Question 11.3

List six important pieces of information that may be obtained from an arterial pressure waveform.
(30% marks)
 

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College answer

Not available.

Discussion

They only wanted six things. However...

  • Information from arterial line amplitude
    • Heart rate
    • Systolic pressure
    • Diastolic pressure (coronary filling)
    • Mean arterial pressure (systemic perfusion)
    • Pulse pressure (high in AR, low in cardiac tamponade or cardiogenic shock)
    • Changes in amplitude associated with respiration (pulse pressure variation)
  • Information from arterial line frequency
    • Heart rate
    • Rhythm
    • Effect of rhythm on MAP
  • Information from arterial waveform shape
    • Slope of anacrotic limb represents aortic valve and LVOT flow
    • Slurred wave in AS
    • Collapsing wave in AS
    • Rapid systolic decline in LVOTO
    • Bisferiens wave in HOCM
    • Low dicrotic notch in states with poor peripheral resistance

References

McGhee and Bridges Monitoring Arterial Blood Pressure: What You May Not Know (Crit Care Nurse April 1, 2002 vol. 22 no. 2 60-79 )

Thomas, Gary, and Victoria Duffin-Jones. "Monitoring arterial blood pressure." Anaesthesia & Intensive Care Medicine 16.3 (2015): 124-127.