Review
Clinical review: Interpretation of arterial pressure wave in shock states
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* Corresponding author: Jean-Louis Teboul jean-louis.teboul@bct.aphp.fr
1 Assistant Professor, Service de Réanimation Médicale, Centre Hospitalier Universitaire de Bicêtre, Assistance Publique – Hôpitaux de Paris, Université Paris Sud 11, Le Kremlin-Bicêtre, France
2 Professor, Service de Physiologie, Centre Hospitalier Universitaire de Bicêtre, Assistance Publique – Hôpitaux de Paris, Université Paris Sud 11, Le Kremlin-Bicêtre, France
3 Professor, Service de Réanimation Médicale, Centre Hospitalier Universitaire de Bicêtre, Assistance Publique – Hôpitaux de Paris, Université Paris Sud 11, Le Kremlin-Bicêtre, France
Critical Care 2005, 9:601-606 doi:10.1186/cc3891
Published: 26 October 2005Abstract
In critically ill patients monitored with an arterial catheter, the arterial pressure signal provides two types of information that may help the clinician to interpret haemodynamic status better: the mean values of systolic, diastolic, mean and pulse pressures; and the magnitude of the respiratory variation in arterial pressure in patients undergoing mechanical ventilation. In this review we briefly discuss the physiological mechanisms responsible for arterial pressure generation, with special focus on resistance, compliance and pulse wave amplification phenomena. We also emphasize the utility of taking into consideration the overall arterial pressure set (systolic, diastolic, mean and pulse pressures) in order to define haemodynamic status better. Finally, we review recent studies showing that quantification of respiratory variation in pulse and systolic arterial pressures can allow one to identify the mechanically ventilated patients who may benefit from volume resuscitation.