non invasive haemodynamic monitor. Cardiac Output with impedance cardiography ICG,
thoracic electrical bioimpedance TEB with cardioscreen / niccomo impedance plethysmography IPG. medis
deutsch english non-invasive continuous cardiac output monitor

Technology Parameters Validation

Validation of the Cardiac Output Calculation

80 simultaneous measurements on 46 heart patients with Thermodilution (•), Doppler (¤) or Fick’s method (×) and CardioScreen® (niccomo™) from medis.

CO in l/min reference methods
CO in l/min CardioScreen® System

The measurements were carried out at ICUs and in heart catheter labs (also with exercise on bicycle) in following clinics (all located in Germany and Austria):

Klinikum Bamberg Klinikum Augsburg Herzzentrum Bad Krozingen
2. Med. Klinik Erlangen Waldkrankenhaus Erlangen Herzchirugie Freiburg
Klinikum Nürnberg Süd Klinikum Nürnberg Nord Klinikum Ingolstadt
Bezirskrankenhaus Salzburg Klinikum Fürth
LVA-Klinik für Lungenkrankheiten Bad Reichenhall

Some of the measurements are published (German language):

Stark, H. J., Schultz, K., Krieger, V., Korn, V., Petro, W.: Nichtinvasive Ermittlung des Herzzeitvolumens mit der Impedanzkardiographie. Hohe Korrelation mit der invasiven Fickschen Methode; Atemwegs- und Lungenkrankheiten 22 (1996). S. 73-75

Other studies comparing impedance cardiography with invasive methods

Impedance cardiography was developed for NASA in the 70ís. In the meantime many validation studies have been published. The following table gives a selection:

Author/Year Patients Correlation Reference method
Edmunds/1982 23 0.94 Fick healthy probands
Hetherington/1985 20 0.93 Fick various heart diseases
Teo/1985 20 0.93 Fick Angina Pectoris
Goldstein/1986 45 0.85 Thermodilution healthy and ICU
Appel/1986 16 0.83 Thermodilution ICU
Bernstein/1986 17 0.88 Thermodilution ICU
Mattar/1986 5 0.95 Thermodilution ICU
Appel/1987 28 0.83 Thermodilution ICU
McKinley/1987 7 0.93 Thermodilution children
Shellok/1987 19 0.95 Thermodilution ICU
Spinale/1987 10 0.77 Thermodilution various heart diseases
Könn/1988 20 0.71 Thermodilution CHD
Jakob/1988 11 0.73 Thermodilution various heart diseases
Introna/1988 8 0.94 Thermodilution children in ICU
Shoemaker/1988 17 0.83 Thermodilution ICU
Saladin/1988 24 0.83 Thermodilution various heart diseases
24 0.82 Fick
24 0.77 Fick vs. Thermodilution
Robert/1988 59 0.94 Thermodilution children with various heart diseases
Castor/1989 1966 0.95 Thermodilution
Castor/1990 641 0.93 Thermodilution
Castor/1990 155 0.91 Thermodilution OR
155 0.93 Thermodilution OR
Klocke/1990 109 0.82 Fick various heart diseases
109 0.90 Thermodilution various heart diseases
109 0.87 Thermodilution with exercise

Selected from V. Korn following an overview of R. K. Klocke (1994)

Please note the study of Saladin1988: He found a correlation of 0.83 comparing impedance cardiography with thermodilution and of 0.82 compared to Fick’s method. But, the correlation between both invasive methods was only 0.77.

Finally, if the limitations of impedance cardiography (not suitable for some heart diseases and high level of arteriosclerosis) are considered, impedance measurements - combined with high level signal evaluation, such as the PASA-algorithms - are comparable with established invasive methods.

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