Cardiac output derived from arterial pressure waveform

Abstract

Although there are differences in invasiveness and the need for external calibration, all available devices provide parameters for enhanced hemodynamic monitoring. Initial validation studies of the more established techniques such as the pulse contour cardiac output (PiCCO) or LiDCO were recently met with less enthusiasm, whereas the initially disappointing validation studies of the FloTrac/Vigileo device had encouraging results after software updates. The pressure recording analytical method (PRAM) technique has not so far been sufficiently evaluated to be able to come to a conclusion. Further investigation is required with regard to the ability of the arterial pressure waveform-based methods to guide goal-directed therapy.

The “systolic volume balance” method for the noninvasive estimation of cardiac output based on pressure wave analysis

“…This result points out that correction or calibration of the other formulas by a single coefficient is ineffective, in contrast to SVB and eSVB. For this reason, most of these PCCO methods require repeated calibrations to provide more consistent results, a possible reason for which these methods are still under criticism (25).…”

Changes in pulse pressure following fluid loading: a comparison between aortic root (non-invasive tonometry) and femoral artery (invasive recordings)

“…In a given individual, it may be reasonably hypothesized that changes in PP are related to SV changes during fluid challenge if one assumes minor changes in pulse wave transmission and if one considers unchanged compliance. Consistently, (1) peripheral PP decreases when central blood volume decreases under low body negative pressure in healthy subjects [10]; (2) respiratory variations in peripheral PP parallel respiratory SV changes and preload responsiveness in sinus rhythm, sedated and mechanically ventilated patients [11][12][13]; and (3) various algorithms based on peripheral PP and pulse contour analysis have been developed to estimate SV and cardiac output in the intensive care unit (ICU) [14,15].…”

Perioperative interventions and post‐operative outcomes

“…[75][76][77] Secondly: What is the goal in goal-directed fluid therapy? Should fluid be given in a restrictive way, in a liberal way or until a predefined threshold is met [78-…”