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COMBED: Rapid non-invasive Cardiac Output Monitoring Baseline assessment in adult Emergency Department patients with

Christopher T Eyeington1,2, Emmanuel Canet1, Salvatore L Cutuli1

  • 1Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia.

Emergency Medicine Australasia : EMA
|January 4, 2022
PubMed

Insights

Rapid, non-invasive cardiac output monitoring (COM) is feasible in over 90% of emergency department patients with hemodynamic instability. This technology offers early insights into circulation, identifying lower cardiac index in hypotension and lower systemic vascular resistance index in suspected infection.

Area of Science:

  • Emergency Medicine
  • Cardiovascular Physiology
  • Medical Technology

Background:

  • Hemodynamic instability (HI) in emergency department (ED) patients requires timely physiological assessment.
  • Non-invasive cardiac output monitoring (COM) offers potential for rapid, operator-independent data acquisition.
  • Early physiological data can guide management of critically ill patients.

Purpose of the Study:

  • To assess the feasibility of non-invasive COM in ED patients with HI.
  • To measure baseline cardiac index (CI) and other hemodynamic parameters.
  • To evaluate the utility of COM for early physiological assessment.

Main Methods:

  • Prospective observational study in an ED setting.
  • Non-invasive COM applied for 5 minutes to adults with tachycardia or hypotension.
  • Recorded CI, mean arterial pressure (MAP), stroke volume index (SVI), and systemic vascular resistance index (SVRI).

Main Results:

  • Feasible COM in >90% of patients (46/49).
  • Hypotension/tachycardia group showed lower MAP, CI, and heart rate compared to tachycardia alone.
  • Suspected infection group exhibited lower SVRI.

Conclusions:

  • Non-invasive COM is feasible and effective in ED patients with HI.
  • Distinct hemodynamic profiles identified in hypotension versus tachycardia alone.
  • COM provides valuable early insights into circulatory status in critical care settings.
Abstract

Keywords:
cardiac outputcritical careemergency medicinehaemodynamicsresuscitation

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