Hämodynamisches Monitoring – Neue Aspekte des minimalinvasiven Herzzeitvolumen-Monitorings

Abstrakt

Die Zahl von Geräten zur minimalinvasiven HZV-Erfassung steigt stetig, sodass es schwierig ist, die Übersicht zu behalten. In diesem Artikel werden die Prinzipien, Limitationen, sowie Validation der Geräte unter Berücksichtigung neuer Aspekte besprochen. Ein integrierter Ansatz zu deren Verwendung wird vorgestellt, da kein Gerät allen klinischen Anforderungen genügt. Das HZV sollte nur im klinischen Kontext mit weiteren hämodynamischen Parametern beurteilt werden. Kein Monitoringverfahren alleine, sondern nur in Kombination mit einem Therapie-Protokoll vermag das Patientenoutcome zu verbessern.

Abstract

The variety of minimally invasive cardiac output (CO) monitoring devices is growing rendering it difficult to keep track of new developments. In this article technical principles, limitations and validation procedures considering new aspects are reviewed. An integrated approach for their use is proposed since no single device can comply with all clinical needs. CO should be interpreted in combination with clinical information and other hemodynamic parameters. It's evident that not the monitor per se, but only the protocol / therapy based on the hemodynamic data can improve patients outcome.

Schlüsselwörter

Herzzeitvolumen - minimal invasive Messung - Pulswellenanalyse - Pulskonturanalyse - Ösophagealer Doppler - Bioreactance - partielle CO₂ Rückatmung

Keywords

Cardiac output - minimal invasive monitoring - pulse wave analysis - pulse contour analysis - oesophageal Doppler - Bioreactance - partial CO₂ rebreathing

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