The automatic detection and correction of abnormal arterial pressure waveforms
In high-risk surgical and critically ill patients, invasive arterial pressure waveforms are often over damped or under damped (1).
Overdamping is responsible for an underestimation of systolic pressure. It is characterized by a flat curve with no visible dicrotic notch and is therefore easy to detect visually. A normal waveform is usually restored by flushing the line. Nurses are very familiar with this issue.
Underdamping is more difficult to detect but observed very frequently, in up to 30% of critically ill patients (2). It is characterized by a high (overestimated) systolic peak.
Both over and underdamping may be responsible for inaccurate cardiac output measurements when obtained from any pulse contour algorithm.
Vygon developed an electronic and dynamic filter able to automatically detect, track and correct underdamping phenomena.
This smart filter is now implemented on the MostCareUp hemodynamic monitor.
It enables the MostCareUp pulse contour algorithm to provide accurate and precise cardiac output measurements which have been shown to be interchangeable with pulmonary thermodilution measurements (3).