Update on minimally invasive hemodynamic monitoring in thoracic anesthesia

作者：Hofer Christoph K^*; Rex Steffen; Ganter Michael T

来源：Current Opinion in Anaesthesiology, 2014, 27(1): 28-35.

DOI：10.1097/ACO.0000000000000034

• bioimpedance
• bioreactance
• cardiac output
• minimal invasive monitoring
• oesophageal Doppler
• partial CO2 rebreathing
• pulse contour analysis
• pulse wave analysis

Purpose of reviewAdvanced hemodynamic monitoring is indispensable for adequate management of patients undergoing major surgery. This article will summarize minimally invasive hemodynamic monitoring technologies and their potential use in thoracic anesthesia.Recent findingsAccording to their inherent principle, currently available technologies can be classified into four groups: bioimpedance and bioreactance, applied Fick's principle, pulse wave analysis and Doppler. All devices measure stroke volume and cardiac output. Functional hemodynamic variables and volumetric parameters have been integrated in some devices. Two major indications can be identified: the hemodynamically unstable' patient and the patient at risk' for hemodynamic instability. Although there is evidence for the first indication, pre-emptive hemodynamic therapy or perioperative hemodynamic optimization for the patient at risk' is still an issue of ongoing debate. There is a growing body of evidence that this approach can positively influence patients' outcome with less postoperative complications in selected patient groups.SummaryMany different minimally invasive hemodynamic monitoring devices have been developed and clinically introduced in the last years. They offer the advantage of being less invasive and easier to use. However, these techniques have several limitations and data are scarce in patients undergoing thoracic anesthesia, preventing their widespread use so far.

• 出版日期2014-2