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British Journal of Anaesthesia, 2001, Vol. 86, No. 4 467-468
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial

Editorial II

Continuous cardiac output by pulse contour analysis?

J.J. van Lieshout and K.H. Wesseling

{dagger}Declaration of interest: Both authors have helped develop and have published on the Modelflow method (mentioned in reference 8). The second author holds a patent on that method.

Theoretically, tissue flow should be maintained at the lowest possible arterial perfusion pressure to minimize afterload and myocardial energy expenditure.1 In the monitoring and measurement of cardiovascular parameters in critically ill patients, however, cardiac output plays a subservient role to arterial blood pressure. Since blood pressure is the principal cardiovascular parameter monitored by the body via baroreceptors, this seems physiological. Furthermore, continuous cardiac output has proved extremely difficult to monitor.

Intermittent methods such as indicator dilution are widely used, but for monitoring purposes cardiac output should be available continuously, like arterial pressure.2 The paper by Linton and Linton in . . . [Full Text of this Article]

Major concerns about pulse contour analysis

Non-linearity
Radial artery pressure
Damped waveforms
Inadequate pulse detection
Absolute cardiac output
Minor concerns

Aortic pathology
Body position
Conclusion

References


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