The ECOM system was designed to function in the most challenging patients in the hospital.  These are all ASA Physical Status 3, 4 and 5 patients requiring an arterial line.  Not only are these the most critical (and potentially fragile) patients, they are also the most expensive to treat.  Examples of procedures in which ECOM is best suited include all major invasive procedures where major fluid shifts are expected:

Major Orthopedic Procedures

  • Spinal fusion
  • Spinal stabilization
  • Hip revision or replacement

Colorectal Procedures

  • Abdominal perineal resection
  • Bowel diversion
  • Bowel or stomach resection

Vascular Procedures

  • Carotid endarterectomy
  • Open AAA
  • Surgical embolectomy

Organ repair/removal

  • Nephrectomy
  • Liver resection
  • Radical prostatectomy

Thoracic Procedures *NEW*

  • Pneumonectomies
  • Lobectomies
  • Wedge resections
  • VATS

Procedures of this nature will result in fluid loss not only through hemorrhaging, but the evaporative loss (upwards of a liter can be lost per hour) can also be considerable because of the length of the procedure.  With few exceptions, most patients undergoing these procedures are going to be older and more fragile.  Many will have cardiac co-morbidities that will increase the risk of complications during surgery.  The ECOM system represents a cost–effective way of providing immediate, real-time monitoring without the need for expensive specialized equipment (e.g., transesophageal echocardiography, etc.), or change in technique.