Arterial waveform analysis for the anesthesiologist: past, present, and future concepts.

Abstract:

:Qualitative arterial waveform analysis has been in existence for millennia; quantitative arterial waveform analysis techniques, which can be traced back to Euler's work in the 18th century, have not been widely used by anesthesiologists and other clinicians. This is likely attributable, in part, to the widespread use of the sphygmomanometer, which allows the practitioner to assess arterial blood pressure without having to develop a sense for the higher-order characteristics of the arterial waveform. The 20-year delay in the development of devices that measure these traits is a testament to the primitiveness of our appreciation for this information. The shape of the peripheral arterial pressure waveform may indeed contain information useful to the anesthesiologist and intensivist. The maximal slope of the peripheral arterial pressure tracing seems to be related to left ventricular contractility, although the relationship may be confounded by other hemodynamic variables. The area under the peripheral arterial pressure tracing is related to stroke volume when loading conditions are stable; this finding has been used in the development of several continuous cardiac output monitors. Pulse wave velocity may be related to vascular impedance and could potentially improve the accuracy of waveform-based stroke volume estimates. Estimates of central arterial pressures (e.g., aortic) can be produced from peripheral (e.g., brachial, radial) tracings using a Generalized Transfer Function, and are incorporated into the algorithms of several continuous cardiac output monitors.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Thiele RH,Durieux ME

doi

10.1213/ANE.0b013e31822773ec

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

766-76

issue

4

eissn

0003-2999

issn

1526-7598

pii

ANE.0b013e31822773ec

journal_volume

113

pub_type

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