick method,” Acta Anaesthesiol Scand, vol. 39, pp. 245–51, 1995.
View at: Google Scholar
A. J. Olszowka, B. E. Shykoff, D. R. Pendergast, C. E. Lundgren, and L. E. Farhi, “Cardiac output: a view from Buffalo,” Eur J Appl Physiol, vol. 90, no. 3-4, pp. 292–304, Oct 2003.
View at: Google Scholar
A. J. Olszowka, B. E. Shykoff, D. R. Pendergast, and L. E. Farhi, “Revised one-step method for determination of cardiac output,” Respir Physiol Neurobiol, vol. 140, no. 1, pp. 99–109, 2004.
View at: Google Scholar
W. T. Cade, S. R. Nabar, and R. E. Keyser, “Reproducibility of the exponential rise technique of CO₂ rebreathing for measuring PvCO₂ and CvCO₂ to non-invasively estimate cardiac output during incremental, maximal treadmill exercise,” Eur J Appl Physiol, vol. 91, no. 5-6, pp. 669–76, 2004.
View at: Google Scholar
H. Noguchi, Y. Ogushi, I. Yoshiya, N. Itakura, and H. Yamabayashi, “Breath-by-breath and require compensation for transport delay and dynamic response. J Appl Physiol Respirat Environ,” Exercise Physiol, vol. 51, no. 6, pp. 1662–75, 1981.
View at: Google Scholar
W. Beaver, N. Lamarra, and K. Wasserman, “Breath-by-breath measurement of true alveolar gas exchange,” J Appl Physiol Respirat Environ. Exercise Physiol, vol. 46, no. 6, pp. 1122–6, 1979.
View at: Google Scholar
H. U. Wessel, R. L. Stout, C. K. Bastanier, and M. H. Paul, “Breath-by breath variation of FRC: effect on VO₂ and VCO₂ measured at the mouth,” J Appl Physiol Respirat Environ. Exercise Physiol, vol. 46, no. 6, pp. 1122–6, 1979.
View at: Google Scholar
J. M. Capek and R. J. Roy, “Noninvasive Measurement of Cardiac Output During Partial CO₂ Rebreathing,” IEEE Transactions on Biomedical Engineering, vol. 35, pp. 653–61, 1988.
View at: Google Scholar
A. Gedeon, L. Forslund, G. Hedenstierna, and E. Romano, “A new method for noninvasive bedside determination of pulmonary blood flow,” Med Biol Eng Comput, vol. 18, pp. 411–18, 1980.
View at: Google Scholar
G. R. Kelman, “Digital computer subroutine for the conversion of oxygen tension into saturation,” J Appl Physiol, vol. 21, no. 4, pp. 1375–1376, 1966.
View at: Google Scholar
G. R. Kelman, “Digital computer procedure for the conversion of PCO₂ into blood CO₂ content,” Respir Physiol, vol. 3, pp. 111–115, 1967.
View at: Google Scholar
J. Nunn, “Nunn's Applied Respiratory Physiology,” 4th Ed, Butterworth-Heinemann, 1993, 183-4.
View at: Google Scholar
R. J. Bosman, C. P. Stountenbeek, and D. F. Zandstra, “Non-invasive pulmonary blood flow measurement by means of CO₂ analysis of expiratory gases,” Intensive Care Med, vol. 17, pp. 98–102, 1991.
View at: Google Scholar
H. Blomqvist, C. Frostell, and G. Hedenstierna, “A non-invasive technique for measurement of lung perfusion,” Intensive Care Med, vol. 12, pp. 172–8, 1986.
View at: Google Scholar
J. Capek and R. Roy, “Encyclopedia of Medical Devices and Instrumentation,” J. G. Webster, Ed., pp. 1309–10, Wiley, N. Y., 1988.
View at: Google Scholar
J. Binder and W. Parkin, “Non-Invasive Cardiac Output Determination: Comparison of a New Partial-Rebreathing Technique with Thermodilution,” Anaesth Intensive Care, vol. 29, pp. 19–23, 2001.
View at: Google Scholar
C. J. Killick and W. G. Parkin, “Non-invasive cardiac output measurement using a fast mixing box to measure carbon dioxide elimination,” Anaesth Intensive Care, vol. 36, pp. 665–73, 2008.
View at: Google Scholar
M. B. Jaffe, “Partial CO₂ rebreathing cardiac output—operating principles of the NICO system,” J Clin Monit Comput, vol. 15, pp. 387–401, 1999.
View at: Google Scholar
Y. Kotake, T. Yamada, H. Nagata et al., “Improved accuracy of cardiac output estimation by the partial CO₂ rebreathing method,” J Clin Monit Comput, vol. 23, pp. 149–55, 2009.
View at: Google Scholar
J. M. Ng, M. Y. Chow, P. C. Ip-Yam, M. H. Goh, and T. Agasthian, “Evaluation of partial carbon dioxide rebreathing cardiac output measurement during thoracic surgery,” J Cardiothorac Vasc Anesth, vol. 21, pp. 655–8, 2007.
View at: Google Scholar
K. Tachibana, H. Imanaka, M. Takeuchi, T. Nishida, Y. Takauchi, and M. Nishimura, “Effects of reduced rebreathing time, in spontaneously breathing patients, on respiratory effort and accuracy in cardiac output measurement when using a partial carbon dioxide rebreathing technique: A prospective observational study,” Crit Care, vol. 9, pp. R569–74, 2005.
View at: Google Scholar
M. Rocco, G. Spadetta, A. Morelli et al., “A comparative evaluation of thermodilution and partial CO₂ rebreathing techniques for cardiac output assessment in critically ill patients during assisted ventilation,” Intensive Care Med, vol. 30, pp. 82–7, 2004.
View at: Google Scholar
K. Tachibana, H. Imanaka, M. Takeuchi, Y. Takauchi, H. Miyano, and M. Nishimura, “Noninvasive cardiac output measurement using partial carbon dioxide rebreathing is less accurate at settings of reduced minute ventilation and when spontaneous breathing is present,” Anesthesiology, vol. 98, pp. 830–7, 2003.
View at: Google Scholar
Y. Kotake, K. Moriyama, Y. Innami et al., “Performance of noninvasive partial CO₂ rebreathing cardiac output and continuous thermodilution cardiac output in patients undergoing aortic reconstruction surgery,” Anesthesiology, vol. 99, pp. 283–8, 2003.
View at: Google Scholar
K. Tachibana, H. Imanaka, H. Miyano, M. Takeuchi, K. Kumon, and M. Nishimura, “Effect of ventilatory settings on accuracy of cardiac output measurement using partial CO₂ rebreathing,” Anesthesiology, vol. 96, pp. 96–102, 2002.
View at: Google Scholar
G. E. Murias, A. Villagra, S. Vatua et al., “Evaluation of a noninvasive method for cardiac output measurement in critical care patients,” Intensive Care Med, vol. 28, pp. 1470–4, 2002.
View at: Google Scholar
H. Odenstedt, O. Stenqvist, and S. Lundin, “Clinical evaluation of a partial CO₂ rebreathing technique for cardiac output monitoring in critically ill patients,” Acta Anaesthesiol Scand, vol. 46, pp. 152–9, 2002.
View at: Google Scholar
L. B. Nilsson, N. Eldrup, and P. G. Berthelsen, “Lack of agreement between thermodilution and carbon dioxide-rebreathing cardiac output,” Acta Anaesthesiol Scand, vol. 45, pp. 680–5, 2001.
View at: Google Scholar
P. V. van Heerden, S. Baker, S. I. Lim, C. Weidman, and M. Bulsara, “Clinical evaluation of the non-invasive cardiac output (NICO) monitor in the intensive care unit,” Anaesth Intensive Care, vol. 28, pp. 427–30, 2000.
View at: Google Scholar
M. Botero, D. Kirby, E. B. Lobato, E. D. Staples, and N. Gravenstein, “Measurement of cardiac output before and after cardiopulmonary bypass: Comparison among aortic transit-time ultrasound, thermodilution, and noninvasive partial CO₂ rebreathing,” J Cardiothorac Vasc Anesth, vol. 18, pp. 563–72, 2004.
View at: Google Scholar
G. Gueret, G. Kiss, B. Rossignol et al., “Cardiac output measurements in off-pump coronary surgery: comparison between NICO and the Swan-Ganz catheter,” Eur J Anaesthesiol, vol. 23, no. 10, pp. 848–54, 2006.
View at: Google Scholar
G. Gueret, G. Kiss, S. Khaldi et al., “Comparison of cardiac output measurements between NICO and the pulmonary artery catheter during repeat surgery for total hip replacement,” Eur J Anaesthesiol, vol. 24, no. 12, pp. 1028–33, 2007.
View at: Google Scholar
J. L. Jover, M. Soro, F. J. Belda, G. Aguilar, P. Caro, and R. Ferrandis, “Measurement of cardiac output after cardiac surgery: validation of a partial carbon dioxide rebreathing (NICO) system in comparison with continuous thermodilution with a pulmonary artery catheter,” Rev Esp Anestesiol Reanim, vol. 52, no. 5, pp. 256–62, 2005.
View at: Google Scholar
J. Allardet-Servent, J. M. Forel, A. Roch et al., “Pulmonary capillary blood flow and cardiac output measurement by partial carbon dioxide rebreathing in patients with acute respiratory distress syndrome receiving lung protective ventilation,” Anesthesiology, vol. 111, no. 5, pp. 1085–92, 2009.
View at: Google Scholar
B. Bein, P. Hanne, R. Hanss et al., “Effect of xenon anaesthesia on accuracy of cardiac output measurement using partial CO₂ rebreathing,” Anaesthesia, vol. 59, pp. 1104–1110, 2004.
View at: Google Scholar
R. J. Levy, R. M. Chiavacci, S. C. Nicolson et al., “An evaluation of a noninvasive cardiac output measurement using partial carbon dioxide rebreathing in children,” Anesth Analg, vol. 99, no. 6, pp. 1642–7, 2004.
View at: Google Scholar
P. Peyton, D. Thompson, and P. Junor, “Non-invasive automated measurement of cardiac output during stable cardiac surgery using a fully integrated differential CO₂ Fick method,” J Clin Monit Comput, vol. 22, no. 4, pp. 285–92, Aug 2008.
View at: Google Scholar
P. Peyton, “Continuous Minimally Invasive Peri-operative Monitoring of Cardiac Output by Pulmonary Capnotracking: Comparison with Thermodilution and Transesophageal Echocardiography,” J Clin Monit Comput, vol. 26, no. 2, pp. 121–32, 2012.
View at: Google Scholar
S. A. Isserles and P. H. Breen, “Can Changes in End-Tidal PCO₂ Measure Changes in Cardiac Output?” Anesth Analg, vol. 73, pp. 808–14, 1991.
View at: Google Scholar
P. H. Breen, “How do changes in exhaled CO₂ measure changes in cardiac output? A numerical analysis model,” J Clin Monit Comput, vol. 24, pp. 413–9, 2010.
View at: Google Scholar
J. Yem, Y. Tang, M. J. Turner, and A. B. Baker, “Sources of error in non-invasive pulmonary blood flow measurements by partial re-breathing: a computer study,” Anesthesiology, vol. 98, pp. 881–7, 2003.
View at: Google Scholar
R. Lundh and G. Hedenstierna, “Ventilation-Perfusion Relationships during Anesthesia and Abdominal Surgery,” Acta Anaesth Scand, vol. 27, pp. 167–73, 1983.
View at: Google Scholar
G. Hedenstierna, R. Lundh, and H. Johansson, “Alveolar Stability during Anesthesia for Reconstructive Vascular Surgery in the Leg,” Acta Anaesth. Scand, vol. 27, pp. 26–34, 1983.
View at: Google Scholar
K. Rehder, T. J. Knopp, A. D. Sessler, and E. P. Didier, “Ventilation-perfusion relationship in young healthy awake and anesthetized-paralyzed man,” J Appl Physiol: Respirat Environ Exercise Physiol, vol. 47, no. 4, pp. 745–53, 1979.
View at: Google Scholar
J. A. Orr, K. Kück, and L. M. Brewer, “Noninvasive Cardiac Output Monitor Algorithms Are More Sophisticated and Perform Better than Indicated in Modeling Paper,” Anesthesiology, vol. 99, pp. 1461–2, 2003.
View at: Google Scholar
J. S. Yem, M. J. Turner, and A. B. Baker, “Sources of error in partial rebreathing pulmonary blood flow measurements in lungs with emphysema and pulmonary embolism,” British Journal of Anaesthesia, vol. 97, no. 5, pp. 732–41, 2006.
View at: Google Scholar
D. G. Haryadi, J. A. Orr, K. Kueck, S. McJames, and D. R. Westenskow, “Partial CO₂ rebreathing indirect Fick technique for noninvasive measurement of cardiac output,” J Clin Monit Comput, vol. 16, pp. 361–74, 2000.
View at: Google Scholar
M. Gama de Abreu, M. Quintel, M. Ragaller et al., “Partial carbon dioxide rebreathing: A reliable technique for noninvasive measurement of nonshunted pulmonary capillary blood flow,” Crit Care Med, vol. 25, pp. 675–83, 1997.
View at: Google Scholar
M. Gama de Abreu, T. Winkler, T. Pahlitzsch, D. Weismann, and D. M. Albrecht, “Performance of the partial CO₂ rebreathing technique under different hemodynamic and ventilation/perfusion matching conditions,” Crit Care Med, vol. 31, pp. 543–51, 2003.
View at: Google Scholar
R. A. Maxwell, J. B. Gibson, J. B. Slade, T. C. Fabian, and K. G. Proctor, “Noninvasive cardiac output by partial CO₂ rebreathing after severe chest trauma,” J Trauma, vol. 51, no. 5, pp. 849–53, 2001.
View at: Google Scholar
M. J. Carretero, J. Fontanals, M. Agustí et al., “Monitoring in resuscitation: comparison of cardiac output measurement between pulmonary artery catheter and NICO,” Resuscitation, vol. 81, no. 4, pp. 404–9, 2010.
View at: Google Scholar
J. M. Bland and D. G. Altman, “Statistical methods for assessing agreement between two methods of clinical measurement,” Lancet, pp. 307–10, 1986.
View at: Google Scholar
L. A. H. Critchley and J. A. Critchley , “A Meta-Analysis of Studies Using Bias and Precision Statistics to Compare Cardiac Output Measurement Techniques,” J Clin Monit Comput, vol. 15, pp. 85–91, 1999.
View at: Google Scholar
P. Peyton and S. W. Chong, “Minimally invasive measurement of cardiac output during surgery and critical care: A meta-analysis of accuracy and precision,” Anesthesiology, vol. 113, no. 5, pp. 1220–35, 2010.
View at: Google Scholar
P. Peyton and S. W. Chong, “Minimally Invasive Measurement of Cardiac Output During Surgery and Critical Care: A Meta-analysis of Accuracy and Precision: Erratum,” Anesthesiology, vol. 116, pp. 972–3, 2012.
View at: Google Scholar
A. H. Critchley, P. J. Peyton, and S. W. Chong, “Bias and Precision Statistics: Should We Still Adhere to the 30% Benchmark for Cardiac Output Monitor Validation Studies?” Anesthesiology, vol. 114, pp. 1245–6, 2011.
View at: Google Scholar
M. Gama de Abreu and M. F. V. Melo, “Giannella Neto A: Pulmonary capillary blood flow by partial CO2 rebreathing: Importance of the regularity of the respiratory pattern,” Clin Physiol, vol. 5, pp. 388–398, 2000.
View at: Google Scholar
P. Slinger and B. Kilpatrick, “Perioperative lung protection strategies in cardiothoracic anesthesia: are they useful?” Anesthesiol Clin, vol. 30, no. 4, pp. 607–628, Dec 2012.
View at: Google Scholar
S. Fujii, M. Kikura, T. Takada, S. Katoh, N. Aoyama, and S. Sato, “A noninvasive partial carbon dioxide rebreathing technique for measurement of pulmonary capillary blood flow is also a useful oxygenation monitor during one-lung ventilation,” J Clin Anesth, vol. 16, pp. 347–352, 2004.
View at: Google Scholar
M. G. de Abreu, S. Geiger, T. Winkler et al., “Evaluation of a new device for noninvasive measurement of nonshunted pulmonary capillary blood flow in patients with acute lung injury,” Intensive Care Med, vol. 28, no. 3, pp. 318–23, 2002.
View at: Google Scholar
M. Suzuki, S. Koda, Y. Nakamura, N. Kawamura, and Y. Shimada, “The relationship between cardiac output measured by the thermodilution method and that measured by the carbon dioxide rebreathing technique during laparoscopic surgery,” Anesth Analg, vol. 100, no. 5, pp. 1381–3, 2005.
View at: Google Scholar
J. M. Ng, “The partial CO₂ rebreathing cardiac output measurement during laparoscopic resection of bilateral pheochromocytoma,” Anesth Analg, vol. 103, no. 6, pp. 1600–1, 2006.
View at: Google Scholar
J. Y. Hong, “Haemodynamic and ventilatory effects of preoperative epidural analgesia during laparoscopic hysterectomy using NICO,” Singapore Med J, vol. 49, no. 3, pp. 233–8, 2008.
View at: Google Scholar
A. Vannucci, V. Krejci, and I. Kangrga, “Performance of Vigileo and LiDCOplus cardiac output monitors during a prolonged cardiac arrest and resuscitation,” Eur J Anaesthesiol, vol. 26, pp. 885–7, 2009.
View at: Google Scholar
C. Nishiwaki, Y. Kotake, T. Yamada, H. Nagata, M. Tagawa, and J. Takeda, “Response Time of Different Methods of Cardiac Output Monitoring During Cardiopulmonary Resuscitation and Recovery,” J Cardiothorac Vasc Anesth, vol. 24, no. 2, pp. 306–8, 2010.
View at: Google Scholar
R. P. Trevino, J. Bisera, M. H. Weil, E. C. Rackow, and W. G. Grundler, “End-tidal CO₂ as a guide to successful cardiopulmonary resuscitation: a preliminary report,” Crit Care Med, vol. 13, pp. 910–1, 1985.
View at: Google Scholar
A. Garnett, J. P. Ornato, E. R. Gonzalez, and B. Johnson, “End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation,” JAMA, vol. 257, pp. 512–5, 1987.
View at: Google Scholar
J. L. Falk, E. C. Rackow, and M. H. Weil, “End-tidal carbon dioxide concentration during cardiopulmonary resuscitation,” NEJM, vol. 318, pp. 607–11, 1988.
View at: Google Scholar
P. Peyton, Y. Venkatesan, S. Hood, P. Junor, and C. May, “Non-invasive, automated and continuous cardiac output monitoring by pulmonary capnodynamics: Breath by breath comparison with ultrasonic flow probe,” Anesthesiology, vol. 105, pp. 72–80, 2006.
View at: Google Scholar
K. J. Ruskin and K. H. Shelley, “Patent medicine and the “black box”,” Anesth Analg, vol. 100, no. 5, pp. 1361–2, 2005.
View at: Google Scholar
M. F. Vidal Melo and B. J. Leone, “Introduction of New Monitors into Clinical Anesthesia,” Anesth Analg, vol. 107, no. 3, pp. 749–50, 2008.
View at: Google Scholar
National Institute for Health and Clinical Excellence, Medical technologies guidance MTG3: CardioQ ODM oesophageal doppler monitor. March 2011, http://www.nice.org.uk/MTG3.
T. E. Miller, A. M. Roche, and T. J. Gan, “Poor Adoption of Hemodynamic Optimization During Major Surgery: Are We Practicing Substandard Care?” Anesth Analg, vol. 112, no. 6, pp. 1274–6, 2011.
View at: Google Scholar
S. Ghosh, B. Arthur, and A. A. Klein, “NICE guidance on ${Cardio}^{TM}$ oesophageal Doppler monitoring,” Anaesthesia, vol. 66, pp. 1081–3, 2011.
View at: Google Scholar
G. Minto and R. Struthers, “Oesophageal Doppler monitoring: costly and supported by weak evidence,” Anaesthesia, vol. 67, pp. 426–7, 2012.
View at: Google Scholar
I. D. E. Nesbitt and J. F. Cosgrove, “Oesophageal Doppler monitoring: a misguided editorial,” Anaesthesia, vol. 67, pp. 427–8, 2012.
View at: Google Scholar
M. Chikhani and I. K. Moppett, “Editorial: Minimally invasive cardiac output monitoring: what evidence do we need?” British Journal of Anaesthesia, vol. 106, no. 4, pp. 451–3, 2011.
View at: Google Scholar

Copyright

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

PDF Download Citation Order printed copies

Views

689

Downloads

1801

Citations