The ECOM® Technology

The ECOM® Advantage

EMI’s ECOM® System is dramatically different from all other Cardiac Output monitors based on bio-impedance technology. Delivering a current and positioning the electrodes immediately adjacent to the ascending aorta achieves significant benefits:

  1. Electrode arrays and ECOM® software quickly and automatically compensates for changes in ET tube position and patient's body position.
  2. Positionally Independent.
  3. Less Susceptible to Peripheral Issues.
  4. Beat to Beat measurements.
  5. Anywhere you would already use an A-line.
  6. Non-invasive, no external catheter needed.

Enter Height • Enter Weight • Enter Age

ECOM® Software Does The Rest!

How It Works

The ECOM® system is based on the basic principle that the electrical resistance of blood changes when it moves or fluctuates in volume. Blood is a charged solution and when it is pumped by the left ventricle, it causes fluid motion and volumetric changes. Therefore, by sending a current through the ascending aorta and measuring the change in resistance, one can deduce the amount of blood pumped by the heart (Cardiac Output).

The ECOM® Monitor is attached to an ET (endotracheal) tube, which has an inflation cuff (balloon) located at its distal end allowing for tracheal occlusion and position anchoring. The cuff is located immediately proximal to the bifurcation of the trachea, which is in direct contact with the ascending aorta. The ascending aorta is the main blood vessel branch from the left ventricle and is therefore ideally suited for Cardiac Output measurements. There are transmitting and receiving electrodes located on the cuff and tube, which allows direct monitoring of impedance changes from the ascending aorta and provide different transmission directions. This eliminates any potential interference or anomalous signals from structures in the heart, lungs or other great vessels, thereby overcoming the inherent limitations of other systems.

The monitor delivers an electrical current through the tracheal wall proximal to the balloon cuff and completes the circuit at the distal section of the cuff. The sensing electrodes can then create multiple geometrically configured pairs. When the blood is pumped by the left ventricle and is forced into the ascending aorta, the blood’s resistance to the current changes. The electrical current allows the volume change to be estimated and the amount of blood being pumped by the heart (Cardiac Output) to be determined.

The delta Z, defined as the change in base impedance (Zo), can be measured over each cardiac cycle. The information is further refined through the multiple sensing electrodes. Using proprietary signal processing methodology, information is derived from these impedance waveforms. This information reflects the changes in impedance and base impedance and is correlated with the cardiac cycle. Utilizing the timing determined by cardiac waveform monitoring, the information from the arterial pressure line, and information from the impedance system, we can calculate the Stroke Volume of each cardiac contraction. Multiplying Stroke Volume by Heart Rate gives us the Cardiac Output in liters per minute. The patient’s body surface area can also be utilized to calculate the Cardiac Index.


Hemodynamic parameters measured and calculated by the ECOM® System:

  • Cardiac Output
  • Cardiac Index
  • Stroke Volume
  • Stroke Volume Variation
  • Systemic Vascular Resistance

High-Risk Patients:

  • Prior MI
  • Elderly
  • Major GI Procedures
  • Major Cardiac/Vascular Procedures
  • Spinal Procedures