{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:22:50Z","timestamp":1790734970957,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The application of rapid, non\u2010operator\u2010dependent, non\u2010invasive cardiac output monitoring (COM) may provide early physiological information in ED patients with haemodynamic instability (HI). Our primary objective was to assess the feasibility of measuring pre\u2010intervention (baseline) cardiac index (CI) and associated haemodynamic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a prospective observational study of adults shortly after presentation to the ED of a large university hospital with tachycardia or hypotension or both. We applied non\u2010invasive COM for 5\u00a0min and recorded CI, mean arterial pressure (MAP), stroke volume index (SVI) and systemic vascular resistance index (SVRI). We assessed for differences between those presenting with hypotension or hypotension and tachycardia with tachycardia alone and between those with or without suspected infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We obtained haemodynamic parameters in 46 of 49 patients. In patients with hypotension or hypotension and tachycardia (<jats:italic>n<\/jats:italic>\u2009=\u200915) rather than tachycardia alone (<jats:italic>n<\/jats:italic>\u2009=\u200931), we observed a lower MAP (60.8 <jats:italic>vs<\/jats:italic> 87.7, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), CI (2.8 <jats:italic>vs<\/jats:italic> 3.9, <jats:italic>P<\/jats:italic> = 0.0167) and heart rate (85.5 <jats:italic>vs<\/jats:italic> 115.4, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). There was no difference in SVI (33.7 <jats:italic>vs<\/jats:italic> 33.4, <jats:italic>P<\/jats:italic>\u2009=\u20090.93) or SVRI (1970 <jats:italic>vs<\/jats:italic> 2088, <jats:italic>P<\/jats:italic>\u2009=\u20090.67). Patients with suspected infection had similar haemodynamic values except for a lower SVRI (1706 <jats:italic>vs<\/jats:italic> 2237, <jats:italic>P<\/jats:italic>\u2009=\u20090.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Rapid, non\u2010operator\u2010dependent, non\u2010invasive COM was possible in &gt;90% of ED patients presenting with HI. Compared with tachycardia alone, patients with hypotension had lower CI, MAP and heart rate, while those with suspected infection had a lower SVRI. This technology provides novel insights into the early state of the circulation in ED patients with HI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13926","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T05:03:15Z","timestamp":1641272595000},"page":"528-538","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>COMBED:<\/scp> Rapid non\u2010invasive Cardiac Output Monitoring Baseline assessment in adult Emergency Department patients with haemodynamic instability"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1124-9576","authenticated-orcid":false,"given":"Christopher T","family":"Eyeington","sequence":"first","affiliation":[{"name":"Department of Intensive Care Austin Hospital  Melbourne Victoria Australia"},{"name":"Division of Anaesthesia Cambridge University Hospitals NHS Trust  Cambridge 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