aDepartment of Critical Care bDepartment of Anaesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Curr Opin Crit Care. 2017 Aug;23(4):302-309. doi: 10.1097/MCC.0000000000000417.
Haemodynamic monitoring is a cornerstone in the diagnosis and evaluation of treatment in critically ill patients in circulatory distress. The interest in using minimally invasive cardiac output monitors is growing. The purpose of this review is to discuss the currently available devices to provide an overview of their validation studies in order to answer the question whether these devices are ready for implementation in clinical practice.
Current evidence shows that minimally invasive cardiac output monitoring devices are not yet interchangeable with (trans)pulmonary thermodilution in measuring cardiac output. However, validation studies are generally single centre, are based on small sample sizes in heterogeneous groups, and differ in the statistical methods used.
Minimally and noninvasive monitoring devices may not be sufficiently accurate to replace (trans)pulmonary thermodilution in estimating cardiac output. The current paradigm shift to explore trending ability rather than investigating agreement of absolute values alone is to be applauded. Future research should focus on the effectiveness of these devices in the context of (functional) haemodynamic monitoring before adoption into clinical practice can be recommended.
血流动力学监测是循环衰竭危重病患者诊断和治疗评估的基石。人们对使用微创心输出量监测器的兴趣日益浓厚。本文的目的是讨论目前可用的设备，概述其验证研究，以回答这些设备是否准备好用于临床实践的问题。
目前的证据表明，微创心输出量监测设备在测量心输出量方面尚不能与（经）肺热稀释法互换。然而，验证研究通常是单中心的，基于异质人群的小样本量，并且使用的统计方法也不同。
微创和非侵入性监测设备在估计心输出量方面可能不够精确，无法替代（经）肺热稀释法。当前，探索趋势能力而不仅仅是研究绝对值的一致性的范式转变值得称赞。在推荐将这些设备应用于临床实践之前，未来的研究应侧重于这些设备在（功能）血流动力学监测方面的有效性。
