J Anesth Perioper Med. 2018;5(4):221-227. https://doi.org/10.24015/ebcmed.japm.2018.0076

Non-Invasive Cardiac Output Measurement: Where Are We Now?

Mingqiang Li1, Longqiu Yang2, Liwen Zhou1, Jasmine Liu3, Srikant Patel3, and Henry Liu3

From the 1Department of Anesthesiology, Xiangyang Central Hospital, Xiangyang, Hubei Province, China; 2Department of Anesthesiology, Huangshi Central Hospital, Huangshi, Hubei Province, China; 3Department of Anesthesiology & erioperative Medicine, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, USA.

Correspondence to Dr. Henry Liu at henryliupa@gmail.com.

EBCMED ID: ebcmed.japm.2018.0076 DOI: 10.24015/ebcmed.japm.2018.0076


Aim of review
Cardiac output measurement has been the centerpiece of hemodynamic monitoring for the last several decades since the introduction of Swan-Ganz catheter in 1970’s. This review is aimed to review the current status of available techniques for noninvasive cardiac output measurement.

This manuscript reviews recently published literature and discusses currently available techniques based on different mechanisms for the non-invasive measurement of cardiac output.

Recent findings
There are multiple complications associated with Swan-Ganz catheterization. It is controversial whether the use of Swan-Ganz catheter improves clinical outcome. Enormous efforts have been made to develop minimally invasive and non-invasive technologies as an alternative to Swan-Ganz catheter. In this review, we discussed the currently available non-invasive cardiac output measurement techniques, which include the arterial waveform analysis-based techniques (ClearSight, CNAP) and bioimpedance-based technologies (Transthoracic electric bioimpedance, Electric bioreactance, Electric cardiograph).

Each of the discussed technology in non-invasive cardiac output measurement has its advantages and disadvantages. The major concerns in applying these new technologies are their accuracy and bias. Selection of patients and surgical conditions are also contributing to their accuracy and error. Many new technologies are still in developing phase, and new integration of different technologies to offset their drawbacks and better determine the cardiovascular function status of perioperative patients will emerge in the near future.

Article Type
Review Article

Declaration of Interests
The author declares no conflicts of interest.

This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.