Mayo Clinic proceedings
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Mayo Clinic proceedings · May 2010
ReviewNoninvasive measurement of central vascular pressures with arterial tonometry: clinical revival of the pulse pressure waveform?
The arterial pulse has historically been an essential source of information in the clinical assessment of health. With current sphygmomanometric and oscillometric devices, only the peak and trough of the peripheral arterial pulse waveform are clinically used. Several limitations exist with peripheral blood pressure. ⋯ Radial artery applanation tonometry is a noninvasive, reproducible, and affordable technology that can be used in conjunction with peripherally obtained blood pressure to guide patient management. Keywords for the PubMed search were applanation tonometry, radial artery, central pressure, cardiovascular risk, blood pressure, and arterial pulse. Articles published from January 1, 1995, to July 1, 2009, were included in the review if they measured central pressure using radial artery applanation tonometry.
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Mayo Clinic proceedings · May 2010
ReviewPain management in the cirrhotic patient: the clinical challenge.
Pain management in patients with cirrhosis is a difficult clinical challenge for health care professionals, and few prospective studies have offered an evidence-based approach. In patients with end-stage liver disease, adverse events from analgesics are frequent, potentially fatal, and often avoidable. ⋯ In patients with cirrhosis, nonsteroidal anti-inflammatory drugs should be avoided to avert renal failure, and opiates should be avoided or used sparingly, with low and infrequent dosing, to prevent encephalopathy. For this review, we searched the available literature using PubMed and MEDLINE with no limits.