Assessment of cardiac output from systemic arterial pressure in humans

Abstract

In the range evaluated (cardiac index from 1.65 to 3.91 L x min(-1) x m(-2) by the Fick method), PRAM provides reliable invasive and noninvasive estimates of cardiac output in hemodynamically stable cardiac patients. PRAM may prove clinically useful for the beat-to-beat monitoring of cardiac output.

Echocardiography and Hemodynamic Monitoring Tools for Clinical Assessment of Patients on Mechanical Circulatory Support

“…Indeed, a "no-value" alarm on the screen could serve as a "wake-up call" for an in-depth hemodynamic evaluation. This is particularly true for MostCare, which displays the dicrotic notch (and hence the aortic valve closure) at each cardiac cycle [68]. .…”

Hemodynamic changes acutely determined by primary PCI in STEMI patients evaluated with a minimally invasive method

“…This system applies, beat by beat, the mathematical analysis of pressure waveform, after careful check of the signal pressure quality, to obtain hemodynamic parameters [7]. At variance with other Pulse Con- tour Methods (PCM), based on a calibration and/or preestimated data obtained from other subjects and applied to the patient examined [8][9][10], PRAM uses directly the pressure wave of the patient under evaluation allowing an analysis more in keeping with the patient under study [5]. It is noteworthy that not only the system analyses the pressure curve during systolic phase, but considers also the diastolic phase and takes into account the whole pressure value during heartbeat: the pulsatory and the continuous contributions.…”

“…In this brief communication we report our preliminary experience, with one of these monitoring systems, PRAM (Pressure Recording Analytical Method) [5,6] used in 20 STEMI patients during primary PCI in…”

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

“…In distinction with other pulse contour methods, PRAM is also based on the physics theory of perturbations: a physical system under the effects of a perturbing factor tends to react in order to reacquire its own stability [75]. According to this principle PRAM will measure the whole systolic area under the pressure curve (pulsatile and continuous) instead of measuring only the pulsatile part of the pressure curve as others pulse contour systems.…”

“…On the other hand all these devices (calibrated or not) will be inaccurate and imprecise in patients with artefacts of the arterial waveform, arrhythmias, severe aortic valve regurgitation, aortic aneurysm, intracardiac and extra cardiac shunts, intra-aortic balloon pump and in severe hemodynamic unstable conditions [9,40,41,75,98]. Regarding the SVV and PPV measured by the APW systems (invasive or not, calibrated or not), the studies performed in cardiac and noncardiac surgical patients demonstrated that these are very good predictors of volume responsiveness [43-46, 59, 65, 66, 95, 96].…”