NON-INVASIVE METHODS FOR MATERNAL CARDIAC OUTPUT MONITORING

In a non-obstetric population, the optimization of cardiac output (CO) had been shown to improve survival and to reduce postoperative complications, organ failure and the length of stay1. CO monitoring might be very useful in the obstetric population as well, as physiologic changes of CO during pregnancy are mandatory for a normal outcome. An uncomplicated pregnancy is associated with a 50% increase in maternal CO, which is mediated by plasma volume expansion and a decrease in peripheral resistance2. An aberrant change of this maternal CO might influence pregnancy outcome: pregnancies complicated with foetal growth restriction and/or preeclampsia are characterized by increased total vascular resistance and reduced systolic function (i.e. lower CO and stroke volume (SV))3–5.

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Uncalibrated arterial pressure waveform analysis for cardiac output monitoring is biased by low peripheral resistance in patients with intracranial haemorrhage †

British Journal of Anaesthesia ◽

10.1093/bja/aer170 ◽

2011 ◽

Vol 107 (4) ◽

pp. 581-586 ◽

Cited By ~ 20

Author(s):

E.K. Junttila ◽

J.K. Koskenkari ◽

P.P. Ohtonen ◽

T.I. Ala-Kokko

Keyword(s):

Cardiac Output ◽

Arterial Pressure ◽

Intracranial Haemorrhage ◽

Peripheral Resistance ◽

Waveform Analysis ◽

Cardiac Output Monitoring ◽

Pressure Waveform ◽

Arterial Pressure Waveform ◽

Output Monitoring

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Continuous cardiac output monitoring in humans by invasive and noninvasive peripheral blood pressure waveform analysis

Journal of Applied Physiology ◽

10.1152/japplphysiol.01488.2005 ◽

2006 ◽

Vol 101 (2) ◽

pp. 598-608 ◽

Cited By ~ 42

Author(s):

Zhenwei Lu ◽

Ramakrishna Mukkamala

Keyword(s):

Blood Pressure ◽

Cardiac Output ◽

Peripheral Resistance ◽

Waveform Analysis ◽

Cardiac Output Monitoring ◽

Time Interval ◽

Data Sets ◽

Data Set ◽

Arterial Blood ◽

Output Monitoring

We present an evaluation of a novel technique for continuous (i.e., automatic) monitoring of relative cardiac output (CO) changes by long time interval analysis of a peripheral arterial blood pressure (ABP) waveform in humans. We specifically tested the mathematical analysis technique based on existing invasive and noninvasive hemodynamic data sets. With the former data set, we compared the application of the technique to peripheral ABP waveforms obtained via radial artery catheterization with simultaneous thermodilution CO measurements in 15 intensive care unit patients in which CO was changing because of disease progression and therapy. With the latter data set, we compared the application of the technique to noninvasive peripheral ABP waveforms obtained via a finger-cuff photoplethysmography system with simultaneous Doppler ultrasound CO measurements made by an expert in 10 healthy subjects during pharmacological and postural interventions. We report an overall CO root-mean-squared normalized error of 15.3% with respect to the invasive hemodynamic data set and 15.1% with respect to the noninvasive hemodynamic data set. Moreover, the CO errors from the invasive and noninvasive hemodynamic data sets were only mildly correlated with mean ABP (ρ = 0.41, 0.37) and even less correlated with CO (ρ = −0.14, −0.17), heart rate (ρ = 0.04, 0.19), total peripheral resistance (ρ = 0.38, 0.10), CO changes (ρ = −0.26, −0.20), and absolute CO changes (ρ = 0.03, 0.38). With further development and successful prospective testing, the technique may potentially be employed for continuous hemodynamic monitoring in the acute setting such as critical care and emergency care.

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