Non-invasive electrical cardiometry cardiac output monitoring during prehospital helicopter emergency medical care: a feasibility study

• Published in: Journal of clinical monitoring and computing 2022-04, Vol.36 (2), p.363-370
• Main Authors: Slagt, Cornelis, Servaas, Sjoerd, Ketelaars, Rein, van Geffen, Geert-Jan, Tacken, Marijn Cornelia Theresia, Verrips, Corien Alexandra, Baggen, Lonneke Ankie Marcel, Scheffer, Gert Jan, van Eijk, Lucas Theodorus
• Format: Article
• Language: English
• Subjects: Anesthesiology; Cardiac output; Critical Care Medicine; Decision making; Emergency medical care; Emergency medical services; Feasibility studies; Health Sciences; Helicopters; Hemodynamics; Intensive; Medicine; Medicine & Public Health; Original Research; Patients; Signal monitoring; Signal quality; Statistics for Life Sciences; Telemedicine
• ISSN: 1387-1307; 1573-2614
• DOI: 10.1007/s10877-021-00657-5

Purpose Introducing advanced hemodynamic monitoring might be beneficial during Helicopter Emergency Medical Service (HEMS) care. However, it should not increase the on-scene-time, it should be easy to use and should be non-invasive. The goal of this study was to investigate the feasibility of non-invasive cardiac output measurements by electrical cardiometry (EC) and the quality of the EC signal during pre-hospital care provided by our HEMS. Methods A convenience sample of fifty patients who required HEMS assistance were included in this study. Problems with respect to connecting the patient, entering patient characteristics and measuring were inventoried. Quality of EC signal of the measurements was assessed during prehospital helicopter care. We recorded the number of measurements with a signal quality indicator (SQI) ≥ 80 and the number of patients having at least 1 measurement with a SQI ≥ 80. Furthermore, the SQI value distribution of the measurements within each patient was analysed. Results In the experience of the attending HEMS caregivers application of the device was easy and did not result in increased duration of on-scene time. Patch adhesion was reported as a concern due to clammy skin in 22% of all cases. 684 measurements were recorded during HEMS care. In 47 (94%) patients at least 1 measurement with an SQI ≥ 80 was registered. Of all recorded measurements 5.8% had an SQI