Pulse Wave Analysis to Estimate Cardiac Output

Karim Kouz, M.D.; Thomas W. L. Scheeren, M.D.; Daniel de Backer, M.D.; Bernd Saugel, M.D.


Anesthesiology. 2020;134(1):119-126. 

In This Article

Abstract and Introduction


Cardiac output (CO)–guided therapy is a promising approach to hemodynamic management in high-risk patients having major surgery[1] and in critically ill patients with circulatory shock.[2] Pulmonary artery thermodilution remains the clinical reference method for CO measurement,[3] but the use of the pulmonary artery catheter decreased over the past two decades.[4] Today, various CO monitoring methods with different degrees of invasiveness are available, including pulse wave analysis.[5] Pulse wave analysis is the mathematical analysis of the arterial blood pressure waveform and enables CO to be estimated continuously and in real time.[6] In this article, we review pulse wave analysis methods for CO estimation, including their underlying measurement principles and their clinical application in perioperative and intensive care medicine.