ABSTRACT
Clinical and therapeutic implications are addressed throughout this book, particularly in its latter sections. We intend in this chapter to summarize these and to point out particular strategies that have either been shown, or which we expect to show, clinical relevance in the future. Medical, surgical, and mechanical issues will be addressed, and in a realistic way that makes the older concepts of arterial Windkessel completely inappropriate. Readers will have seen enough evidence of wave reflection in this book to appreciate that any conceptual model (including Windkessel) that excludes the possibility of wave reflection cannot be regarded as realistic and thus must show serious deficiencies with change in cardiac and vascular function. If these principles are to be useful for monitoring of sick patients as in an intensive care ward (which is our ultimate aim), they must apply widely with change in heart rate, blood pressure, cardiac output, and arteriolar tone. It is not enough to show association under basal conditions. In addition to therapeutic strategies, we will need to discuss how hemodynamic parameters can best be monitored and assessed.
