Noninvasive continuous hemodynamic monitoring文档.pdf

J Clin Monit Comput (2012) 26:267–278 DOI 10.1007/s10877-012-9375-8 Noninvasive continuous hemodynamic monitoring Jasper Truijen • Johannes J. van Lieshout • Wilbert A. Wesselink • Berend E. Westerhof Received: 2 October 2011 / Accepted: 30 May 2012 / Published online: 14 June 2012 The Author(s) 2012. This article is published with open access at S Abstract Monitoring of continuous blood pressure and 1 Introduction cardiac output is important to prevent hypoperfusion and to guide fluid administration, but only few patients receive The primary evaluation of the hemodynamic condition is such monitoring due to the invasive nature of most of the done by assessing heart rate (HR) and mean blood pressure methods presently available. Noninvasive blood pressure (BP) as a surrogate of tissue perfusion. When these can be determined continuously using finger cuff technol- parameters change rapidly, a single measurement conveys ogy and cardiac output is easily obtained using a pulse insufficient information, making continuous measurement contour method. In this way completely noninvasive con- desirable [1]. For continuous measurement of BP, cannu- tinuous blood pressure and cardiac output are available for lation of an artery is the primary approach. However, clinical use in all patients that would otherwise not be noninvasive and continuous monitoring of BP has several monitored. Developments and state of art in hemodynamic advantages, particularly if intra-arterial measurement of BP monitoring are reviewed here, with a focus on noninvasive is not warranted while intermittent measurements do not continuous hemodynamic monitoring form the finger. have the required time resoluti