Hi goodson_girl,
Here are some articles on Cardiac Monitoring. I had started working on
your question over a day ago, but didn't feel I had found sufficient
information to post. I have since found more, and hope you find it to
be what you are seeking.
Why measure cardiac output?
From BioPac: ?Why Measure Cardiac Output?
The reasons for determining cardiac output are many, including:
checking for arterial blockage, determining efficiency of the heart
pump, determining mean vascular pressure, and diagnoses of various
inlet impedance problems, including microstenosis, venous obstruction,
atrial fibrilation, cardiac tamponade, ventricular non-compliance, and
extremely rapid heartrate. ?
http://www.biopac.com/newsletter/spring_2001/cardiac_output.htm
?Since the cardiovascular system is a closed system, a change in any
hemodynamic parameter
induces a compensatory change in the others. For example, an increase
in heart rate may
compensate for unstable or decreased stroke volume due to underlying
disorders in its basic
components. Thus, monitoring cardiac output only may be an
insufficient assessment of a
patient hemodynamic status.? Page 2
Hemosonic.com
http://www.hemosonic.com/resources/clinicalpdfs/clinical_notes_1.pdf
This Critical Care London site outlines cardiac cutput measurements
done using the closed system CO-Set
http://www.lhsc.on.ca/critcare/icu/cctc/procprot/nursing/procedures/cardout1.htm
This page on the above site details Critical Care London?s ICU cardiac outputs.
http://www.lhsc.on.ca/critcare/icu/cctc/procprot/nursing/procedures/hemoprotocol.htm
This Anesthesia UK site has a good explanation of cardiac output. You
will need to click on the fifth link, Cardiac Output, under
?General?.
http://www.frca.co.uk/sectioncontents.aspx?sectionid=62#
Cardiac Monitoring
Critical Care Forum
http://ccforum.com/content/6/1/52
Comparison of bedside measurement of cardiac output with the
thermodilution method and the Fick method in mechanically ventilated
patients.
BioMedCentral
http://bmc.ub.uni-potsdam.de/cc1848/
What is the Best Way to Measure Cardiac Output?
http://www.findarticles.com/cf_dls/m0984/3_122/92132980/p1/article.jhtml
?Assessment of the cardiac output is important in determining the work
that the heart is actually performing with respect to the rest of the
cardiovascular system.
http://www.ebme.co.uk/arts/card_op.htm
To see the entire ?Emerging Technologies in Cardiac Output Monitoring?
article, click the PDF link, on this Clinical Window site:
http://www.datex-ohmeda.com/clinical/cw_prev_11_article1.htm#
Honors MatLab, Indiana and Purdue Universities
http://www.math.iupui.edu/m163/matlab/Honors/HP14.pdf
Altered Cardiac Function
http://www.rcsed.ac.uk/Journal/vol46_1/4610005.htm
Cardiac Output Measurement during Cardiac Surgery:
Esophageal Doppler Versus Pulmonary Artery Catheter
http://www.anesth.org/contents/40/40_127-133.pdf
From Illuminations, a sort of self-tutorial on Cardiac Output, Rates
of Change and Accumulation
http://illuminations.nctm.org/imath/912/cardiac/
This cadiac sensor manufacturer site, Lidco, explains the difference
in the Fick, Bioimpedance, and Echocardiography methods of cardiac
monitoring.
http://www.lidco.com/cardiac_output.asp
and the Lithium method:
http://shr.hama-med.ac.jp/ISCAIC18/AbstractSymposium/Robert_Linton_abstract.htm
Nurses Meeting Place-Scroll down almost to the middle of the page:
http://groups.msn.com/NURSESMEETINGPLACE/cardiacplace.msnw
Non-invasive measurement of cardiac output in heart failure patients
using a new foreign
gas rebreathing technique. Clinical Science
http://www.clinsci.org/cs/102/0247/1020247.pdf
Why Measure Cadiac Output?
http://ccforum.com/content/7/2/114/abstract
and
http://ccforum.com/content/7/2/171
Usefulness of cardiac monitoring
http://www.findarticles.com/cf_dls/m0NUB/4_12/105556275/p5/article.jhtml?term=
Which Patients Need Cardiac Output Monitoring?
The short answer is: Any patient may need this, depending on condition!
This patient was seen for unusual insulin reactions:
http://www.circulatorboot.com/casehistory/case24.html
Hemodynamic changes in pregnancy
http://www.findarticles.com/cf_dls/m0NUC/4_23/107140380/p1/article.jhtml
Post-surgical
http://www.hbot4u.com/cardiac1.html
Sports Injuries
http://www.physioroom.com/research/blood_doping_7.shtml
Cardiac Output and Renal Function
http://www.medhelp.org/forums/cardio/messages/32376a.html
Sepsis
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1623756&dopt=Abstract
Anemia
http://www.scuba-doc.com/overview.html
You?ll need a subscription, or access to these sites to read the
entire article. You may have access to these sites through your school
library.
Comparative overview of cardiac output measurement methods: Has
impedance cardiography come of age?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12029189&dopt=Abstract
High cardiac output should not be maintained in severe sepsis
BioMedCentral
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=270705
Impedance cardiography for cardiac output measurement
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2092994&dopt=Abstract
Beat to Beat monitoring
http://www.lidco.com/documents/draftASA2002.pdf
eLibrary: Effect of Ambient Temperature and Cardiac Stability on Two
Methods of Cardiac Output Measurement
http://static.elibrary.com/j/journalofcardiovascularnursing/april011999/effectofambienttemperatureandcardiacstabilityontwo/
PubMed: The High Risk Patient
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=137223
Additional Information:
BioPac?s Systems. This is an equipment site, but it has some great
illustrations, and differentiates results between band electrodes and
spot electrodes.
http://www.biopac.com/AppNotes/app196CardiacOut/CardiacOut.htm
http://www.biopac.com/newsletter/spring_2001/cardiac_output.htm
From UNC, Monitoring of burn patients
http://www.unc.edu/news/newsserv/archives/oct01/burncare101201.htm
LookSmart
http://www.findarticles.com/cf_dls/m0984/3_119/72730270/p1/article.jhtml
USCOM, a chart of methods of cardiac output monitoring
http://www.uscom.com.au/methods.htm
Hemodynamic Monitoring
http://course1.winona.msus.edu/nursing412/Winona/lecture%20outlines%20nosek/hemodynamic%20monitoring.htm
Cardiac Output Measurement Using Thermodilution
http://www.rocket.pwp.blueyonder.co.uk/advanced_cardiac_outputs.htm
and
http://www.manbit.com/PAC/chapters/P43.cfm
Probability model:
http://medg.lcs.mit.edu/people/wjl/aaij88/section3_6.html
EduBriefs: ?If SvO2 decreases, it indicates that the tissues are
extracting a higher percentage of oxygen from the blood than normal.
In otherwords, a decreased SvO2 indicates that the cardiac output is
not high enough to meet tissue oxygen needs. Thus, SvO2 can indicate
whether an individual's cardiac output is high enough to meet their
needs.
A rise in SvO2 demonstrates a decrease in oxygen extraction, and
usually indiates that the cardiac output is meeting the tissue oxygen
need. A return of the SvO2 to normal suggests patient improvement.
However, a rise in SvO2 in the presence of a rising lactate is
inappropriate - the patient who has resorted to anaerobic metabolism
(third compensation) should have evidence of a high cardiac output and
increased extraction. This is an ominous finding, suggesting that the
tissues are unable to extract. It can be seen in late septic shock,
or in cell poisoning such as cyanide.
Cardiac output is routinely measured to evaluate drug effectiveness.
Unfortunately, the cardiac output measurement only gives us a value,
it does not indicate whether the measured cardiac output is meeting
the patient's needs. For some individuals, a cardiac output that
falls below the normal range may be adequte, whereas for others, a
normal or elevated cardiac output value may be too low. An SvO2 in
the normal range, along with a normal lactate, suggests that the
cardiac output is adequate. ?
http://www.lhsc.on.ca/critcare/icu/education/svo2.html
Data Guide
http://www.transonic.com/Hemodialysis_Home/HD_Products/AUTDIG-EN.pdf
Non-invasive cardiac monitoring
http://www.aadee.com/CHEST_Editorial.pdf
Invasive cardiac monitoring
http://www.ccmtutorials.com/cvs/clinshock/clinshock7.htm
A free animated cardiac quiz
http://www.skillstat.com/cardiactriviaLPdemo.html
RnCeus quiz
https://www.rnceus.com/secured/rnceus_exam.asp?exam_id=46
What do Those Numbers Mean?
http://www.mededcon.com/card01.htm
Cardiac Output Calculator
http://www.medstudents.com.br/calculat/cardout.htm
I certainly hope you and your fellow student find this information
useful. If any part of this answer is unclear, please request an
Answer Clarification, before rating. This will allow me to assist you
further, if possible.
Regards
crabcakes
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Cardiac outputs
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