From Arterial Pressure to Cardiac Output

  • M. Cecconi
  • A. Rhodes
  • G. Della Rocca
Conference paper


There are a number of companies that market devices for the monitoring of cardiac output from the arterial pressure waveform. These devices all share a number of characteristics that need to be understood if they are to be used appropriately. This chapter aims to describe the underlying history and physics behind these computer based algorithms.


Cardiac Output Stroke Volume Pulse Contour Transpulmonary Thermodilution Pulse Contour Analysis 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Baselli G, Porta A, Pagani M (2006) Coupling arterial windkessel with peripheral vasomotion: modeling the effects on low-frequency oscillations. IEEE Trans Biomed Eng 53: 53–64PubMedCrossRefGoogle Scholar
  2. 2.
    Finkelstein SM, Cohn JN (1992) First-and third-order models for determining arterial compliance. J Hypertens Suppl 10: S11–S14PubMedCrossRefGoogle Scholar
  3. 3.
    Erlanger J, Hooker DR (1904) An experimental study of blood-pressure and of pulse-pressure in man. Johns Hopkins Hosp Rep 12: 145–378Google Scholar
  4. 4.
    Rhodes A, Sunderland R (2004) Arterial pulse pressure analysis: The LiDCOplus System. In: Pinsky MR, Payen D (eds) Functional Hemodynamic Monitoring. Spinger, Heidelberg, pp 183–192Google Scholar
  5. 5.
    Cecconi M, Wilson J, Rhodes A (2006) Pulse pressure analysis. In Vincent JL (ed) Yearbook of Intensive Care and Emergency Medicine. Springer, Heidelberg, pp 176–184CrossRefGoogle Scholar
  6. 6.
    Wesseling KH, Jansen JR, Settels JJ, Schreuder JJ (1993) Computation of aortic flow from pressure in humans using a nonlinear, three-element model. J Appl Physiol 74: 2566–2573PubMedGoogle Scholar
  7. 7.
    Chen CW, Shau YW, Wu CP (1997) Analog transmission line model for simulation of systemic circulation. IEEE Trans Biomed Eng 44: 90–94PubMedCrossRefGoogle Scholar
  8. 8.
    Cole RT, Lucas CL, Cascio WE, Johnson TA (2005) A LabVIEW model incorporating an openloop arterial impedance and a closed-loop circulatory system. Ann Biomed Eng 33: 1555–1573PubMedCrossRefGoogle Scholar
  9. 9.
    Langewouters GJ, Wesseling KH, Goedhard WJ (1984) The static elastic properties of 45 human thoracic and 20 abdominal aortas in vitro and the parameters of a new model. J Biomech 17: 425–435PubMedCrossRefGoogle Scholar
  10. 10.
    Langewouters GJ, Goedhard WJ, Wesseling KH (1985) [The effect of aging and sclerosis on the viscoelastic properties of the human thoracic aorta]. Tijdschr Gerontol Geriatr 16: 61–70PubMedGoogle Scholar
  11. 11.
    Langewouters GJ, Zwart A, Busse R, Wesseling KH (1986) Pressure-diameter relationships of segments of human finger arteries. Clin Phys Physiol Meas 7: 43–56PubMedCrossRefGoogle Scholar
  12. 12.
    Langewouters GJ, Wesseling KH, Goedhard WJ (1985) The pressure dependent dynamic elasticity of 35 thoracic and 16 abdominal human aortas in vitro described by a five component model. J Biomech 18: 613–620PubMedCrossRefGoogle Scholar
  13. 13.
    Della RG, Costa MG, Coccia C, et al (2003) Cardiac output monitoring: aortic transpulmonary thermodilution and pulse contour analysis agree with standard thermodilution methods in patients undergoing lung transplantation. Can J Anaesth 50: 707–711CrossRefGoogle Scholar
  14. 14.
    Torgay A, Pirat A, Akpek E, Zeyneloglu P, Arslan G, Haberal M (2005) Pulse contour cardiac output system use in pediatric orthotopic liver transplantation: preliminary report of nine patients. Transplant Proc 37: 3168–3170PubMedCrossRefGoogle Scholar
  15. 15.
    Hofer CK, Furrer L, Matter-Ensner S, et al (2005) Volumetric preload measurement by thermodilution: a comparison with transoesophageal echocardiography. Br J Anaesth 94: 748–755PubMedCrossRefGoogle Scholar
  16. 16.
    Sakka SG, Ruhl CC, Pfeiffer UJ, et al (2000) Assessment of cardiac preload and extravascular lung water by single transpulmonary thermodilution. Intensive Care Med 26: 180–187PubMedCrossRefGoogle Scholar
  17. 17.
    Della RG, Costa MG, Coccia C, Pompei L, Pietropaoli P (2002) Preload and haemodynamic assessment during liver transplantation: a comparison between the pulmonary artery catheter and transpulmonary indicator dilution techniques. Eur J Anaesthesiol 19: 868–875CrossRefGoogle Scholar
  18. 18.
    Della RG, Costa GM, Coccia C, Pompei L, Di MP, Pietropaoli P (2002) Preload index: pulmonary artery occlusion pressure versus intrathoracic blood volume monitoring during lung transplantation. Anesth Analg 95: 835–843CrossRefGoogle Scholar
  19. 19.
    Pearse RM, Ikram K, Barry J (2004) Equipment review: an appraisal of the LiDCO plus method of measuring cardiac output. Crit Care 8: 190–195PubMedCrossRefGoogle Scholar
  20. 20.
    Hamilton TT, Huber LM, Jessen ME (2002) PulseCO: a less-invasive method to monitor cardiac output from arterial pressure after cardiac surgery. Ann Thorac Surg 74: S1408–S1412PubMedCrossRefGoogle Scholar
  21. 21.
    Pittman J, Bar-Yosef S, SumPing J, Sherwood M, Mark J (2005) Continuous cardiac output monitoring with pulse contour analysis: a comparison with lithium indicator dilution cardiac output measurement. Crit Care Med 33: 2015–2021Google Scholar
  22. 22.
    Tsutsui M, Mori T, Aramaki Y, Fukuda I, Kazama T (2004) [A comparison of two methods for continuous cardiac output measurement: PulseCO VS CCO]. Masui 53: 929–933PubMedGoogle Scholar
  23. 23.
    Langewouters GJ, Settels JJ, Roelandt R, Wesseling KH (1998) Why use Finapres or Portapres rather than intra-arterial or intermittent non-invasive techniques of blood pressure measurement? J Med Eng Technol 22: 37–43PubMedCrossRefGoogle Scholar
  24. 24.
    Manecke GR (2005) Edwards FloTrac sensor and Vigileo monitor: easy, accurate, reliable cardiac output assessment using the arterial pulse wave. Expert Rev Med Devices 2: 523–527PubMedCrossRefGoogle Scholar
  25. 25.
    Button D, Weibel L, Reuthebuch O, Genoni M, Zollinger A, Hofer CK (2007) Clinical evaluation of the FloTrac/Vigileo system and two established continuous cardiac output monitoring devices in patients undergoing cardiac surgery. Br J Anaesth 99: 329–336PubMedCrossRefGoogle Scholar
  26. 26.
    de Waal EE, Kalkman CJ, Rex S, Buhre WF (2007) Validation of a new arterial pulse contourbased cardiac output device. Crit Care Med 35: 1904–1909PubMedCrossRefGoogle Scholar
  27. 27.
    Mayer J, Boldt J, Schollhorn T, Rohm KD, Mengistu AM, Suttner S (2007) Semi-invasive monitoring of cardiac output by a new device using arterial pressure waveform analysis: a comparison with intermittent pulmonary artery thermodilution in patients undergoing cardiac surgery. Br J Anaesth 98: 176–182PubMedCrossRefGoogle Scholar
  28. 28.
    Opdam HI, Wan L, Bellomo R (2007) A pilot assessment of the FloTrac cardiac output monitoring system. Intensive Care Med 33: 344–349PubMedCrossRefGoogle Scholar
  29. 29.
    Guarracino F, Stefani M, Lapolla F, et al (2007) Monitoring cardiac output with Flo Trac Vigileo. Br J Anaesth 99: 142–143PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • M. Cecconi
    • 1
  • A. Rhodes
    • 2
  • G. Della Rocca
    • 3
  1. 1.Department of Anesthesia and Intensive Care MedicineUniversity HospitalUdineItaly
  2. 2.General Intensive Care Unit St. James’ WingSt. George’s HospitalLondonUK
  3. 3.Department of Anesthesia and Intensive Care MedicineAzienda Ospedaliero Universitaria S.M. della MisericordiaUdineItaly

Personalised recommendations