AANA journal
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Risk management and cost containment concerns inherent in central venous cannulation and pulmonary artery catheter insertion have prompted the search for noninvasive cardiac output methods. Thoracic electrical bioimpedance is one such method, revitalized since the early days of space flight. Thoracic electrical bioimpedance measures the impedance changes associated with plethysmographic changes within the thoracic cavity and determines cardiac output. An appreciation of the foundational principles underlying thoracic electrical bioimpedance when compared to the Fick, indicator dilution and Doppler cardiac output monitoring methods will facilitate the nurse anesthetist's understanding and utilization of these modalities.
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Cost issues and questions related to graduate nurse anesthesia education are raised from the perspective of a dean of a college of nursing. Suggestions relative to these issues are made, and various funding mechanisms that exist in institutions of higher learning are briefly discussed in relation to their cost and benefits.