**5.8. Cost and availability**

When using MICOM running costs need consideration. In addition to the monitor most systems require disposable items to operate. Oesophageal Doppler requires disposable oesophageal probes which are made for single use (Figure 8). The FloTrac-Vigileo uses a disposable pressure transducer (Figure 10). The PiCCO uses a femoral artery catheter that also acts as a thermodilution catheter. The LiDCO and PRAM systems work on a credit card system to buy user time (Figure 10). The NICOM uses purpose made skin electrodes (Figure 4). The NICO had a disposable breathing attachment to facilitate carbon dioxide rebreathing (Figure 2). Most of these disposables are priced around the same cost as thermodilution catheter. The only system that does not to require disposable items other than ultrasound gel is the USCOM. The ultrasound probe is cleaned between patient uses. Financing ones supply of these disposable items can be a problem when first introducing what is a relatively new and unproven technology into ones clinical practice and may limit use. Manufacturers will calm that it is a necessary evil to sustain the company financially and replay their investment in research and development.
