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Bernd Saugel - One of the best experts on this subject based on the ideXlab platform.

  • how to measure blood pressure using an Arterial Catheter a systematic 5 step approach
    Critical Care, 2020
    Co-Authors: Agnes S Meidert, Bernd Saugel, Karim Kouz, Leonie Schulteuentrop, Stefano Romagnoli
    Abstract:

    Arterial blood pressure (BP) is a fundamental cardiovascular variable, is routinely measured in perioperative and intensive care medicine, and has a significant impact on patient management. The clinical reference method for BP monitoring in high-risk surgical patients and critically ill patients is continuous invasive BP measurement using an Arterial Catheter. A key prerequisite for correct invasive BP monitoring using an Arterial Catheter is an in-depth understanding of the measurement principle, of BP waveform quality criteria, and of common pitfalls that can falsify BP readings. Here, we describe how to place an Arterial Catheter, correctly measure BP, and identify and solve common pitfalls. We focus on 5 important steps, namely (1) how to choose the Catheter insertion site, (2) how to choose the type of Arterial Catheter, (3) how to place the Arterial Catheter, (4) how to level and zero the transducer, and (5) how to check the quality of the BP waveform.

  • continuous noninvasive Arterial pressure measurement using the volume clamp method an evaluation of the cnap device in intensive care unit patients
    Journal of Clinical Monitoring and Computing, 2015
    Co-Authors: Julia Y. Wagner, Alexander Hapfelmeier, Agnes S Meidert, Bernd Saugel, Roland M Schmid, W. Huber, Ileana Negulescu, Miriam Schofthaler
    Abstract:

    The CNAP system allows continuous noninvasive Arterial pressure measurement based on the volume clamp method using a finger cuff. We aimed to evaluate the agreement between Arterial pressure measurements noninvasively obtained using the CNAP device and Arterial Catheter-derived Arterial pressure measurements in intensive care unit patients. In 55 intensive care unit patients, we simultaneously recorded Arterial pressure values obtained by an Arterial Catheter placed in the abdominal aorta through the femoral artery (criterion standard) and Arterial pressure values determined noninvasively using CNAP. We performed Bland–Altman analysis and calculated the percentage error. The mean difference (±standard deviation, 95 % limits of agreement, percentage error) between noninvasive (CNAP) and invasively assessed Arterial pressure was for mean Arterial pressure +1 mmHg (±9 mmHg, −16 to +19 mmHg, 22 %), for systolic Arterial pressure −10 mmHg (±16 mmHg, −42 to +21 mmHg, 27 %), and for diastolic Arterial pressure +7 mmHg (±9 mmHg, −10 to +24 mmHg, 28 %). Our results indicate a reasonable accuracy and precision for the determination of mean and diastolic Arterial pressure by noninvasive continuous Arterial pressure measurements using the volume clamp method compared with the criterion standard (invasive Arterial Catheter). Systolic Arterial pressure is determined less accurately and precisely.

  • Measurement of blood pressure
    Best Practice and Research: Clinical Anaesthesiology, 2014
    Co-Authors: Bernd Saugel, Ron Dueck, Julia Y. Wagner
    Abstract:

    Blood pressure is overwhelmingly the most commonly measured parameter for the assessment of haemodynamic stability. In clinical routine in the operating theatre and in the intensive care unit, blood pressure measurements are usually obtained intermittently and non-invasively using oscillometry (upper-arm cuff method) orcontinuously and invasively with an Arterial Catheter. However, both the oscillometric method and Arterial Catheter-derived blood pressure measurements have potential limitations. A basic technical understanding of these methods is crucial in order to avoid unreliable blood pressure measurements and consequential treatment errors. In the recent years, technologies for continuous non-invasive blood pressure recording such as the volume clamp method or radial artery applanation tonometry have been developed and validated. The question in which patient groups and clinical settings these technologies should be applied to improve patient safety or outcome has not been definitively answered. In critically ill patients and high-risk surgery patients, further improvement of these technologies is needed before they can be recommended for routine clinical use.

  • non invasive continuous Arterial pressure measurement based on radial artery tonometry in the intensive care unit a method comparison study using the t line tl 200pro device
    BJA: British Journal of Anaesthesia, 2013
    Co-Authors: Bernd Saugel, Alexander Hapfelmeier, Agnes S Meidert, Roland M Schmid, Florian Eyer, W. Huber
    Abstract:

    Abstract Background The T-Line TL-200pro (TL-200pro) device (Tensys Medical, Inc., San Diego, CA, USA), based on radial artery tonometry, provides an Arterial pressure (AP) waveform and beat-to-beat values of systolic Arterial pressure (SAP), mean Arterial pressure (MAP), and diastolic Arterial pressure (DAP). The aim of the study was to evaluate this non-invasive technique for continuous AP monitoring in medical intensive care unit (ICU) patients. Methods Arterial pressure measurements obtained using the TL-200pro technology were compared using Bland–Altman analysis with values measured directly from a femoral Arterial Catheter in 34 ICU patients. Results Arterial pressure values were analysed and compared in 4502 averaged 10-beat epochs. A bias of +0.72 mm Hg (95% limits of agreement −9.37 to +10.82 mm Hg) was observed for MAP. For SAP and DAP, there was a mean difference of −1.39 mm Hg (95% limits of agreement −18.74 to +15.96 mm Hg) and +4.36 mm Hg (95% limits of agreement −8.66 to +17.38 mm Hg), respectively. The percentage error for MAP, SAP, and DAP was 12%, 14%, and 21%, respectively. Conclusions Arterial pressure measurement based on radial artery tonometry using the TL-200pro technology is feasible in medical ICU patients. The TL-200pro system is capable of providing MAP values with high accuracy (low mean difference) and precision (narrow limits of agreement) compared with MAP measured invasively using a femoral Arterial Catheter. The TL-200pro technology is promising for the measurement of SAP and DAP but further development is necessary to improve accuracy and precision.

  • the t line tl 200 system for continuous non invasive blood pressure measurement in medical intensive care unit patients
    Intensive Care Medicine, 2012
    Co-Authors: Bernd Saugel, Alexander Hapfelmeier, Agnes S Meidert, Roland M Schmid, Florian Fassio, W. Huber
    Abstract:

    Purpose The T-Line TL-200 (Tensys Medical, San Diego, CA, USA) is a non-invasive Arterial blood pressure (BP) monitoring system allowing continuous “beat-to-beat” monitoring of systolic Arterial pressure (SAP), mean Arterial pressure (MAP), and diastolic Arterial pressure (DAP). It provides a real-time BP waveform like that obtained using an Arterial Catheter. The aim of this study was to compare BP measurements obtained using the T-Line TL-200 with simultaneous invasive BP measurements using a femoral Arterial Catheter in unselected critically ill medical patients.

W. Huber - One of the best experts on this subject based on the ideXlab platform.

  • continuous noninvasive Arterial pressure measurement using the volume clamp method an evaluation of the cnap device in intensive care unit patients
    Journal of Clinical Monitoring and Computing, 2015
    Co-Authors: Julia Y. Wagner, Alexander Hapfelmeier, Agnes S Meidert, Bernd Saugel, Roland M Schmid, W. Huber, Ileana Negulescu, Miriam Schofthaler
    Abstract:

    The CNAP system allows continuous noninvasive Arterial pressure measurement based on the volume clamp method using a finger cuff. We aimed to evaluate the agreement between Arterial pressure measurements noninvasively obtained using the CNAP device and Arterial Catheter-derived Arterial pressure measurements in intensive care unit patients. In 55 intensive care unit patients, we simultaneously recorded Arterial pressure values obtained by an Arterial Catheter placed in the abdominal aorta through the femoral artery (criterion standard) and Arterial pressure values determined noninvasively using CNAP. We performed Bland–Altman analysis and calculated the percentage error. The mean difference (±standard deviation, 95 % limits of agreement, percentage error) between noninvasive (CNAP) and invasively assessed Arterial pressure was for mean Arterial pressure +1 mmHg (±9 mmHg, −16 to +19 mmHg, 22 %), for systolic Arterial pressure −10 mmHg (±16 mmHg, −42 to +21 mmHg, 27 %), and for diastolic Arterial pressure +7 mmHg (±9 mmHg, −10 to +24 mmHg, 28 %). Our results indicate a reasonable accuracy and precision for the determination of mean and diastolic Arterial pressure by noninvasive continuous Arterial pressure measurements using the volume clamp method compared with the criterion standard (invasive Arterial Catheter). Systolic Arterial pressure is determined less accurately and precisely.

  • non invasive continuous Arterial pressure measurement based on radial artery tonometry in the intensive care unit a method comparison study using the t line tl 200pro device
    BJA: British Journal of Anaesthesia, 2013
    Co-Authors: Bernd Saugel, Alexander Hapfelmeier, Agnes S Meidert, Roland M Schmid, Florian Eyer, W. Huber
    Abstract:

    Abstract Background The T-Line TL-200pro (TL-200pro) device (Tensys Medical, Inc., San Diego, CA, USA), based on radial artery tonometry, provides an Arterial pressure (AP) waveform and beat-to-beat values of systolic Arterial pressure (SAP), mean Arterial pressure (MAP), and diastolic Arterial pressure (DAP). The aim of the study was to evaluate this non-invasive technique for continuous AP monitoring in medical intensive care unit (ICU) patients. Methods Arterial pressure measurements obtained using the TL-200pro technology were compared using Bland–Altman analysis with values measured directly from a femoral Arterial Catheter in 34 ICU patients. Results Arterial pressure values were analysed and compared in 4502 averaged 10-beat epochs. A bias of +0.72 mm Hg (95% limits of agreement −9.37 to +10.82 mm Hg) was observed for MAP. For SAP and DAP, there was a mean difference of −1.39 mm Hg (95% limits of agreement −18.74 to +15.96 mm Hg) and +4.36 mm Hg (95% limits of agreement −8.66 to +17.38 mm Hg), respectively. The percentage error for MAP, SAP, and DAP was 12%, 14%, and 21%, respectively. Conclusions Arterial pressure measurement based on radial artery tonometry using the TL-200pro technology is feasible in medical ICU patients. The TL-200pro system is capable of providing MAP values with high accuracy (low mean difference) and precision (narrow limits of agreement) compared with MAP measured invasively using a femoral Arterial Catheter. The TL-200pro technology is promising for the measurement of SAP and DAP but further development is necessary to improve accuracy and precision.

  • the t line tl 200 system for continuous non invasive blood pressure measurement in medical intensive care unit patients
    Intensive Care Medicine, 2012
    Co-Authors: Bernd Saugel, Alexander Hapfelmeier, Agnes S Meidert, Roland M Schmid, Florian Fassio, W. Huber
    Abstract:

    Purpose The T-Line TL-200 (Tensys Medical, San Diego, CA, USA) is a non-invasive Arterial blood pressure (BP) monitoring system allowing continuous “beat-to-beat” monitoring of systolic Arterial pressure (SAP), mean Arterial pressure (MAP), and diastolic Arterial pressure (DAP). It provides a real-time BP waveform like that obtained using an Arterial Catheter. The aim of this study was to compare BP measurements obtained using the T-Line TL-200 with simultaneous invasive BP measurements using a femoral Arterial Catheter in unselected critically ill medical patients.

  • the t line tl 200 system for continuous non invasive blood pressure measurement in medical intensive care unit patients
    Intensive Care Medicine, 2012
    Co-Authors: Bernd Saugel, Alexander Hapfelmeier, Agnes S Meidert, Roland M Schmid, Florian Fassio, W. Huber
    Abstract:

    The T-Line TL-200 (Tensys Medical, San Diego, CA, USA) is a non-invasive Arterial blood pressure (BP) monitoring system allowing continuous “beat-to-beat” monitoring of systolic Arterial pressure (SAP), mean Arterial pressure (MAP), and diastolic Arterial pressure (DAP). It provides a real-time BP waveform like that obtained using an Arterial Catheter. The aim of this study was to compare BP measurements obtained using the T-Line TL-200 with simultaneous invasive BP measurements using a femoral Arterial Catheter in unselected critically ill medical patients. In 28 patients treated in a medical intensive care unit (ICU), BP values were simultaneously obtained using a femoral Arterial Catheter and the T-Line TL-200. All recorded data were included in the final analysis. For comparison of BP measurements, Bland–Altman analysis accounting for repeated measurements was performed (primary endpoint). A total of 76,826 pairs of BP measurements (each consisting of SAP, MAP, and DAP) were analyzed. For MAP, Bland–Altman analysis revealed a mean difference of +0.47 mmHg (95 % limits of agreement −16.53 to +17.46 mmHg). For SAP and DAP, the bias and 95 % limits of agreement were −9.01 mmHg (−37.47 to +19.45 mmHg) and +5.22 mmHg (−13.50 to +23.94 mmHg), respectively. Non-invasive, continuous, radial BP measurement with the T-Line TL-200 is basically feasible in medical ICU patients (with a low bias for MAP compared to MAP assessed using a femoral Arterial Catheter). High limits of agreement (particularly of SAP and DAP) preclude the use of the device as a single source of BP information in unstable critically ill patients.

Didier Jacques - One of the best experts on this subject based on the ideXlab platform.

  • relation between respiratory variations in pulse oximetry plethysmographic waveform amplitude and Arterial pulse pressure in ventilated patients
    Critical Care, 2005
    Co-Authors: Maxime Cannesson, Cyril Besnard, Pierre G Durand, Julien Bohe, Didier Jacques
    Abstract:

    Introduction Respiratory variation in Arterial pulse pressure is a reliable predictor of fluid responsiveness in mechanically ventilated patients with circulatory failure. The main limitation of this method is that it requires an invasive Arterial Catheter. Both Arterial and pulse oximetry plethysmographic waveforms depend on stroke volume. We conducted a prospective study to evaluate the relationship between respiratory variation in Arterial pulse pressure and respiratory variation in pulse oximetry plethysmographic (POP) waveform amplitude.

  • relation between respiratory variations in pulse oximetry plethysmographic waveform amplitude and Arterial pulse pressure in ventilated patients
    Critical Care, 2005
    Co-Authors: Maxime Cannesson, Cyril Besnard, Pierre G Durand, Julien Bohe, Didier Jacques
    Abstract:

    Introduction Respiratory variation in Arterial pulse pressure is a reliable predictor of fluid responsiveness in mechanically ventilated patients with circulatory failure. The main limitation of this method is that it requires an invasive Arterial Catheter. Both Arterial and pulse oximetry plethysmographic waveforms depend on stroke volume. We conducted a prospective study to evaluate the relationship between respiratory variation in Arterial pulse pressure and respiratory variation in pulse oximetry plethysmographic (POP) waveform amplitude. Method This prospective clinical investigation was conducted in 22 mechanically ventilated patients. Respiratory variation in Arterial pulse pressure and respiratory variation in POP waveform amplitude were recorded simultaneously in a beat-tobeat evaluation, and were compared using a Spearman correlation test and a Bland–Altman analysis. Results There was a strong correlation (r2 = 0.83; P < 0.001) and a good agreement (bias = 0.8 ± 3.5%) between respiratory variation in Arterial pulse pressure and respiratory variation in POP waveform amplitude. A respiratory variation in POP waveform amplitude value above 15% allowed discrimination between patients with respiratory variation in Arterial pulse pressure above 13% and those with variation of 13% or less (positive predictive value 100%). Conclusion Respiratory variation in Arterial pulse pressure above 13% can be accurately predicted by a respiratory variation in POP waveform amplitude above 15%. This index has potential applications in patients who are not instrumented with an intra-Arterial Catheter.

Agnes S Meidert - One of the best experts on this subject based on the ideXlab platform.

  • how to measure blood pressure using an Arterial Catheter a systematic 5 step approach
    Critical Care, 2020
    Co-Authors: Agnes S Meidert, Bernd Saugel, Karim Kouz, Leonie Schulteuentrop, Stefano Romagnoli
    Abstract:

    Arterial blood pressure (BP) is a fundamental cardiovascular variable, is routinely measured in perioperative and intensive care medicine, and has a significant impact on patient management. The clinical reference method for BP monitoring in high-risk surgical patients and critically ill patients is continuous invasive BP measurement using an Arterial Catheter. A key prerequisite for correct invasive BP monitoring using an Arterial Catheter is an in-depth understanding of the measurement principle, of BP waveform quality criteria, and of common pitfalls that can falsify BP readings. Here, we describe how to place an Arterial Catheter, correctly measure BP, and identify and solve common pitfalls. We focus on 5 important steps, namely (1) how to choose the Catheter insertion site, (2) how to choose the type of Arterial Catheter, (3) how to place the Arterial Catheter, (4) how to level and zero the transducer, and (5) how to check the quality of the BP waveform.

  • continuous noninvasive Arterial pressure measurement using the volume clamp method an evaluation of the cnap device in intensive care unit patients
    Journal of Clinical Monitoring and Computing, 2015
    Co-Authors: Julia Y. Wagner, Alexander Hapfelmeier, Agnes S Meidert, Bernd Saugel, Roland M Schmid, W. Huber, Ileana Negulescu, Miriam Schofthaler
    Abstract:

    The CNAP system allows continuous noninvasive Arterial pressure measurement based on the volume clamp method using a finger cuff. We aimed to evaluate the agreement between Arterial pressure measurements noninvasively obtained using the CNAP device and Arterial Catheter-derived Arterial pressure measurements in intensive care unit patients. In 55 intensive care unit patients, we simultaneously recorded Arterial pressure values obtained by an Arterial Catheter placed in the abdominal aorta through the femoral artery (criterion standard) and Arterial pressure values determined noninvasively using CNAP. We performed Bland–Altman analysis and calculated the percentage error. The mean difference (±standard deviation, 95 % limits of agreement, percentage error) between noninvasive (CNAP) and invasively assessed Arterial pressure was for mean Arterial pressure +1 mmHg (±9 mmHg, −16 to +19 mmHg, 22 %), for systolic Arterial pressure −10 mmHg (±16 mmHg, −42 to +21 mmHg, 27 %), and for diastolic Arterial pressure +7 mmHg (±9 mmHg, −10 to +24 mmHg, 28 %). Our results indicate a reasonable accuracy and precision for the determination of mean and diastolic Arterial pressure by noninvasive continuous Arterial pressure measurements using the volume clamp method compared with the criterion standard (invasive Arterial Catheter). Systolic Arterial pressure is determined less accurately and precisely.

  • non invasive continuous Arterial pressure measurement based on radial artery tonometry in the intensive care unit a method comparison study using the t line tl 200pro device
    BJA: British Journal of Anaesthesia, 2013
    Co-Authors: Bernd Saugel, Alexander Hapfelmeier, Agnes S Meidert, Roland M Schmid, Florian Eyer, W. Huber
    Abstract:

    Abstract Background The T-Line TL-200pro (TL-200pro) device (Tensys Medical, Inc., San Diego, CA, USA), based on radial artery tonometry, provides an Arterial pressure (AP) waveform and beat-to-beat values of systolic Arterial pressure (SAP), mean Arterial pressure (MAP), and diastolic Arterial pressure (DAP). The aim of the study was to evaluate this non-invasive technique for continuous AP monitoring in medical intensive care unit (ICU) patients. Methods Arterial pressure measurements obtained using the TL-200pro technology were compared using Bland–Altman analysis with values measured directly from a femoral Arterial Catheter in 34 ICU patients. Results Arterial pressure values were analysed and compared in 4502 averaged 10-beat epochs. A bias of +0.72 mm Hg (95% limits of agreement −9.37 to +10.82 mm Hg) was observed for MAP. For SAP and DAP, there was a mean difference of −1.39 mm Hg (95% limits of agreement −18.74 to +15.96 mm Hg) and +4.36 mm Hg (95% limits of agreement −8.66 to +17.38 mm Hg), respectively. The percentage error for MAP, SAP, and DAP was 12%, 14%, and 21%, respectively. Conclusions Arterial pressure measurement based on radial artery tonometry using the TL-200pro technology is feasible in medical ICU patients. The TL-200pro system is capable of providing MAP values with high accuracy (low mean difference) and precision (narrow limits of agreement) compared with MAP measured invasively using a femoral Arterial Catheter. The TL-200pro technology is promising for the measurement of SAP and DAP but further development is necessary to improve accuracy and precision.

  • the t line tl 200 system for continuous non invasive blood pressure measurement in medical intensive care unit patients
    Intensive Care Medicine, 2012
    Co-Authors: Bernd Saugel, Alexander Hapfelmeier, Agnes S Meidert, Roland M Schmid, Florian Fassio, W. Huber
    Abstract:

    Purpose The T-Line TL-200 (Tensys Medical, San Diego, CA, USA) is a non-invasive Arterial blood pressure (BP) monitoring system allowing continuous “beat-to-beat” monitoring of systolic Arterial pressure (SAP), mean Arterial pressure (MAP), and diastolic Arterial pressure (DAP). It provides a real-time BP waveform like that obtained using an Arterial Catheter. The aim of this study was to compare BP measurements obtained using the T-Line TL-200 with simultaneous invasive BP measurements using a femoral Arterial Catheter in unselected critically ill medical patients.

  • the t line tl 200 system for continuous non invasive blood pressure measurement in medical intensive care unit patients
    Intensive Care Medicine, 2012
    Co-Authors: Bernd Saugel, Alexander Hapfelmeier, Agnes S Meidert, Roland M Schmid, Florian Fassio, W. Huber
    Abstract:

    The T-Line TL-200 (Tensys Medical, San Diego, CA, USA) is a non-invasive Arterial blood pressure (BP) monitoring system allowing continuous “beat-to-beat” monitoring of systolic Arterial pressure (SAP), mean Arterial pressure (MAP), and diastolic Arterial pressure (DAP). It provides a real-time BP waveform like that obtained using an Arterial Catheter. The aim of this study was to compare BP measurements obtained using the T-Line TL-200 with simultaneous invasive BP measurements using a femoral Arterial Catheter in unselected critically ill medical patients. In 28 patients treated in a medical intensive care unit (ICU), BP values were simultaneously obtained using a femoral Arterial Catheter and the T-Line TL-200. All recorded data were included in the final analysis. For comparison of BP measurements, Bland–Altman analysis accounting for repeated measurements was performed (primary endpoint). A total of 76,826 pairs of BP measurements (each consisting of SAP, MAP, and DAP) were analyzed. For MAP, Bland–Altman analysis revealed a mean difference of +0.47 mmHg (95 % limits of agreement −16.53 to +17.46 mmHg). For SAP and DAP, the bias and 95 % limits of agreement were −9.01 mmHg (−37.47 to +19.45 mmHg) and +5.22 mmHg (−13.50 to +23.94 mmHg), respectively. Non-invasive, continuous, radial BP measurement with the T-Line TL-200 is basically feasible in medical ICU patients (with a low bias for MAP compared to MAP assessed using a femoral Arterial Catheter). High limits of agreement (particularly of SAP and DAP) preclude the use of the device as a single source of BP information in unstable critically ill patients.

Maxime Cannesson - One of the best experts on this subject based on the ideXlab platform.

  • relation between respiratory variations in pulse oximetry plethysmographic waveform amplitude and Arterial pulse pressure in ventilated patients
    Critical Care, 2005
    Co-Authors: Maxime Cannesson, Cyril Besnard, Pierre G Durand, Julien Bohe, Didier Jacques
    Abstract:

    Introduction Respiratory variation in Arterial pulse pressure is a reliable predictor of fluid responsiveness in mechanically ventilated patients with circulatory failure. The main limitation of this method is that it requires an invasive Arterial Catheter. Both Arterial and pulse oximetry plethysmographic waveforms depend on stroke volume. We conducted a prospective study to evaluate the relationship between respiratory variation in Arterial pulse pressure and respiratory variation in pulse oximetry plethysmographic (POP) waveform amplitude.

  • relation between respiratory variations in pulse oximetry plethysmographic waveform amplitude and Arterial pulse pressure in ventilated patients
    Critical Care, 2005
    Co-Authors: Maxime Cannesson, Cyril Besnard, Pierre G Durand, Julien Bohe, Didier Jacques
    Abstract:

    Introduction Respiratory variation in Arterial pulse pressure is a reliable predictor of fluid responsiveness in mechanically ventilated patients with circulatory failure. The main limitation of this method is that it requires an invasive Arterial Catheter. Both Arterial and pulse oximetry plethysmographic waveforms depend on stroke volume. We conducted a prospective study to evaluate the relationship between respiratory variation in Arterial pulse pressure and respiratory variation in pulse oximetry plethysmographic (POP) waveform amplitude. Method This prospective clinical investigation was conducted in 22 mechanically ventilated patients. Respiratory variation in Arterial pulse pressure and respiratory variation in POP waveform amplitude were recorded simultaneously in a beat-tobeat evaluation, and were compared using a Spearman correlation test and a Bland–Altman analysis. Results There was a strong correlation (r2 = 0.83; P < 0.001) and a good agreement (bias = 0.8 ± 3.5%) between respiratory variation in Arterial pulse pressure and respiratory variation in POP waveform amplitude. A respiratory variation in POP waveform amplitude value above 15% allowed discrimination between patients with respiratory variation in Arterial pulse pressure above 13% and those with variation of 13% or less (positive predictive value 100%). Conclusion Respiratory variation in Arterial pulse pressure above 13% can be accurately predicted by a respiratory variation in POP waveform amplitude above 15%. This index has potential applications in patients who are not instrumented with an intra-Arterial Catheter.