. Author manuscript; available in PMC: 2021 Oct 1.

Published in final edited form as: Anesthesiology. 2020 Oct 1;133(4):921–928. doi: 10.1097/ALN.0000000000003483

Table 1:

Minimally-Invasive and Non-Invasive Cardiac Output Monitoring

Method		Device name	Pitfalls
Minimally-invasive cardiac output monitoring methods
Minimally-invasive pulse wave analysis		FloTrac (Edwards Lifesciences) ProAQT/Pulsioflex (Pulsion) LiDCOrapid (LiDCO) Argos CO monitor (Retia Medical) Mostcare UP (Vygon)	• Invasive • Estimation of stroke volume relies on theoretical assumptions • Measurement performance essentially depends on blood pressure waveform quality • Rapid changes in vasomotor tone make CO estimations less reliable (e.g., patients with liver disease or liver surgery and septic patients)
Esophageal Doppler		CardioQ-ODM (Deltex Medical)	• (Invasive) • Operator-dependent • Prone to motion artifacts, not easily usable in awake and alert patients • Assumption of constant distribution of arterial blood flow between the upper and lower parts of the body does not hold in all pathophysiologic circumstances • Estimation of blood flow depends on the correct estimation of the diameter of the aorta
Non-invasive cardiac output monitoring methods
Non-invasive pulse wave analysis	Finger cuff method	CNAP (CNSystems) ClearSight (Edwards Lifesciences)	• Same general limitations as minimally-invasive pulse wave analysis • Limited in patients with peripheral vasoconstriction, impaired finger perfusion, and severe peripheral edema
Non-invasive pulse wave analysis	Radial artery applanation tonometry	T-Line (Shanshi International Medical Group) DMP Life (DAEYOMEDI)	• Same general limitations as minimally-invasive pulse wave analysis • Prone to motion artifacts
Pulse wave transit time		esCCO (Nihon Kohden)	• Does not work when patients have cardiac arrhythmias or rapid changes in peripheral vascular tone
Thoracic bioimpedance and bioreactance	Thoracic bioimpedance	BioZ (Cardiodynamics) CSM3000 (Cheers Sails Medical) ICG (Philips Medical Systems) ICON (Osypka Cardiotronic) NCCOM (Bomed Medical) NICOMON (Larsen and Toubro) Physioflow (Manatec Biomedical)	• Prone to motion artifacts and electrical interference • Limited in patients with arrhythmias and mechanical ventilation • Erroneous stroke volume estimations in patients with obesity, pleural effusion, and pulmonary edema
Thoracic bioimpedance and bioreactance	Thoracic bioreactance	NICOM (Cheetah Medical) Starling (Cheetah Medical)