The peripheral pulse wave: Information overlooked View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1996-09

AUTHORS

Willie Bosseau Murray, Patrick Anthony Foster

ABSTRACT

although the waveform derived from a peripheral pulse monitor or pulse oximeter may resemble an arterial pressure waveform, it is in fact a visualization of blood volume change in transilluminated tissue caused by passage of blood: an indication of perfusion or blood flow. Most currently available pulse oximeters indicate this flow, but few display it in usable form. Since adequate tissue blood flow is a prerequisite for normal metabolic activity, it is a parameter that should merit a place in standard anesthesia or intensive care monitors. That the peripheral tissue blood flow is not routinely displayed may be in part due to the difficulty in quantifying data obtained: flow is not accurately measured as simply as pressure, even by invasive means. It is in the pattern of the waveform that beat-to-beat changes in stroke volume can be better seen than measured, or in the interaction of ventilation and circulation that tests general circulatory performance. The origin and interpretation of these changes are discussed and illustrated with examples. We indicate how new physiological tests of autonomic function and cardiac preload can be developed using pulse plethysmography. The importance and application of the Valsalva effect on the waveform is emphasized. This effect is particularly applicable for monitoring adequate fluid loading and the action of vasodilator drugs, which are both important in anesthesia. Differences between the arterial pulse pressure wave and tissue flow wave are discussed, as well as the cause of certain artifacts, including the wandering dicrotic notch. More... »

PAGES

365-377

References to SciGraph publications

  • 1990-03. Vascular volume monitoring with pulse oximetry during paediatric anaesthesia in JOURNAL CANADIEN D'ANESTHÉSIE
  • 1986. Pneumatically Controlled Circulation in Peripheral Vascular Diseases in CLOSED-CIRCUIT SYSTEM AND OTHER INNOVATIONS IN ANAESTHESIA
  • 1986. Physical Aspects in Peripheral Perfusion in CLOSED-CIRCUIT SYSTEM AND OTHER INNOVATIONS IN ANAESTHESIA
  • 1988-10. Pulse oximetry: Analysis of theory, technology, and practice in JOURNAL OF CLINICAL MONITORING AND COMPUTING
  • 1986. A New Approach to Photoelectric Plethysmography in CLOSED-CIRCUIT SYSTEM AND OTHER INNOVATIONS IN ANAESTHESIA
  • 1993-09. The detection of peripheral venous pulsation using the pulse oximeter as a plethysmograph in JOURNAL OF CLINICAL MONITORING AND COMPUTING
  • Journal

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/bf02077634

    DOI

    http://dx.doi.org/10.1007/bf02077634

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1051793045

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/8934343


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