Valor clínico de la medición del gasto cardiaco por bioimpedancia

Abstract

Hemodynamic monitoring is mandatory in critical care and a perioperative surgical patient, cardiac output is the most important hemodynamic functional parameter. Cardiac output invasive methods (thermo dilution) has been widely used it is very invasive highly risky and cannot be used in all patients its clinical usefulness has been challenged. Non invasive methods are more reliable to be used in all different clinical settings with acceptable accuracy and without risks. Bioimpedance cardiac output method has been widely used since 1969 when it was introduce by NASA its accuracy has been challenged nowadays technology advanced has allow this method to gain confidence and accuracy in many different clinical settings. Physio flow bioimpedance method was used in a 47 year old highly risk female with antecedent of mitral stenosis and low cardiac output syndrome submitted for partial hepatectomy. A pre induction cardiac output bioimpedance record confirms a low cardiac index with compensatory peripheral vaso-constriction. Bleeding and hypothermia was two of the major complications present after 4 hour surgery leading to a massive volume transfusion and atrial fibrillation. Cardiac output monitoring allows infusing large amounts of fluids when atrial fibrillation occurs there where not any significant drop on cardiac index according to bioimpedance monitoring allowing the anesthesiologist to treat with drugs instead or cardioversion. Bioimpedance was accurate method in this case allows to manage it safely with good perioperative results. Bioimpedance seems to be a useful cardiac output method for perioperative monitoring. © 2013 Springer.