Continuous and less invasive central hemodynamic monitoring by blood pressure waveform analysis

Mukkamala R, Xu D. Continuous and less invasive central hemodynamic monitoring by blood pressure waveform analysis. Am J Physiol Heart Circ Physiol 299: H584-H599, 2010. First published July 9, 2010; doi:10.1152/ajpheart.00303.2010.-Blood pressure waveform analysis may permit continuous (i.e., automated) and less invasive (i.e., safer and simpler) central hemodynamic monitoring in the intensive care unit and other clinical settings without requiring any instrumentation beyond what is already in use or available. This practical approach has been a topic of intense investigation for decades and may garner even more interest henceforth due to the evolving demographics as well as recent trends in clinical hemodynamic monitoring. Here, we review techniques that have appeared in the literature for mathematically estimating clinically significant central hemodynamic variables, such as cardiac output, from different blood pressure waveforms. We begin by providing the rationale for pursuing such techniques. We then summarize earlier techniques and thereafter overview recent techniques by our collaborators and us in greater depth while pinpointing both their strengths and weaknesses. We conclude with suggestions for future research directions in the field and a description of some potential clinical applications of the techniques.