Non-invasive hemodynamic monitoring in trauma patients.

Kuster, Matthias; Exadaktylos, Aristomenis; Schnüriger, Beat (2015). Non-invasive hemodynamic monitoring in trauma patients. World journal of emergency surgery, 10(11), p. 11. BioMed Central 10.1186/s13017-015-0002-0

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BACKGROUND The assessment of hemodynamic status is a crucial task in the initial evaluation of trauma patients. However, blood pressure and heart rate are often misleading, as multiple variables may impact these conventional parameters. More reliable methods such as pulmonary artery thermodilution for cardiac output measuring would be necessary, but its applicability in the Emergency Department is questionable due to their invasive nature. Non-invasive cardiac output monitoring devices may be a feasible alternative. METHODS A systematic literature review was conducted. Only studies that explicitly investigated non-invasive hemodynamic monitoring devices in trauma patients were considered. RESULTS A total of 7 studies were identified as suitable and were included into this review. These studies evaluated in a total of 1,197 trauma patients the accuracy of non-invasive hemodynamic monitoring devices by comparing measurements to pulmonary artery thermodilution, which is the gold standard for cardiac output measuring. The correlation coefficients r between the two methods ranged from 0.79 to 0.92. Bias and precision analysis ranged from -0.02 +/- 0.78 l/min/m(2) to -0.14 +/- 0.73 l/min/m(2). Additionally, data on practicality, limitations and clinical impact of the devices were collected. CONCLUSION The accuracy of non-invasive cardiac output monitoring devices in trauma patients is broadly satisfactory. As the devices can be applied very early in the shock room or even preclinically, hemodynamic shock may be recognized much earlier and therapeutic interventions could be applied more rapidly and more adequately. The devices can be used in the daily routine of a busy ED, as they are non-invasive and easy to master.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Exadaktylos, Aristomenis and Schnüriger, Beat

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1749-7922

Publisher:

BioMed Central

Language:

English

Submitter:

Romana Saredi

Date Deposited:

22 Apr 2015 14:41

Last Modified:

26 Jun 2016 02:01

Publisher DOI:

10.1186/s13017-015-0002-0

PubMed ID:

25774210

Uncontrolled Keywords:

Hypovolemic shock; Initial care; Non-invasive hemodynamic monitoring; Trauma

BORIS DOI:

10.7892/boris.67017

URI:

https://boris.unibe.ch/id/eprint/67017

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