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ECOM cardiac output monitor.

dchz

Avoiding the Dunning-Kruger
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Sep 25, 2012
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  1. Attending Physician
    Anyone heard of this new cardiac output monitor?

    It's a ET tube with transducers that measure the impedance of the aorta, match that info from A lines and gives out the variables of CO, CI, SV, SVV, and SVR.

    I spent a while looking at the electrodes on the ET tube, trying to figure out how it can measure impedance accurately, then i realized it probably doesn't.... it's probably just added a random variable of "impedance" to bypass the patent on current pulse contour analysis.

    Anyone has any more info on this thing? so far the only advantage i see is that it's more cost effective than the Vigileo;

    Price quoted from the rep:

    Vigileo: base unit cost: ~$30k, variable cost (transducer): ~$300

    ECOM: base unit cost: ~$7k, variable cost (ETT): ~$200

    Anyone else have any experience with them?
     

    cchoukal

    Senior Member
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    Jul 11, 2001
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    1. Attending Physician
      These have been around for a decade or more. They were developed by a mentor of mine (a cardiac anesthesiologist and engineer), and were developed and validated in cardiac surgery patients. I have only seen data validating them against the Swan, comparing cardiac output between the two technologies, and the R^2 was in the 0.6 range. I use them, however, for their stroke volume variability metric, which I do find helpful for decisions about fluid in larger cases. Some common issues relate to poor impedence signals, which can often be corrected by adjusting the tube position or deflating/reinflating the cuff.

      As for the underlying technology, I can't say exactly how it calculates impedence. I was under the impression that the leads detected a current generated by the flow of electroytes through the ascending aorta. I will ask the developer, though, to explain it to me (again) and would be happy to post what he says.
       
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      cchoukal

      Senior Member
      Volunteer Staff
      Verified Expert
      Jul 11, 2001
      2,199
      479
      SF, CA
      1. Attending Physician
        These have been around for a decade or more. They were developed by a mentor of mine (a cardiac anesthesiologist and engineer), and were developed and validated in cardiac surgery patients. I have only seen data validating them against the Swan, comparing cardiac output between the two technologies, and the R^2 was in the 0.6 range. I use them, however, for their stroke volume variability metric, which I do find helpful for decisions about fluid in larger cases. Some common issues relate to poor impedence signals, which can often be corrected by adjusting the tube position or deflating/reinflating the cuff.

        As for the underlying technology, I can't say exactly how it calculates impedence. I was under the impression that the leads detected a current generated by the flow of electroytes through the ascending aorta. I will ask the developer, though, to explain it to me (again) and would be happy to post what he says.

        "it generates a 2 mA sine wave across the electrodes at 20 KHz and then measures voltages in 3D. Those voltages are used in an empiric formula to calculate stroke volume."

        Still sounds like Greek to me.
         
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          These have been around for a decade or more. They were developed by a mentor of mine (a cardiac anesthesiologist and engineer), and were developed and validated in cardiac surgery patients. I have only seen data validating them against the Swan, comparing cardiac output between the two technologies, and the R^2 was in the 0.6 range. I use them, however, for their stroke volume variability metric, which I do find helpful for decisions about fluid in larger cases. Some common issues relate to poor impedence signals, which can often be corrected by adjusting the tube position or deflating/reinflating the cuff.

          As for the underlying technology, I can't say exactly how it calculates impedence. I was under the impression that the leads detected a current generated by the flow of electroytes through the ascending aorta. I will ask the developer, though, to explain it to me (again) and would be happy to post what he says.

          what is Wallace cooking up these days?
           
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