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 Direct arterial pressure monitoring is recommended for all ICU patients with hemodynamic instability who require inotropic or vasopressor medications as well as significant ventilatory deficits. This allows for continuous monitoring of blood pressure as well as access to the arterial circulation for the measurement of arterial oxygenation and frequent blood sampling.

 As the pulse moves peripherally, the pressure waveform is distorted with higher systolic pressure and pulse pressure (Figure 11.1).