Electrical bioimpedance cardiography: An old technology with new hopes for the future

摘要

THE POSITIVE IMPACT of early goal-directed hemody-namic therapy on postoperative outcome increasingly has been investigated over the last few years in high-risk patients undergoing noncardiac and cardiac surgeries.1"4 However, these preemptive strategies require advanced hemodynamic monitoring to assess cardiac output and stroke volume. The classic available tools (intermittent pulmonary arterial or trans-pulmonary thermodilution or esophageal Doppler), either invasive or operator-dependent and necessitating a learning curve, are not convenient for routine practice. Therefore, they remain insufficiently used among North American and European anesthesiologists.5 Besides, new mini-invasive cardiac output devices have been developed commercially over the last decade.6 Less accurate but more convenient and easy to use, they potentially could help the practitioners in promoting advanced hemodynamic monitoring and early goal-directed therapy at the bedside in high-risk patients in an attempt to further improve postoperative outcome. Among these mini-invasive technologies, thoracic electrical bioimpedance (TEB) has major theoretical advantages and could be of great clinical utility in the settings of anesthesiology, cardiology, and peri-operative medicine. Despite extensive literature published over the last 50 years, TEB remains scarcely used by practitioners.