The role of the maximal first derivative of the radial pulse wave (Rad dP/dtmax) in monitoring cardiac function

The ultimate purpose of perioperative cardiac function monitoring and hemodynamic treatment is to ensure adequate perfusion and oxygenation (1). Advanced cardiovascular monitoring tools are useful to ensure the hemodynamic stability of patients, especially the critical ones (2). Among these tools, cardiac output (CO), which is measured with the Swan-Ganz catheter, has been accepted as the clinical “golden standard” (3). CO is significantly meaningful in estimating hemodynamic changes and cardiac function in critical patients (4). However, CO could be influenced by many factors such as myocardial contractility, cardiac preload, and afterload, etc. (5). There are still difficulties in quickly and accurately estimating the myocardial contractility when CO declines abruptly in clinical practice and this delayed judgment will affect treatment