Noninvasive continuous hemodynamic monitoring

Abstract

Monitoring of continuous blood pressure and cardiac output is important to prevent hypoperfusion and to guide fluid administration, but only few patients receive such monitoring due to the invasive nature of most of the methods presently available. Noninvasive blood pressure can be determined continuously using finger cuff technology and cardiac output is easily obtained using a pulse contour method. In this way completely noninvasive continuous blood pressure and cardiac output are available for clinical use in all patients that would otherwise not be monitored. Developments and state of art in hemodynamic monitoring are reviewed here, with a focus on noninvasive continuous hemodynamic monitoring form the finger.

Current concepts in fluid therapy and non-invasive haemodynamic monitoring

“…Some concerns have been raised in patients with thick fingers due to oedema and in states of profound shock. The technology is used in ClearSight system (Edwards Lifesciences, Irwine, CA, USA; formerly known as Nexfin) and CNAP (CNSystems Medizintechnik AG, Graz, Austria) (26,27). But since the actual purpose of monitors is to guide therapy, studies are needed to determine if a non-invasive haemodynamic monitor coupled with an interventional protocol effects patients' outcome.…”

A cholinergic contribution to the circulatory responses evoked at the onset of handgrip exercise in humans

“…Cardiovascular variables were sampled at 1 kHz, and beat-to-beat values for HR and BP were stored for offline analysis. Stroke volume (SV) was calculated by analysis of the blood pressure waveform using pulse contour analysis (protocol 1; Beatscope, FMS, Amsterdam, Netherlands; protocol 2; Nexfin, Bmeye, Amsterdam, Netherlands) (49). Mean arterial pressure (MAP) was determined on a beat-to-beat basis by integration of the BP waveform.…”

The European Society for Computing and Technology in Anaesthesia and Intensive Care (ESCTAIC): a special issue of full papers (Amsterdam meeting 2010) and conference abstracts (Erlangen meeting 2011)

“…Eight full papers [3][4][5][6][7][8][9][10] were accepted following peer review for publication in this issue, and these reflect the activities of ESCTAIC meeting participants. Three of the papers [3][4][5] deal with monitoring of oxygenation and perfusion covering a spectrum of topics from basic physiological principles to the state of the art in monitoring technologies.…”

“…Three of the papers [3][4][5] deal with monitoring of oxygenation and perfusion covering a spectrum of topics from basic physiological principles to the state of the art in monitoring technologies. Schober and Schwarte [3], starting with the clinical need to prevent hypoxia and hyperoxia, provide a review of the basic physiology of oxygen transport and a state of the art description of perfusion and oxygen monitoring technologies necessary to evaluate oxygen status.…”

“…These range from standard systemic oxygen monitoring techniques in the blood and respiratory gasses to modern tissue and cellular oxygenation measurements. Truijen et al [4] continue the theme of perfusion monitoring, describe the state of the art in non-invasive blood pressure and cardiac output monitoring using finger-cuff and pulse contour analysis. Scheeren et al [5] take a deeper look at monitoring of tissue oxygenation using near infrared spectroscopy.…”