From: Clinical review: Does it matter which hemodynamic monitoring system is used?
Technology | System | Invasiveness | Mechanism | Advantages | Disadvantages | Outcome studies |
---|---|---|---|---|---|---|
Pulmonary artery catheter | Vigilance | +++ | Thermodilution | Gold standard for continuous/intermittent cardiac output monitoring. Allows measuring pulmonary pressures and mixed venous oxygen saturation. | No dynamic parameters of fluid responsiveness, Provides cardiac output information every few minutes. | - |
Calibrated pulse contour analysis | PiCCO plus | ++ | Transpulmonary thermodilution + pulse contour analysis | Continuous cardiac output monitoring. Central venous oxygen saturation with specific device. Good accuracy. | Remains significantly invasive. Requires a specific femoral artery catheter. | 0 |
 | VolumeView | ++ | Transpulmonary thermodilution + pulse contour analysis | Continuous cardiac output monitoring. Central venous oxygen saturation with specific device. Good accuracy. | Remains significantly invasive. Requires a specific femoral artery catheter. | 0 |
 | LiDCO plus | + | Lithium dilution | Continuous cardiac output monitoring. |  | + |
Uncalibrated pulse contour analysis | FloTrac | + | Pulse wave analysis | Continuous cardiac output monitoring. Mini-invasive, self-calibration systems. | Accuracy of cardiac output has been a concern. Sensitive to changes in vasomotor tone. Requires a specific arterial pressure sensor. | + |
 | LiDCO Rapid | + | Pulse wave analysis | Continuous cardiac output monitoring. Mini-invasive, self-calibration systems. Can be used with any arterial line and arterial pressure sensor. | Not enough validation studies. | 0 |
 | Pulsioflex | + | Pulse wave analysis | Continuous cardiac output monitoring. Mini-invasive, self-calibration systems. Can be used with any arterial line and arterial pressure sensor. | No validation study. | 0 |
 | PRAM | + | Pulse wave analysis | Continuous cardiac output monitoring. Mini-invasive, self-calibration systems. | Not enough validation studies. Requires a specific arterial kit. | 0 |
 | Nexfin | 0 | Non-invasive pulse wave analysis | Continuous cardiac output monitoring. Completely non-invasive, self-calibration system. | Not enough validation study. Motion artifact. | 0 |
Ultrasound | Cardio Q | 0+ | Doppler ultrasound | Less invasive then arterial-based systems, qualifies for billable monitoring in the USA. | Requires frequent manipulation for proper position, significant potential for user variability. | +++ |
 | USCOM | 0 | Suprasternal ultrasound | Non-invasive cardiac output measurement. | Intermittent. Operator dependent. | 0 |
Bioreactance | NiCOM | 0 | Bioreactance | Non-invasive continuous cardiac output monitoring. | Few validation studies. Many limitations. | 0 |
Endotracheal bioimpedance | ECOM | + | Bioimpedance | Mini-invasive and continuous cardiac output monitoring. | Few validation studies. Requires a specific arterial kit and a specific endotracheal tube. | 0 |
Thoracic bioimpedance | BioZ | 0 | Bioimpedance | Non-invasive cardiac output measurement. | Many negative studies in the critical care setting. | 0 |