Cardiac Output Insights application: democratising advanced hemodynamic  monitoring in the OR 

Every year, millions of high-risk surgical patients experience hemodynamic instability—a condition linked to postoperative morbidity and mortality. Yet only 10% to 40% of these patients receive cardiac output (CO) monitoring ¹⁵ which is recommended to identify the underlying causes of hemodynamic instability and guide treatment. Why? Mainly because existing solutions are not accessible to all patients. Cardiac Output Insights changes that by making CO monitoring simple, affordable, and available on demand. 

A patient’s reality 

Maria is 72, has multiple co-morbidities, and is scheduled for major abdominal surgery. She’s at high risk of developing intraoperative complications such as hemodynamic instability. Her anesthesiologist knows this, but in most operating rooms today, the tools to truly understand what’s driving perioperative hypotension aren’t available for every patient. 

Traditional CO monitoring solutions can be expensive, require dedicated hardware, and are not readily available for every patient who could benefit—creating barriers to adoption and leaving many high-risk individuals without advanced hemodynamic assessment when it matters most. 

It’s time to change that. 

The limitations of traditional cardiac output monitoring systems 

CO monitoring is widely recognised as essential for managing hemodynamic instability because it helps clinicians identify whether instability is related to vasodilation, hypovolemia, or cardiac dysfunction—and guide therapy accordingly ^1,13 

However, the real limitation is access. Traditional systems require separate monitors and specialised sensors—making them costly and logistically complex. These barriers mean that many high risk patients, most of whom already have an arterial line in place do not receive guideline-recommended monitoring. Surveys and observational studies confirm that adoption remains low, with only a minority of high-risk surgical patients having their cardiac output  monitored, primarily due to cost and availability constraints².  

This gap is even more pronounced in resource-limited settings, where fewer than 40% of clinicians report access to CO monitoring tools when needed³  . 

Benefits of a new solution by GE HealthCare: Cardiac Output Insights 

Cardiac Output Insights is an integrated proprietary technology of the GE HealthCare Carevance  ^TM patient monitor. Cardiac Output Insights make advanced monitoring accessible, affordable, and easy to use—removing the barriers of traditional systems. 

Here’s how Cardiac Output Insights helps clinicians and patients: 

• Accessibility 

Cardiac Output Insights application uses the standard arterial blood pressure transducer. By leveraging the arterial line already in place, clinicians can access accurate CO measurements with one click—no extra equipment, no added complexity. This seamless integration supports guideline adherence and expands access to more patients at a fraction of the cost of other solutions ⁴ 

• Accuracy 

Cardiac Output Insights is powered by the validated PRAM (Pressure Recording Analytical Method) algorithm which calculates Cardiac Output using pulse contour analysis⁵. 

The PRAM algorithm is validated against pulmonary thermodilution⁶ and echocardiography⁷. PRAM accuracy is not influenced by vascular tone ⁸ and PRAM is proven to be more accurate and precise than other algorithms⁹ . 

• Decision support view 

Cardiac Output Insights provides an intuitive, physiologically organised display that brings cardiac output and related variables together in a clear context. This approach helps clinicians quickly interpret hemodynamic profiles—such as vasodilation versus low flow—and make informed decisions without needing to mentally combine separate data points. By presenting information in a structured and meaningful way, Cardiac Output Insights may support faster recognition of underlying mechanisms and timely, cause-directed therapy ¹⁰ .  

• Quantification of hypotension 

Hypotension is linked to morbidity and mortality, so quantifying its duration is useful: for example in a  study MAP (mean arterial pressure) < 60 mm Hg for >20 min was independently linked to postoperative acute kidney injury. Incidence of intensive care units admission (3.97% vs 1.24%) and mortality (2.76% vs 0.80%) was significantly higher in acute kidney injury patients ¹¹.  

Cardiac Output Insights provides a visual representation of time spent outside the target MAP range, helping clinicians reduce risks. 

• Predictive insights 

Cardiac Output Insights send alerts just before MAP becomes too low, prompting clinicians to activate monitoring and intervene proactively—supporting faster, cause-directed care. 

• Economic and environmental value 

Traditional monitoring approaches involve additional hardware and proprietary disposables, which increase cost and complexity and limit widespread adoption. The Carevance ^TM patient monitor’s Cardiac Output Insights technology removes these barriers by leveraging the arterial line and standard pressure transducer already in place, eliminating the need for dedicated cardiac output monitors or specialised sensors. Combined with a flexible licensing model, this approach dramatically reduces cost per patient and helps expand access. By reducing extra equipment and reducing waste, it also supports institutional sustainability goals ¹²  . 

• Available on-demand 

Traditional systems often lead to inefficiencies—patients may develop instability before monitoring is in place, or resources may be wasted when monitoring is unnecessary. Cardiac Output Insights solves this with on-demand activation: one click enables monitoring whenever a patient’s condition changes, supported by proactive alerts when MAP approaches a dangerous zone. 

From barriers to breakthrough: making Cardiac Output  monitoring more accessible  

Cardiac Output Insights (part the Carevance ^TM  bedside monitor) removes barriers of cost and complexity—making cause-directed care available when and where it is needed. 

In the case of Maria Cardiac Output Insights application could be exactly ‘’ ready to use’’ at her vital signs monitor available in the operating room.   

With on-demand activation, intuitive visual guidance, and a validated algorithm, Maria’s anesthesiologist could act faster, treat with confidence, and align care with leading guidelines.  

Combined with a sustainable, pay-per-use model, Cardiac Output Insights delivers accessibility, accuracy, and affordability—helping hospitals improve outcomes while reducing waste and cost. 

This is more than innovation. It’s democratisation of advanced hemodynamic monitoring—a smarter, simpler, and more equitable way forward for perioperative care. 

References 

1. Scott MJ. Perioperative patients with hemodynamic instability: Consensus recommendations of the Anesthesia Patient Safety Foundation. Anesth Analg. 2024;138:713–24. 

2. Flick M, Joosten A, Scheeren TWL, et al. Haemodynamic monitoring and management in patients having noncardiac surgery: a survey among members of the European Society of Anaesthesiology and Intensive Care. Eur J Anaesthesiol Intensive Care. 2023;2:e0017. 

3. Michard F, Divatia J, Nacul FE, et al. Access to haemodynamic evaluation tools in middle-income countries: a survey of 1593 anaesthetists and intensivists from 39 nations. BJA Open. 2026;17:100515. 

4. Michard F, Chew M, Futier E. Perioperative cardiac output monitoring for the many. Intensive Care Med. 2025;51:1526–9. 

5. https://hemodynamic-management.vygon.com/product-solutions/the-concept-pram-method/ 

6. Franchi F, Silvestri R, Cubattoli L, et al. Comparison between an uncalibrated pulse contour method and thermodilution technique for cardiac output estimation in septic patients. Br J Anaesth. 2011;107:202–8 

7. Scolletta S, Franchi F, Romagnoli S, et al. Comparison between Doppler-echocardiography and uncalibrated pulse contour method for cardiac output measurement: a multicenter observational study. Crit Care Med. 2016;44:1370–79. 

8. Franchi F, Silvestri R, Cubattoli L, et al. Comparison between an uncalibrated pulse contour method and thermodilution technique for cardiac output estimation in septic patients. Br J Anaesth. 2011;107:202–8 

9. Romagnoli S, Ricci Z, Romano SM, et al. FloTrac/Vigileo™ and MostCare®/PRAM versus Echocardiography for cardiac output estimation in vascular surgery. J Cardiothorac Vasc Anesth. 2013;27:1114–21. 

10. Michard F, Abou-Arab O. Hemodynamic phenotyping 4.0. Anaesth Crit Care Pain Med. 2025;101647. 

11. Li J, Ma Y, et al. Intraoperative hypotension associated with postoperative acute kidney injury in hypertension patients undergoing non-cardiac surgery: a retrospective cohort study. Burns & Trauma. 2024;12:tkae029. 

12. Michard F, Romagnoli S, Saugel B. Make my haemodynamic monitor GREEN: sustainable monitoring solutions. Br J Anaesth. 2024;133:1367–70. 

13. Saugel B, Buhre W, Chew MS, et al. Intra-operative haemodynamic monitoring and management of adults having noncardiac surgery: a statement from the European Society of Anaesthesiology and Intensive Care. Eur J Anaesthesiol. 2025;42:543–56. 

14. Cannesson M, Pestel G, Ricks C, Hoeft A, Perel A. Hemodynamic monitoring and management in patients undergoing high-risk surgery: a survey among North American and European anesthesiologists. Crit Care. 2011;15:R197 

Always refer to the User Manual of the device for more information on the Cardiac Output Insights application.  

Data subject to change. © 2026 GE HealthCare  

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GE is a trademark of General Electric Company used under trademark license. 

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