Cardiac output (CO)–guided therapy is a promising approach to hemodynamic management in high-risk patients having major surgery and in critically ill patients with circulatory shock.

Pulmonary artery thermodilution remains the clinical reference method for CO measurement, but the use of the pulmonary artery catheter decreased over the past two decades.

Today, various CO monitoring methods with different degrees of invasiveness are available, including pulse wave analysis.

Pulse wave analysis is the mathematical analysis of the arterial blood pressure waveform and enables CO to be estimated continuously and in real time.

In this article, we review pulse wave analysis methods for CO estimation, including their underlying measurement principles and their clinical application in perioperative and intensive care medicine.

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