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Related Concept Videos

Pulse01:05

Pulse

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The pulse is one of the most fundamental physiological indicators of the body's cardiovascular health. It is the rhythmic expansion and contraction of the arterial walls in response to the pressure generated by the heart's pumping action.
Pulse Rate and its Significance
Pulse rate, often measured in beats per minute (bpm), reflects the heart rate (HR), which is influenced by numerous factors such as stress, physical activity, and hormonal changes. A normal resting adult pulse rate falls...
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Pulse01:16

Pulse

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When the heart pumps blood out, arterial elastic fibers play a crucial role in sustaining a high-pressure gradient. They expand to accommodate the received blood and then recoil - a process known as the pulse that can be either manually palpated or electronically quantified. Despite a reduction in its effect with increased distance from the heart, elements of the pulse's systolic and diastolic components persist, observable even at the arteriole level.
The pulse serves as a clinical...
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Pulse amplitude and quality01:17

Pulse amplitude and quality

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Pulse amplitude is a crucial indicator of cardiac health because it provides valuable insights into the strength of left ventricular contractions and the overall uniformity of blood circulation within the vasculature. The strength of the pulse is directly related to the force with which the heart contracts and the volume of blood being pumped.
A weak or absent pulse may indicate reduced cardiac output or poor left ventricular contraction, which can be signs of cardiovascular dysfunction or...
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Special considerations while measuring pulse01:13

Special considerations while measuring pulse

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Assessing a patient's pulse is a fundamental skill in healthcare, but certain situations require special attention:
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Cardiac Output and Stroke Volume01:11

Cardiac Output and Stroke Volume

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Cardiac output (CO) is an integral aspect of human physiology, reflecting the heart's efficiency and responsiveness to the body's needs. It represents the volume of blood that the left or right ventricle ejects into the aorta or pulmonary trunk each minute. The CO is calculated by multiplying the heart rate (HR)—the number of heartbeats per minute—by the stroke volume (SV)—the amount of blood pumped out with each heartbeat.
In an average resting adult male, the typical cardiac...
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Cardiac Output II: Effect of Stroke Volume on Cardiac Output01:22

Cardiac Output II: Effect of Stroke Volume on Cardiac Output

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Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
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Cardiac output estimation using pulse wave analysis-physiology, algorithms, and technologies: a narrative review.

Bernd Saugel1, Karim Kouz2, Thomas W L Scheeren3

  • 1Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Outcomes Research Consortium, Cleveland, OH, USA.

British Journal of Anaesthesia
|November 28, 2020
PubMed
Summary

Pulse wave analysis (PWA) estimates cardiac output (CO) by analyzing arterial blood pressure (AP) waveforms. This review covers PWA physiology, algorithms, and technologies for clinical use.

Keywords:
arterial pressurecardiovascular dynamicshaemodynamic monitoringmonitorpulse contour analysisstroke volume

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Area of Science:

  • Cardiovascular Physiology
  • Biomedical Engineering

Background:

  • Arterial blood pressure (AP) waveform analysis, known as pulse wave analysis (PWA), is a method for estimating cardiac output (CO).
  • The AP waveform is a complex physiological signal influenced by stroke volume, systemic vascular resistance, and vascular compliance.

Purpose of the Study:

  • To describe the physiological basis of the AP waveform.
  • To explain the fundamental principles of PWA algorithms used for CO estimation.
  • To review available PWA technologies for clinical application.

Main Methods:

  • Discussion of the physiological determinants of the AP waveform.
  • Overview of various PWA algorithms (e.g., Windkessel models, multi-beat analysis, pulse power analysis, pressure recording analytical method).
  • Classification of PWA monitoring systems based on calibration methods (invasive, minimally-invasive, noninvasive; externally, internally, uncalibrated).

Main Results:

  • The AP waveform's complexity arises from the interaction of cardiac output, vascular resistance, and compliance.
  • Multiple PWA algorithms exist for CO estimation, each with distinct principles.
  • PWA systems vary in their calibration techniques, impacting clinical applicability.

Conclusions:

  • Pulse wave analysis offers a versatile approach to estimating cardiac output.
  • Understanding PWA physiology and algorithms is crucial for selecting appropriate clinical technologies.
  • Advancements in PWA continue to enhance cardiovascular monitoring capabilities.