Promoted as a noninvasive alternative to the Swan Ganz catheter, this technology from Australian company USCOM Ltd. is nothing short of miraculous. We had a chance to play with the USCOM monitor at the ASA meeting, and found it easy to use and very informative. The device provides 14 parameters of cardiac function, such as stroke volume (SV), cardiac output (CO) and cardiac index. We tested the monitor by applying its transducer suprasternally, and it easily calculated hemodynamic values from trans-aortic flow profiles.
The company provides FAQs and answers on its technology:
What is the USCOM device?
The USCOM device is a sophisticated continuous wave Doppler ultrasound device utilizing unique specialised transducers, algorithms, signal processing and software to provide a simple, accurate and cost-effective tool for non-invasive hemodynamic assessment.
USCOM provides non-invasive beat to beat quantitative evaluation of cardiac haemodynamics and has been validated in high, normal and low outputs, and in the elderly down to pre-term neonates of 380gms.
Has it been validated?
USCOM is a sophisticated CW Doppler ultrasound device. CW Doppler has been used safely and reliably for over 25 years in clinical practice in multiple clinical applications.
The USCOM algorithms are based on data from neonates of 23wks gestational age to 86yr olds, and have been specifically validated for cardiac outputs ranging from 0.12 to 17 l/min.
USCOM has been validated against flow probes in haemodynamic models and animals, and against thermodilution and echocardiography in humans and during altered cardiovascular physiology.
A full list of the USCOM validation, presentations and research is available on request.
How is volume calculated?
Both SV and CO can be reliably determined from the spectral flow profile as a product of the velocity time integral (vti) and the flow cross sectional area (CSA), and, for CO, times heart rate (HR).
This method has been in use for over 20 years in clinical practice and is probably considered the clinical haemodynamic “gold standard”.