Cardiac output estimation using pulse wave analysis-physiology, algorithms, and technologies: a narrative review

Bernd Saugel*, Karim Kouz, Thomas W L Scheeren, Gillis Greiwe, Phillip Hoppe, Stefano Romagnoli, Daniel de Backer

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

1 Citation (Scopus)


Pulse wave analysis (PWA) allows estimation of cardiac output (CO) based on continuous analysis of the arterial blood pressure (AP) waveform. We describe the physiology of the AP waveform, basic principles of PWA algorithms for CO estimation, and PWA technologies available for clinical practice. The AP waveform is a complex physiological signal that is determined by interplay of left ventricular stroke volume, systemic vascular resistance, and vascular compliance. Numerous PWA algorithms are available to estimate CO, including Windkessel models, long time interval or multi-beat analysis, pulse power analysis, or the pressure recording analytical method. Invasive, minimally-invasive, and noninvasive PWA monitoring systems can be classified according to the method they use to calibrate estimated CO values in externally calibrated systems, internally calibrated systems, and uncalibrated systems.

Original languageEnglish
Pages (from-to)67-76
Number of pages10
JournalBritish Journal of Anaesthesia
Issue number1
Publication statusE-pub ahead of print - 24-Nov-2020

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