Survey of cardiac output monitoring in intensive care units in England and Wales

Background

Haemodynamic monitoring is essential for the management of critically ill patients. There are many methods of monitoring the haemodynamic status of patients, and cardiac output (CO) is one of the major determinants of organ perfusion. Currently there are various techniques available in clinical practice to measure CO in ICUs including pulmonary artery catheter (PAC), oesophageal Doppler, lithium dilution cardiac output (LiDCO) and pulse-induced contour cardiac output (PiCCO) studies. We surveyed current CO monitoring practices in adult ICUs in England and Wales.

Methods

Adult ICUs in England and Wales were surveyed via telephone. A senior member of the on-call ICU team was consulted to ascertain their unit's preferred CO monitoring techniques.

Results

Two hundred and twenty-six adult ICUs were surveyed and all the replies were recorded on paper (100% response). In the majority of ICUs, PAC (76%) and oesophageal Doppler (53%) devices are available. Among the other techniques 33% of the ICUs use PiCCO and a further 19% use LiDCO systems for CO monitoring (Table 1). Most of the ICUs (69%) have two or more CO monitoring techniques available and oesophageal Doppler (41%) was preferred as a first choice for CO monitoring. Only 20% of the ICUs regularly measure central venous saturation (SvO₂).

Table 1 Cardiac output monitoring technique availability in the ICUs in England and Wales

Conclusion

The majority of the ICUs have two or more CO monitoring techniques available. The most popular technique for CO monitoring in England and Wales is oesophageal Doppler. This least invasive technique is now the preferred choice of the intensive care physicians in England and Wales. Although PAC is available in most ICUs, only 20% prefer to use them in critically ill patients as the less invasive CO monitoring devices are becoming more accessible.