Utilization of impedance cardiography in noninvasive assessment of hemodynamic status in cirrhotic patients.

Background/aims: This study aimed to assess hemodynamic alterations noninvasively using a dedicated device Task Force® Monitor providing various hemodynamic data utilizing impedance cardiography and beat-to-beat blood pressure analysis via a vascular unloading unit.

Methods: Forty-seven patients with cirrhosis awaiting hepatic transplantation and 26 healthy volunteers matched for age and gender were enrolled. Basic hemodynamic status of these patients (following temporary interruption of any drugs affecting the cardiovascular system) was evaluated noninvasively by Task Force® Monitor with patients in the supine position.

Results: Mean age of the patients was 46 years and 74.5% were male. The etiology of cirrhosis was viral hepatitis in 59.5% and alcoholic cirrhosis in 19.1% of cases, whereas 17% had cryptogenic cirrhosis. 38.3%, 25.5%, and 36.1% of the patients were stratified into groups A, B and C according to the Child-Pugh classification, respectively. Heart rate, cardiac output and cardiac index were significantly higher in patients with cirrhosis compared to the control group. However, diastolic blood pressure, total peripheral resistance and total peripheral resistance index were significantly lower in the cirrhosis group. This situation representing a hyperdynamic circulatory state became more prominent in conjunction with advanced disease severity.

Conclusions: The present study demonstrates that the Task Force® Monitor device is capable of delineating the hyperdynamic circulatory state in cirrhotic patients and satisfactorily indicates differences between controls and patients at diverse levels of severity. Regarding potential applications in clinical practice and research, noninvasive hemodynamic monitoring by Task Force® Monitor may be a reliable and reasonable alternative tool to invasive procedures.