New developments in perioperative cardiovascular monitoring.

Substantial technological progress has been made recently in the area of perioperative cardiovascular monitoring. Specialized monitoring may be performed for problems identified by preoperative evaluation. New technologies have been developed for monitoring the blood pressure continuously and non-invasively. Electrocardiographic monitoring of perioperative ischemia has been characterized. Newer techniques in echocardiography such as the use of contrast, and tissue characterization allowed improved monitoring of ischemia as well as ventricular function. Continuous monitoring of cardiac output can be performed by impedance cardiography and Doppler ultrasound and by continuous thermodilution. Improved rules for the differentiation of ventricular from supraventricular tachycardia have been developed. Detection of MI has been facilitated by new scintigraphic and enzymatic techniques. In critically ill patients, multi-system monitoring may be required to adequately assess the cardiovascular system.