Comprehensive noninvasive physiological monitoring

Non-invasive circulatory monitoring is attractive because it is easier, cheaper, and more feasible to use. Although previous bio-impedance instruments have been unreliable, new high-technology hardware and software innovations developed by the defense industry have greatly improved bio-impedance technology so that the data are more reliable.

Comparison of a new bio-impedance method (Renaissance Technologies, Newtown, PA) with the standard thermodilution technique in 842 paired measurements showed a close correlation (r = 0.86) in the ability to track and trend thermodilution changes ( Sho§make.L§.L.§/: 1994).

The new impedance cardiac output system can be combined with other non-invasive monitoring systems, including pulse oximetry to assess pulmonary function and transcutaneous oximetry to assess tissue oxygenation. These non-invasive monitors evaluate the interactions of the three circulatory components to identify, diagnose, and recommend treatment at an early stage when circulatory problems are easily reversible.

Irrespective of the precipitating event in shock, one should look at cardiac, pulmonary, and tissue perfusion in terms of the primary problem, pathophysiology, compensation mechanisms, decompensations, and therapy. This allows a more comprehensive approach to acute circulatory problems irrespective of the precipitating etiological event (cardiogenic, hemorrhagic, traumatic, septic, or postsurgical).

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Sleep Apnea

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