Advances in continuous, noninvasive hemodynamic surveillance. Impedance cardiography

In the current climate of shrinking health care reimbursement and increasing importance of patient centered care, impedance cardiography is one method of enhancing quality of patient care and appropriate use of resources. Hemodynamic and thoracic fluid status data may be obtained quickly, accurately, and without risk, providing a global clinical perspective. Patients benefit from the ability to immediately obtain real time hemodynamic data, particularly those patients who otherwise may not be afforded a high level of monitoring or those needing hemodynamic monitoring when assessment and treatment are delayed because of inaccessibility of critical care beds or in the cardiac catheterization laboratory. Application of a technology assessment model to impedance cardiography illustrates the utility of this method of hemodynamic monitoring. Careful review and critique of the literature differentiates the available impedance technologies, supports use in areas not traditionally associated with hemodynamic monitoring, such as the home and emergency department, and validates the use of impedance cardiography in place of, or as an indication for, pulmonary artery catheterization.