Cardiac outputnoninvasive 2 Pulse contour analysis

The concept of this technique is that the contour of the arterial pressure waveform is proportional to stroke volume. However, it is also influenced by aortic impedance so another cardiac output measuring technique (e.g. commercial devices utilising COLD-Pulsion or LiDCO) must be used in tandem for initial calibration. Although it can then be used as a means of continuous cardiac output monitoring, frequent re-calibration should be performed against the reference technique. This is particularly important when changes in impedance occur, e.g. with changes in cardiac output, vascular tone, body temperature.

Advantages

Continuous flow monitoring, uses data from arterial cannula already in situ for pressure monitoring.

Disadvantages

Changes in vascular compliance will affect accuracy requiring frequent recalibration. Requires a good quality, non-obstructed and non-damped arterial waveform. There is debate about the relative quality of signal from radial vs. femoral artery.

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