Emergency department non-invasive cardiac output study (EDNICO): a feasibility and repeatability study.

Area of Science:

• Emergency Medicine
• Critical Care
• Cardiovascular Physiology

Background:

• Limited data exists on non-invasive cardiac output monitoring in emergency departments (ED).
• Assessing fluid responsiveness is crucial in ED settings for patient management.
• Six non-invasive methods were evaluated for feasibility and repeatability.

Purpose of the Study:

• To assess the feasibility and repeatability of six non-invasive cardiac output monitoring methods in the ED.
• To compare the performance of different non-invasive techniques for fluid responsiveness assessment.
• To identify suitable methods for further investigation in ED populations.

Main Methods:

• Prospective observational study in non-ventilated adult ED patients requiring fluid resuscitation.
• Feasibility assessed by the proportion of interpretable measurements.
• Repeatability evaluated by paired measurements after fluid bolus administration.

Main Results:

• Bioreactance demonstrated the highest feasibility rate (97.6%), significantly higher than other methods.
• Other methods evaluated included vascular unloading, common carotid artery blood flow, inferior vena cava collapsibility, LVOT VTI, and suprasternal aortic Doppler.
• Non-ultrasound methods exhibited higher repeatability of measurements.

Conclusions:

• Selected non-invasive methods are feasible for fluid responsiveness monitoring in the ED.
• Non-ultrasound techniques offer promising repeatability for cardiac output assessment.
• Findings support further research into the accuracy and clinical impact of these methods in fluid-depleted ED patients.