COVID-19 Patient Management
Value of Electrical Cardiometry™
SARS-CoV-2
SARS-CoV-2 broke out in December 2019, and it spreads from Wuhan, Hubei Province, to all over China and many other countries in the world, and since COVID-19 emerged, data was needed on the clinical characteristics of the affected patients.
Monitoring Hemodynamics
Achieving circulatory stability is sometimes a real challenge in critical patients due to the complex hemodynamics (blood flow, vascular resistance and fluid status) of these patients, and the difficulty to use invasive lines.
The clinical assessment of systemic blood flow (SBF) by indirect parameters, such as “blood pressure, capillary refill time, heart rate, urine output, and CVP” is inaccurate. Information on cardiac output, systemic vascular resistance and end organ perfusion should be obtained to detect inadequate tissue perfusion and oxygenation at early stage.
When deciding to initiate treatment? Should every patient with hypotension be treated the same way? Which therapy is the best for each patient, inotropes, vasopressors or fluid?
The hemodynamic response to the initiated treatment should be regularly assessed and the dose adjusted accordingly, as changes in cardiovascular function can occur quickly.
COVID-19 Patient Management using Electrical Cardiometry™
- SVV (Stroke Volume Variation) and FTc (Flow Time), are good predictors of intravascular volume and fluid responsiveness. Electrical Cardiometry™ is great tool for fluid management of COVID-19 patients.
- TFC (Thoracic Fluid Content) is a very good parameter to estimate and detect lung and chest congestion, without the need for regular chest X-Ray.
- TFC can detect the response for diuretics on chest congestion of COVID-19 patients.
- Monitoring pre-load and chest congestion at the same time in a non-invasive way helps to decide the type of fluid to give (Crystalloids or Colloids).
- Additionally, the other hemodynamic EC-parameters are helping to assess blood flow, contractility, systemic vascular resistance, ejection fraction… (SV, CO, SVR, ICON, STR, LVET, …).
- Titrating Inotropes (Norepinephrine, Vasopressin or Dobutamine) cannot be done perfectly without keeping a continuous measurement of the cardiac contractility to maintain MAP of 60:65mmHg, while avoiding the use of Dopamine, as per guidelines.