Feasibility of noninvasive hemodynamic monitoring by bioreactance for air-evacuated casualties.

Background: The purpose of this study was to assess the feasibility of hemodynamic monitoring by bioreactance during the air evacuation of war casualties.
Methods: From June 2011 to January 2012, the French Air Force used a noninvasive bioreactance monitor during the aeromedical evacuation of patients with severe battle injury. Patients were continuously monitored from takeoff (baseline) until arrival. Cardiac index, quality, and viability of signal and fluctuations in values were assessed during the entire flight.
Results: Eighteen patients were included, and monitoring was possible for 16 patients. The implementation of the monitoring was found to be straightforward for both doctors and paramedics, and we observed no loss of signal or interference during the flights. Cardiac index decreased significantly during the takeoff and returned to baseline value after the 50th minute of flight.
Conclusion: The application of noninvasive bioreactance hemodynamic monitoring is feasible and pertinent in the specific environment of aeromedical evacuation. This monitoring can be particularly useful during the strategic evacuation of patients with severe injury from field hospital to tertiary centers.
Level of Evidence: Care management study, level V.