Pulse contour analysis

The pulse contour analysis is a method for semi-invasive evaluation of cardiac output (HMV). From the shape of the arterial blood pressure curve, which is continuously derived by suitable apparatus and shown via a catheter in a peripheral artery, the stroke volume of the heart (more precisely: the left ventricle) is estimated using mathematical methods . The aim of this method is to extract, simplify and present the information contained in the arterial blood pressure curve in a clinically usable manner . Despite good agreement between the values ​​determined using this method and PAH measurements, the following requirements exist for the valid implementation of this method:

Development of the blood pressure curve
SV = stroke volume, C _aorta = aortic compliance, v _blood = blood flow velocity , PP = pulse pressure

• good quality of the derived pressure curve - depending on
  • physical properties of the pressure measuring system ( natural frequency > 12 Hz , damping coefficient between 0.3 and 0.5)
  • Puncture site (e.g. femoral artery )
  • Geometry of the vascular system
  • Stroke volume
  • Heart mechanics ( heart valve defect )
• Estimation of patient-specific aortic compliance - depending on
  • anatomy
  • Age
  • general condition of the vascular system (e.g. presence of arteriosclerosis )
• Calibration of the measuring system at regular intervals
  • Indicator dilution methods ( thermal dilution , lithium as an indicator )

The advantage of pulse contour analysis consists in

• the moderate invasiveness,
• the low complication rate,
• the representation of essential hemodynamic parameters in (quasi) real time and in
• the derivation of special parameters (e.g. stroke volume variability , heart rate variability ) that have been used more and more in recent years.

The disadvantage is the strong dependence on the quality of the pressure signal derived. The gold standard - at least currently - is still measurement with the Swan-Ganz catheter .

The first work on the connection between pulse curve and HMV appeared in 1904 ( Erlanger J, Hooker DR: An experimental study of blood pressure and of pulse pressure in man. Johns Hopkins Hosp Rep 1904 ).

See also

• PiCCO

literature

• Amitava Majumder, Anne Paschen: Medical working techniques. In: Jörg Braun, Roland Preuss (Ed.): Clinic Guide Intensive Care Medicine. 9th edition. Elsevier, Munich 2016, ISBN 978-3-437-23763-8 , pp. 29–93, here: pp. 41–43: Pulse contour analysis (PiCCO ^® ) .

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !