Pressure recording analytical method (PRAM) for measurement of cardiac output during various haemodynamic states

Br J Anaesth. 2005 Aug;95(2):159-65. doi: 10.1093/bja/aei154. Epub 2005 May 13.


Background: Cardiac output (CO) can be measured using the pressure recording analytical method (PRAM), which is a new, less invasive technique allowing beat-by-beat stroke volume monitoring from the pressure signals recorded in femoral or radial arteries.

Methods: We investigated PRAM by comparing its cardiac output (PRAM-CO) with paired measurements obtained by electromagnetic flowmetry (EM-CO) and by standard thermodilution (ThD-CO) during various haemodynamic states in a swine model. Nine pigs were monitored with a pulmonary artery catheter and a femoral artery catheter at baseline, in a hyperdynamic state produced by administration of dobutamine and in a hypodynamic state induced by progressive exsanguination. Bland-Altman analysis was used.

Results: One hundred and eight paired cardiac output values over a range of EM-CO of 1.8-10.4 litre min(-1) resulted. We found close agreement between the techniques. Mean bias between EM-CO and PRAM-CO was -0.03 litre min(-1) (precision 0.58 litre min(-1)). The 95% limits of agreement were -0.61 to +0.55 litre min(-1). Similar results between ThD-CO and PRAM-CO were found.

Conclusions: In a porcine model we have demonstrated accuracy of PRAM during various haemodynamic states. PRAM is a reliable tool to detect changes in cardiac output in pigs and has ability as a basic research tool.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Analysis of Variance
  • Animals
  • Arteries
  • Blood Pressure
  • Cardiac Output*
  • Electromagnetic Phenomena
  • Models, Animal
  • Rheology
  • Sensitivity and Specificity
  • Stroke Volume
  • Swine
  • Thermodilution