A contribution from new technologies: towards a non-invasive method for measuring arterial pulse pressure?

Abstract

In clinical practice, the prospect of better validated use of non-invasive pulse wave analysis techniques offers many advantages. In this area, the non-invasive monitoring of arterial pressure could provide better detection of the rapid variations in pressure seen during situations of haemodynamic instability, where invasive measurement is either difficult or not commonly implemented. Continuous monitoring is also of interest in the immediate assessment of the effectiveness of a fluid challenge. Furthermore, and although validation is still required in clinical practice, the concept of continuous non-invasive monitoring of pulse pressure respiratory variations appears promising in mechanically ventilated patients under general anaesthetic or sedation, not only to guide fluid administration during surgery (abdominal surgery with minimal loss, orthopaedic surgery, orthognathic surgery, etc.), but also within the scope of haemodynamic optimisation for pre-hospital care, in the trauma and emergency department and upon admission to the intensive care unit. For patients in the intensive care unit with shock or receiving catecholamines, non-invasive measurement methods are difficult to use and interpret, so the insertion of a radial arterial catheter remains the standard clinical method in these cases.