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Review
. 2020 Oct 28:9:2048004020970038.
doi: 10.1177/2048004020970038. eCollection 2020 Jan-Dec.

Physiology and clinical utility of the peripheral venous waveform

Devin Chang  1 , Philip J Leisy  2 , Jenna H Sobey  3 , Srijaya K Reddy  3 , Colleen Brophy  4 , Bret D Alvis  5 , Kyle Hocking  5 , Monica Polcz  5
Affiliations
Review

Physiology and clinical utility of the peripheral venous waveform

Devin Chang et al. JRSM Cardiovasc Dis. .

Abstract

The peripheral venous system serves as a volume reservoir due to its high compliance and can yield information on intravascular volume status. Peripheral venous waveforms can be captured by direct transduction through a peripheral catheter, non-invasive piezoelectric transduction, or gleaned from other waveforms such as the plethysmograph. Older analysis techniques relied upon pressure waveforms such as peripheral venous pressure and central venous pressure as a means of evaluating fluid responsiveness. Newer peripheral venous waveform analysis techniques exist in both the time and frequency domains, and have been applied to various clinical scenarios including hypovolemia (i.e. hemorrhage, dehydration) and volume overload.

Keywords: Peripheral venous pressure; hemodynamic monitoring; vascular; waveform analysis.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Kyle Hocking is Founder, CEO and President of VoluMetrix and an inventor on intellectual property in the field of venous waveform analysis assigned to Vanderbilt and licensed to VoluMetrix. Colleen Brophy is Founder and CMO of VoluMetrix and an inventor on intellectual property in the field of venous waveform analysis assigned to Vanderbilt and licensed to VoluMetrix. Bret D Alvis, CSO of VoluMetrix and an inventor on intellectual property in the field of venous waveform analysis assigned to Vanderbilt and licensed to VoluMetrix and is married to the COO of VoluMetrix.

Figures

Figure 1.
Figure 1.
Comparison of peripheral venous and central venous (CVP) waveforms, time-synced with EKG. CVP consists of three peaks (a,c,v) and two descents (x,y).
Figure 2.
Figure 2.
Raw venous waveforms in the time-domain (left) and frequency domain (right). The top is a central venous waveform, followed by a peripheral venous waveform acquired from direct transduction (middle) and noninvasively with a piezoelectric sensor (bottom).f0 corresponds to the fundamental frequency which is equal to the pulse rate. Higher harmonics of the pulse rate are denoted by f1 and f2, as well as a low frequency component (frr) corresponding to the respiratory rate.
See this image and copyright information in PMC

References

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