Pulse wave analysis - basic concepts and clinical application in intensive care medicine
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Pulse wave analysis - basic concepts and clinical application in intensive care medicine. / Thomsen, Kristen K; Kouz, Karim; Saugel, Bernd.
in: CURR OPIN CRIT CARE, Jahrgang 29, Nr. 3, 01.06.2023, S. 215-222.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Pulse wave analysis - basic concepts and clinical application in intensive care medicine
AU - Thomsen, Kristen K
AU - Kouz, Karim
AU - Saugel, Bernd
N1 - Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - PURPOSE OF REVIEW: The measurement of cardiac output (CO) is important in patients with circulatory shock. Pulse wave analysis (PWA) estimates CO continuously and in real-time using the mathematical analysis of the arterial pressure waveform. We describe different PWA methods and provide a framework for CO monitoring using PWA in critically ill patients.RECENT FINDINGS: PWA monitoring systems can be classified according to their invasiveness (into invasive, minimally invasive, and noninvasive systems) and their calibration method (into externally calibrated, internally calibrated, and uncalibrated systems). PWA requires optimal arterial pressure waveform signals. Marked alterations and rapid changes in systemic vascular resistance and vasomotor tone can impair the measurement performance of PWA.SUMMARY: Noninvasive PWA methods are generally not recommended in critically ill patients (who have arterial catheters anyway). PWA systems can be used to continuously track stroke volume and CO in real-time during tests of fluid responsiveness or during therapeutic interventions. During fluid challenges, continuous CO monitoring is important because - if CO decreases - a fluid challenge can be stopped early to avoid further unnecessary fluid administration. PWA externally calibrated to indicator dilution methods can be used - in addition to echocardiography - to diagnose the type of shock.
AB - PURPOSE OF REVIEW: The measurement of cardiac output (CO) is important in patients with circulatory shock. Pulse wave analysis (PWA) estimates CO continuously and in real-time using the mathematical analysis of the arterial pressure waveform. We describe different PWA methods and provide a framework for CO monitoring using PWA in critically ill patients.RECENT FINDINGS: PWA monitoring systems can be classified according to their invasiveness (into invasive, minimally invasive, and noninvasive systems) and their calibration method (into externally calibrated, internally calibrated, and uncalibrated systems). PWA requires optimal arterial pressure waveform signals. Marked alterations and rapid changes in systemic vascular resistance and vasomotor tone can impair the measurement performance of PWA.SUMMARY: Noninvasive PWA methods are generally not recommended in critically ill patients (who have arterial catheters anyway). PWA systems can be used to continuously track stroke volume and CO in real-time during tests of fluid responsiveness or during therapeutic interventions. During fluid challenges, continuous CO monitoring is important because - if CO decreases - a fluid challenge can be stopped early to avoid further unnecessary fluid administration. PWA externally calibrated to indicator dilution methods can be used - in addition to echocardiography - to diagnose the type of shock.
KW - Arterial Pressure
KW - Cardiac Output
KW - Critical Care
KW - Critical Illness
KW - Heart Rate
KW - Humans
U2 - 10.1097/MCC.0000000000001039
DO - 10.1097/MCC.0000000000001039
M3 - SCORING: Review article
C2 - 37078625
VL - 29
SP - 215
EP - 222
JO - CURR OPIN CRIT CARE
JF - CURR OPIN CRIT CARE
SN - 1070-5295
IS - 3
ER -