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Minimally Invasive and Noninvasive Hemodynamic Monitoring of the Cardiovascular System: Available Options and Future Perspectives

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Monitoring of Cardiac Output (CO) is of paramount importance in the critical patient. Established methods used to measure CO, such as oxygen Fick approach and thermodilution, are invasive and do not allow continuous monitoring. In addition, they are not reliable in the hemodynamically instable patient and suffer several technical drawbacks.

Alternative methods are available, such as the Pulse Contour Method, but are dependent upon external calibration to evaluate cardiac activity. Recently, the Pressure Recording Analytical Method (PRAM) has been developed: it allows a more complete and detailed analysis of pressure morphology and "beat-to-beat" measurement of the stroke volume (SV) without external calibration. The basic principle of PRAM algorithm is the ability of detecting interactions between the cardiac and circulatory system, and therefore of calculating a new parameter, describing the work expenditure of cardiovascular system strictly correlated to SV, the Cardiac Cycle Efficiency (CCE). PRAM is becoming a promising alternative to traditional techniques, and may expand the potential applications of hemodynamic monitoring in clinical practice.

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Keywords: Cardiac Cycle Efficiency (CCE); accelerated idioventricular rhythm (AIR); aortic pressure; pulse contour method (PCM); thermodilution

Document Type: Research Article

Affiliations: Department of Critical Care, Internal Medicine and Cardiology, University of Florence, Viale Morgagni 85, I-50134 Florence, Italy.

Publication date: February 1, 2006

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  • Current Cardiology Reviews publishes frontier reviews on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in cardiology.
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