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European Journal of Trauma and Emergency Surgery

Published in:

01-12-2019 | Original Article

Non-invasive cardiac output monitoring device “ICON” in trauma patients: a feasibility study

Authors: Matthias Kuster, Tobias Haltmeier, Aristomenis Exadaktylos, Beat Schnüriger

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2019

Abstract

Purpose

Assessment of hemodynamics is crucial for the evaluation of major trauma patients. Cardiac output (CO) monitoring provides additional information and may improve volume resuscitation. The goal of this prospective pilot study was to evaluate the feasibility of a new non-invasive CO monitoring (NICOM) device in the emergency department (ED).

Methods

Single-center prospective observational pilot study including 20 trauma patients admitted to a level 1 trauma center. CO was continuously monitored for 60 min after ED admission using the new NICOM device ICON^®. This device measures changes of the thoracic bioimpedance to calculate CO. Conventional vital signs were recorded simultaneously. Feasibility, safety, reliability, user-friendliness, and impact of the device on standard ED procedures were assessed.

Results

Thirteen (65%) patients were male, median age was 57.5 (IQR 25), and median ISS was 10.5 (IQR 14.8). Median CO over time was 9.8 l/min (IQR 4.6). No adverse effects were recorded. The device proved to be user-friendly with no negative impact on routine ED care. In four patients, detachment of electrodes was observed, and in four patients, the CO recording was temporary discontinued. Short-term changes of the CO were observed 44 times after the placement of electrodes and during patient transfers.

Conclusions

Non-invasive CO monitoring proved to be feasible and safe for the initial hemodynamic evaluation of trauma patients. Problems with the NICOM device were detachment of electrodes and temporary signal loss. Due to the small sample size and relatively low injury burden of the patients included in this study, further prospective investigation is warranted.

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Title: Non-invasive cardiac output monitoring device “ICON” in trauma patients: a feasibility study
Authors: Matthias Kuster
Tobias Haltmeier
Aristomenis Exadaktylos
Beat Schnüriger
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2019
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-0984-x

At a glance: The STEP trials

Springer Medicine

Non-invasive cardiac output monitoring device “ICON” in trauma patients: a feasibility study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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