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:
- good quality of the derived pressure curve - depending on
- Estimation of patient-specific aortic compliance - depending on
- general condition of the vascular system (e.g. presence of arteriosclerosis )
- Calibration of the measuring system at regular intervals
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 ).
- 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 ® ) .