Calculating Arterial Pressure-Based Cardiac Output Using a Novel Measurement and Analysis Method

Abstract

Work on applying physical and physiological principles for determining cardiac output by analysis of pressure measurements has been pursued for decades. Reference measurements for this kind of cardiac output analysis rely on the pulmonary artery catheter (PAC), considered the clinical gold standard for cardiac output monitoring. Recent advances in signal processing, as well as applied information on the relationships that enable arterial pulse pressure to be used to determine stroke volume, have led to the development of a novel system that can continuously measure cardiac output from an arterial pressure waveform that does not require an external calibration reference method. There are significant challenges in applying statistical- and signal-processing practices to the analysis of complex physiological waveforms. This paper reviews the historical basis for measuring flow from the analysis of pressure in a vessel, establishes the physiological and mathematical basis for this new system and describes its performance under various physiological conditions.

Stroke volume variation obtained with Vigileo/FloTrac™ system during bleeding and fluid overload in dogs

“…In the Vigileo-FloTrac TM system, SVV is calculated by taking (maximum SV (SV max ) -minimum SV (SV min ))/ mean SV every 20 s. SV is reported to be proportional to the standard deviation of the pulse pressure and therefore SV can be calculated by using the following equation: SV = v 9 SD [12]. The Vigileo-FloTrac TM system uses this equation to calculate SV.…”

Advanced Hemodynamic Monitoring: Principles and Practice in Neurocritical Care

“…An alternative method to derive continuous CO from the properties of the arterial waveform is the one used by FloTrac/Vigileo (Edwards LifeSciences, Irvine, CA) [18]. This is a self-calibrating algorithm (does not require thermodilution) that incorporates a proprietary multivariate equation taking into account biometric variables related to arterial compliance (e.g., age and sex) and geometric variables describing the arterial pressure waveform [19,20].…”

Calibrated versus uncalibrated arterial pressure waveform analysis in monitoring cardiac output with transpulmonary thermodilution in patients with severe sepsis and septic shock

“…1 The FloTrac/Vigileo system estimates CO by using the standard deviation of the pulse pressure, incorporating actual vascular tone based on waveform analysis and patient characteristics. 6 The arterial waveform is analysed over 20 s with a frequency of 100 Hz. The thirdgeneration software version (3.02) includes two separate models for the arterial tone factor: first, an arterial tone model that was developed predominantly from patients who did not have a hyperdynamic circulation (this is the same model used in the previous version 1.10); and second, an arterial tone model that was developed predominantly from patients who had a hyperdynamic circulation.…”