Advanced cardiovascular monitoring

Abstract 

On the occasions a patient is particularly unwell or unstable, clinical assessment and routine non-invasive monitoring may be insufficient and more advanced techniques are indicated.

This article briefly revises basic cardiovascular physiology before introducing invasive measurement of arterial, central and pulmonary artery pressure and the indications for invasive monitoring. Further discussion includes measurement of cardiac using the Fick principle, thermal and dye dilution, arterial waveform analysis, Doppler ultrasound and other non-invasive methods. The principles underlying these methods and the relative merits of available techniques are highlighted.

Keywords: Cardiac output, Fick principle, invasive monitoring, LiDCO™, oesophageal Doppler, PiCCO, pulmonary artery catheter, thermodilution, transoesophageal echocardiography