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Intensive Care Medicine

, Volume 37, Issue 3, pp 411–419 | Cite as

Interpretation of blood pressure signal: physiological bases, clinical relevance, and objectives during shock states

  • J.-F. Augusto
  • J.-L. Teboul
  • P. Radermacher
  • P. AsfarEmail author
Review

Abstract

Achievement of a mean blood pressure (MBP) target is one of the hemodynamic goals to ensure an adequate blood perfusion pressure in critically ill patients. Arterial catheter allows for a continuous and precise monitoring of arterial pressure signal. In addition to giving a precise MBP monitoring, analysis of the blood pressure wave provides information that may help the clinician to interpret hemodynamic status. The interpretation of BP wave requires the understanding of simple principles. In this review, we first discuss the physiological mechanism responsible for arterial pressure generation. We then emphasize the interpretation of the static indexes and the dynamic indexes generated by heart–lung interactions derived from arterial pressure wave. Finally, we focus on MBP value as a therapeutic target in critically ill patients. We discuss the recommended target MBP value by reviewing available data from experimental and clinical studies.

Keywords

Mean blood pressure Arterial pressure Hemodynamics Septic shock 

Abbreviations

ARDS

Acute respiratory distress syndrome

BP

Blood pressure

C

Compliance

CO

Cardiac output

DBP

Diastolic blood pressure

HR

Heart rate

LV

Left ventricle

MBP

Mean blood pressure

PEEP

Positive end-expiratory pressure

PP

Pulse pressure

RV

Right ventricle

SBP

Systolic blood pressure

SV

Stroke volume

SVR

Systemic vascular resistance

RAP

Right atrial pressure

Supplementary material

134_2010_2092_MOESM1_ESM.doc (46 kb)
Supplementary material 1 (DOC 46 kb)

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Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • J.-F. Augusto
    • 1
  • J.-L. Teboul
    • 2
  • P. Radermacher
    • 3
  • P. Asfar
    • 1
    Email author
  1. 1.Laboratoire HIFIH, IFR 132Université d’ Angers et service de réanimation médicale et médecine hyperbare, CHU AngersAngers Cedex 9France
  2. 2.Service de réanimation médicale, CHU de BicêtreLe Kremlin-Bicêtre CedexFrance
  3. 3.Sektion Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Klinik für AnästhesiologieUniversitätsklinikumUlmGermany

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