ADVANCED HAEMODYNAMIC SIMULATION

By Dr Laurence Weinberg

In the final post from SMACC Gold 2014, Dr Laurence Weinberg demonstrates the Flo Trac haemodynamic monitoring system! Flo Trac is a minimally invasive advanced haemodynamic monitor that allows continuous monitoring of patient’s SV, CI, SVV and SVI via a peripherally inserted arterial line. It is a useful piece of equipment in many clinical scenarios and can be utilized in the OT and the ICU to monitor the effects of fluids and medications on patient physiology.

In this video demonstration, Dr Weinberg uses a real-life volunteer, hooks her up to the monitor and performs physiological experiments on her in order to demonstrate their impact on haemodynamics and how to use the Flo Trac to to monitor these effects. He induces a state of controlled shock using a GTN infusion and his subject demonstrates an excellent example of how a fit young patient can compensate in shocked states! When compensation fails, you will see how vasoconstrictors affect cardiac parameters to improve cardiac output in preload responsive patients. Dr Weinberg also describes how to tell the difference between a euvolemic, preload responsive patient and a bleeding, preload unresponsive patient in the intraoperative setting and how to differently manage the two.

To further demonstrate chemical manipulation of cardiac physiology, he also demonstrates the sympathomimetic effects of dopamine on an otherwise healthy patient.

This entertaining and enlightening presentation provides an excellent demonstration of advanced haemodynamic monitoring in a controlled environment. Although he uses a real patient and real medications, all interventions are carefully planned and consented to in order to minimize risks! It should go without saying but don’t try this at home!