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February 1, 1993Critical Care Medicine

Unreliability of blood pressure and heart rate to evaluate cardiac output in emergency resuscitation and critical illness

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Why the study?

Can arterial blood pressure and heart rate reliably evaluate cardiac output in emergency resuscitation and critical illness?

Population

224 patients, comprising 61 high-risk trauma patients with accidental injury studied immediately after…

Design

Cohort

Authors

CWCharles C.J. WoUniversity of Southern CaliforniaWSWilliam C. ShoemakerNorthwestern UniversityPAPaul L. AppelKraft Heinz (United States)

Discussion

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Implication

Arterial pressure poorly reflects cardiac output except at extreme nadirs; leaves open whether pressure-guided resuscitation reliably restores perfusion in critical illness.

Structured PICO

Can arterial blood pressure and heart rate reliably evaluate cardiac output in emergency resuscitation and critical illness?

P
Population
224 patients, comprising 61 high-risk trauma patients with accidental injury studied immediately after Emergency Department admission, and 163 critically ill postoperative ICU patients
I
Intervention
Standard fluid therapy (crystalloids, packed red cell transfusions, and colloids as indicated by clinical criteria)
O
Outcome
Correlation between vital signs (arterial blood pressure, heart rate) and cardiac index/blood flow measured by thermodilutionsurrogate

Arterial blood pressure and heart rate are unreliable indicators of cardiac output and blood flow in critically ill and trauma patients, except during extreme hypotension.

Cite This Study

Wo et al. (1993) studied this question.

synapsesocial.com/papers/6a6fd804ce524a4339c3adf6https://doi.org/10.1097/00003246-199302000-00012
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reliability of clinical monitoring to assess blood volume in critically ill patients1984 · 348 citations
  2. 2Cardiac Output Monitors2013 · 1 citations
  3. 3Physiologic and Clinical Principles behind Noninvasive Resuscitation Techniques and Cardiac Output Monitoring2011 · 7 citations
  4. 4Association between Cardiac Index and Mortality in Patients Assessed on the Ward by a Nurse-Led Critical Care Outreach Team2008
  5. 5Hemodynamic monitoring in the critically ill: an overview of current cardiac output monitoring methods2016 · 99 citations