Pro: The FloTrac device should be used to follow cardiac output in cardiac surgical patients.

摘要

IT IS A GOOD THING the title does not have the word "routinely" in it. If it did, the "Pro" argument would be very difficult. Clinicians now use a vast array of powerful monitoring and diagnostic technology to assess hemodynamics in cardiac surgical patients. This toolbox includes, in addition to routine American Society of Anesthesiologists monitoring, transesophageal echocardiography (TEE), pulmonary artery catheterization (PAC), central pressure monitoring (CVP), and invasive arterial pressure monitoring. Many would agree that routinely using the FloTrac (Edwards Lifesciences Corp, Irvine, CA), in addition to all the previously mentioned techniques, on all cardiac surgeries, would be "over the top." The argument will be made, however, that the FloTrac potentially is very valuable in a variety of circumstances, particularly when PAC is contraindicated or of questionable value. The case also will be made that FloTrac or minimally invasive technology with similar capability should be available immediately in all cardiac suraerv centers.