Clinical applications of photoplethysmography in paediatric intensive care.
OBJECTIVE
The photoplethysmographic wave is displayed by most pulse oximeters. It may be used as a non-invasive alternative to invasive arterial blood pressure trace analysis for continuous haemodynamic monitoring in selected situations.


METHODS
Four cardiac patients treated in a tertiary neonatal-paediatric intensive care unit.


METHODS
Simultaneous monitoring of the photoplethysmographic wave, ECG, and invasive blood pressure.


CONCLUSIONS
Photoplethysmography allows for monitoring pulse rate in patients with (possible) heart rate/pulse rate dissociation (pacemaker dependency, pulsatile ventricular assist device); monitoring sudden changes in heart beat volume, which are unrelated to respiration (pulseless electrical activity, pulsus alternans); and monitoring respiratory-dependent fluctuations of the plethysmographic wave (heart failure, hypovolaemia, asthma, upper airway obstruction, pericardial effusion). Deterioration, slowly evolving over time, may be detected by this method.
Frey
Bernhard
B
Department of Intensive Care and Neonatology, University Children's Hospital, 8032 Zurich, Switzerland. Bernhard.Frey@kispi.uzh.ch
Waldvogel
Katharina
K
Balmer
Christian
C
D000293:Adolescent; D001795:Blood Pressure Determination / Q000379:methods; D002648:Child; D004562:Electrocardiography / Q000379:methods; D006331:Heart Diseases / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010092:Oximetry / Q000379:methods; D017156:Photoplethysmography / Q000379:methods*