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Abstract
The aim of cardiovascular monitoring is to warn the anesthesiologist in the operating room and ICU about any early hemodynamic instability or impending circulatory failure. Cardiac output monitoring is the most reliable technique for assessing cardiovascular system.
Many methods developed for cardiac output measurements which are either invasive or non-invasive. Invasive techniques are based on the application of Fick’s principle, they include thermodilution technique which still is the standard method of cardiac output measurement, also the indicator dilution methods.
Thermodilution technique was used for many years for cardiac output monitoring as it is accurate and more popular to the anesthesiologists since Swan and Ganz introduced the flow directed balloon-tipped thermal sensation multilumen catheter.
On the other hand, thermodilution technique produces many complications which may range from slight to even fatal complications as pulmonary artery rupture leading to fatal bleeding.
Many non-invasive methods of cardiac output measuring have been developed in the last few years especially with advances in technology, sensor designs and interpretation of data giving these methods the advantage of being non-invasive, providing online, continuous measurements with trends to follow disease progression, as partial CO2 rebreathing technique, thoracic bioimpedence, pulse-contour analysis and transesophageal Doppler. The application of these new methods confers much more safety to the patient and much more feasibility to the anesthesiologists than the older invasive methods knowing that these new methods are reliable when compared to thermodilution technique when used in the right time for the right patient.