Journal of clinical monitoring and computing
-
J Clin Monit Comput · Oct 2020
Editorial CommentNon-invasive monitoring is coming the full circle, making our patients safer!
Non-invasive monitoring is becoming more accurate, more available and mobile. The clinical advantage that this developing technology provides is that the data may be monitored continuously; relatively unobtrusively, and transmitted directly to the caregiver. The downside of being non-invasive has been the potential loss of accuracy in the data displayed. ⋯ The study by Applegate et al. [1] confirms the trend accuracy of SpHb as an indication to perform a laboratory confirmation of hemoglobin level. This will lead to earlier laboratory screening, so that developing adverse conditions, such as postoperative bleeding, may be identified at a time that major events, such as failure to rescue can be avoided. This increased availability of non-invasive technology will make patients safer both in our hospitals and at home.
-
Given the number of clinical studies and meta-analyses investigating the impact of cardiac output-guided hemodynamic management on the postoperative outcome of patients undergoing high-risk surgery, clinicians should already have a fair idea of the clinical and economic benefits. However, this is still a matter of debate, there are still large outcome studies going on, and surveys and audits have shown that clinical adoption remains low. Rational patient selection, more affordable monitoring solutions, and the personalization of therapeutic strategies are desirable to ensure that cardiac output monitoring adds value and becomes part of the routine anesthesia management of high-risk surgical patients.