重症患者の心拍出量測定を行うための侵襲的な心拍出量モニタリングの代表は肺動脈カテーテルであるが，感染や合併症などを考えると適応は限られた症例となり，心臓外科症例以外ではAPCO（Arterial Pressure-based Cardiac Output）が使用されることが多い．今回紹介するLiDCO（Lithium Dilution Output measurement） Rapid V3には心拍出量センサキット（Aライン）を使用するAPCOのRapidモードと非侵襲のCNAP（Continuous Noninvasive Arterial Pressure）モードがある．LiDCO CNAPモードはフィンガーカフにより指動脈圧を連続的に測定し，上腕の非観血的血圧で定時校正し，非侵襲ながら拍動毎の心拍出量を測定できるものである．それぞれの特徴やRapid モード，CNAPモード共に...

Theresa M. Wadas is a coordinator for the adult acute and continuing care nurse practitioner program at the University of Alabama at Birmingham, Birmingham, Ala. Heart failure is a clinical syndrome that affects 5 million persons in the United States and results in substantial morbidity and mortality. Despite advances in pharmacological management, 50% of patients with chronic heart failure wil...

The pulmonary artery catheter has been a key tool for monitoring hemodynamic status in the intensive care unit for nearly 40 years. During this period of time, it has been the hemodynamic monitoring technique most commonly used for the diagnosis of many clinical situations, allowing clinicians to understand the underlying cardiovascular physiopathology, and helping to guide treatment interventi...

Background: Cardiac output (CO) is the total volume of blood pumped by the heart per minute and is a function of heart rate and stroke volume. CO is one of the most important parameters for monitoring cardiac function, estimating global oxygen delivery and understanding the causes of high blood pressure. Hence, measuring CO has always been a matter of interest to researchers and clinicians. Sev...

BACKGROUND The clinical and hemodynamic assessment at the bedside and the use of pulmonary artery catheter for the estimation of hemodynamic data have been used in decompensated heart failure. However, there are no data on the use of continuous noninvasive hemodynamic monitoring. OBJECTIVE To compare the data obtained through noninvasive hemodynamic monitoring with invasive ones in patients w...