Medical Image of the Week: Undulating Arterial Waveform

Figure 1. Arterial line and oxygen saturation tracings demonstrating variability with inspiration, a sign of volume responsiveness.

Volume responsiveness assessed by variation in arterial line tracing demonstrating either stroke volume variation, systolic pressure variation, or pulse pressure variation has been shown to be far superior to traditional static indicators of preload responsiveness as they consider cardiopulmonary interactions (1). Additionally, variability in the O2 sat tracing has also been shown to be a reliable indicator of volume responsiveness (2).  

Jarrod M. Mosier, MD and John W. Bloom, MD

Emergency Medicine-Critical Care Program

Division of Pulmonary and Critical Care

University of Arizona

Tucson, Arizona

References

1. Marik PE, Baram M. Noninvasive hemodynamic monitoring in the intensive care unit. Crit Care Clin. 2007;23(3):383-400. [CrossRef] [PubMed]
2. Feissel M, Teboul JL, Merlani P, Badie J, Faller JP, Bendjelid K. Plethysmographic dynamic indices predict fluid responsiveness in septic ventilated patients. Intensive Care Med. 2007;33(6):993-9. [CrossRef] [PubMed] 

Reference as: Mosier JM, Bloom JW. Medical image of the week: undulating arterial waveform. Southwest J Pulm Crit Care. 2013;7(5):315. doi: http://dx.doi.org/10.13175/swjpcc153-13 PDF