Obesity Surgery

, Volume 19, Issue 1, pp 128–130 | Cite as

Response to Dr. Bernstein’s Review: Pressure Pulse Contour-Derived Stroke Volume and Cardiac Output in the Morbidly Obese Patient

  • Francesco Forfori
  • Salvatore Mario Romano
  • Tania Balderi
  • Marco Anselmino
  • Francesco Giunta
Letter to the Editor

To the Editor:

We read with interest the article by Dr. Bernstein on Pressure Pulse Contour-derived Stroke Volume and Cardiac Output in the Morbidly Obese Patient [1]. It is important to discuss the data presented in the review, considering that caution is necessary to accept his conclusion on pressure recording analytical method (PRAM) [2]. We wonder how it is possible to draw similar conclusions based on the small number of studies considered and patients enrolled [3, 4, 5]. We may also highlight some discrepancies not only between the studies considered but also within each study [3, 4, 5]. It is important to distinguish between hemodynamic data measured directly, such as mean arterial pressure (MAP) or heart rate (HR), and hemodynamic data calculated by the PRAM [6, 7, 8, 9, 10, 11] or other methods [12].

From an analysis of MAP and HR in reviewed studies, we can observe how [ 3, 4, 5] these values present different trends compared with our results (Table  1).
Table 1



Cardiac Output Obese Patient Stroke Volume Mean Arterial Pressure Cardiac Index 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Francesco Forfori
    • 1
  • Salvatore Mario Romano
    • 3
  • Tania Balderi
    • 1
  • Marco Anselmino
    • 2
  • Francesco Giunta
    • 1
  1. 1.Division of Anesthesiology and Intensive Care, Department of SurgeryUniversity of PisaPisaItaly
  2. 2.Bariatric Surgery UnitAzienda Ospedaliera PisanaPisaItaly
  3. 3.Unit of Internal Medicine and Cardiology, Department of Critical Care MedicineUniversity of FlorenceFlorenceItaly

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