Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divid...Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.展开更多
This study proposed a measurement platform for continuous blood pressure estimation based on dual photoplethysmography(PPG)sensors and a deep learning(DL)that can be used for continuous and rapid measurement of blood ...This study proposed a measurement platform for continuous blood pressure estimation based on dual photoplethysmography(PPG)sensors and a deep learning(DL)that can be used for continuous and rapid measurement of blood pressure and analysis of cardiovascular-related indicators.The proposed platform measured the signal changes in PPG and converted them into physiological indicators,such as pulse transit time(PTT),pulse wave velocity(PWV),perfusion index(PI)and heart rate(HR);these indicators were then fed into the DL to calculate blood pressure.The hardware of the experiment comprised 2 PPG components(i.e.,Raspberry Pi 3 Model B and analog-todigital converter[MCP3008]),which were connected using a serial peripheral interface.The DL algorithm converted the stable dual PPG signals acquired from the strictly standardized experimental process into various physiological indicators as input parameters and finally obtained the systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP).To increase the robustness of the DL model,this study input data of 100 Asian participants into the training database,including those with and without cardiovascular disease,each with a proportion of approximately 50%.The experimental results revealed that the mean absolute error and standard deviation of SBP was 0.17±0.46 mmHg.The mean absolute error and standard deviation of DBP was 0.27±0.52 mmHg.The mean absolute error and standard deviation of MAP was 0.16±0.40 mmHg.展开更多
Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in ...Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.展开更多
This study aims to confirm whether noncontact monitoring of relative changes in blood pressure can be estimated using microwave radar sensors. First, an equation to estimate blood pressure was derived, after which, th...This study aims to confirm whether noncontact monitoring of relative changes in blood pressure can be estimated using microwave radar sensors. First, an equation to estimate blood pressure was derived, after which, the effectiveness of the estimation equation was confirmed using data obtained by a noncontact method while inducing variations in blood pressure. We considered that the Bramwell-Hill equation, which contains some parameters that directly indicate changes in blood pressure, would be an appropriate reference to construct an estimation equation for the noncontact method, because measurements using microwave radar sensors can measure minute scale motion on the skin surface induced by the pulsation of blood vessels. In order to estimate relative changes in blood pressure, we considered a simple equation including the pulse transit time (PTT), amplitude of signals and body dimensions as parameters. To verify the effectiveness of the equation for estimating changes in blood pressure, two experiments were conducted: a cycling task using an ergometer, which induces blood pressure fluctuations because of changes in cardiac output, and a task using the Valsalva maneuver, which induces blood pressure fluctuations because of changes in vascular resistance. The results obtained from the two experiments suggested that the proposed equation using microwave radar sensors can accurately estimate relative changes of blood pressure. In particular, relatively favorable results were obtained for the changes in blood pressure induced by the changes in cardiac volume. Although many issues remain, this method could be expected to contribute to the continuous evaluation of cardiac function while reducing the burden on patients.展开更多
目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP...目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP波的连续值,本研究期望基于卷积神经网络-长短期记忆神经网络(CNN-LSTM)利用PPG信号波重建ABP波信号,实现连续无创血压监测。方法构建CNN-LSTM混合神经网络模型,利用重症监护医学信息集(medical information mart for intensive care,MIMIC)中的PPG与ABP波同步记录信号数据,将PPG信号波经预处理降噪、归一化、滑窗分割后输入该模型,重建与之同步对应的ABP波信号。结果使用窗口长度312的CNN-LSTM神经网络时,重建ABP值与实际ABP值间误差最小,平均绝对误差(mean absolute error,MAE)和均方根误差(root mean square error,RMSE)分别为2.79 mmHg和4.24 mmHg,余弦相似度最大,重建ABP值与实际ABP值一致性和相关性情况良好,符合美国医疗器械促进协会(Association for the Advancement of Medical Instrumentation,AAMI)标准。结论CNN-LSTM混合神经网络可利用PPG信号波重建ABP波信号,实现连续无创血压监测。展开更多
本研究为克服在基于脉搏波传导时间(pulse transit time,PTT)方法无创血压检测中个体差异对测量准确性的影响,分析了个体脉搏波特征参数与血压值的相关性,并将个体脉搏波特征参数中与血压值相关度高的参数作为优化脉搏波特征参数加入PT...本研究为克服在基于脉搏波传导时间(pulse transit time,PTT)方法无创血压检测中个体差异对测量准确性的影响,分析了个体脉搏波特征参数与血压值的相关性,并将个体脉搏波特征参数中与血压值相关度高的参数作为优化脉搏波特征参数加入PTT与血压的校正模型中,以提高模型普适性。基于偏最小二乘法(partial least squares,PLS)对50名志愿者200组PTT和脉搏波特征参数数据进行训练建模,得到舒张压、收缩压的预测模型。再选取5名新志愿者的PPT和脉搏波特征参数进行预测,最大预测误差小于5 mm Hg,满足AAMI国际电子血压计标准。将优化的脉搏波特征参数和PTT引入到连续血压预测模型当中,有助于提高血压预测模型的准确度和普适性,有助于无创连续血压检测的临床应用。展开更多
文摘Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.
基金This study was supported in part by the Ministry of Science and Technology MOST 108-2221-E-150-022-MY3 and Taiwan Ocean University.
文摘This study proposed a measurement platform for continuous blood pressure estimation based on dual photoplethysmography(PPG)sensors and a deep learning(DL)that can be used for continuous and rapid measurement of blood pressure and analysis of cardiovascular-related indicators.The proposed platform measured the signal changes in PPG and converted them into physiological indicators,such as pulse transit time(PTT),pulse wave velocity(PWV),perfusion index(PI)and heart rate(HR);these indicators were then fed into the DL to calculate blood pressure.The hardware of the experiment comprised 2 PPG components(i.e.,Raspberry Pi 3 Model B and analog-todigital converter[MCP3008]),which were connected using a serial peripheral interface.The DL algorithm converted the stable dual PPG signals acquired from the strictly standardized experimental process into various physiological indicators as input parameters and finally obtained the systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP).To increase the robustness of the DL model,this study input data of 100 Asian participants into the training database,including those with and without cardiovascular disease,each with a proportion of approximately 50%.The experimental results revealed that the mean absolute error and standard deviation of SBP was 0.17±0.46 mmHg.The mean absolute error and standard deviation of DBP was 0.27±0.52 mmHg.The mean absolute error and standard deviation of MAP was 0.16±0.40 mmHg.
文摘Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.
文摘This study aims to confirm whether noncontact monitoring of relative changes in blood pressure can be estimated using microwave radar sensors. First, an equation to estimate blood pressure was derived, after which, the effectiveness of the estimation equation was confirmed using data obtained by a noncontact method while inducing variations in blood pressure. We considered that the Bramwell-Hill equation, which contains some parameters that directly indicate changes in blood pressure, would be an appropriate reference to construct an estimation equation for the noncontact method, because measurements using microwave radar sensors can measure minute scale motion on the skin surface induced by the pulsation of blood vessels. In order to estimate relative changes in blood pressure, we considered a simple equation including the pulse transit time (PTT), amplitude of signals and body dimensions as parameters. To verify the effectiveness of the equation for estimating changes in blood pressure, two experiments were conducted: a cycling task using an ergometer, which induces blood pressure fluctuations because of changes in cardiac output, and a task using the Valsalva maneuver, which induces blood pressure fluctuations because of changes in vascular resistance. The results obtained from the two experiments suggested that the proposed equation using microwave radar sensors can accurately estimate relative changes of blood pressure. In particular, relatively favorable results were obtained for the changes in blood pressure induced by the changes in cardiac volume. Although many issues remain, this method could be expected to contribute to the continuous evaluation of cardiac function while reducing the burden on patients.
文摘目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP波的连续值,本研究期望基于卷积神经网络-长短期记忆神经网络(CNN-LSTM)利用PPG信号波重建ABP波信号,实现连续无创血压监测。方法构建CNN-LSTM混合神经网络模型,利用重症监护医学信息集(medical information mart for intensive care,MIMIC)中的PPG与ABP波同步记录信号数据,将PPG信号波经预处理降噪、归一化、滑窗分割后输入该模型,重建与之同步对应的ABP波信号。结果使用窗口长度312的CNN-LSTM神经网络时,重建ABP值与实际ABP值间误差最小,平均绝对误差(mean absolute error,MAE)和均方根误差(root mean square error,RMSE)分别为2.79 mmHg和4.24 mmHg,余弦相似度最大,重建ABP值与实际ABP值一致性和相关性情况良好,符合美国医疗器械促进协会(Association for the Advancement of Medical Instrumentation,AAMI)标准。结论CNN-LSTM混合神经网络可利用PPG信号波重建ABP波信号,实现连续无创血压监测。
文摘本研究为克服在基于脉搏波传导时间(pulse transit time,PTT)方法无创血压检测中个体差异对测量准确性的影响,分析了个体脉搏波特征参数与血压值的相关性,并将个体脉搏波特征参数中与血压值相关度高的参数作为优化脉搏波特征参数加入PTT与血压的校正模型中,以提高模型普适性。基于偏最小二乘法(partial least squares,PLS)对50名志愿者200组PTT和脉搏波特征参数数据进行训练建模,得到舒张压、收缩压的预测模型。再选取5名新志愿者的PPT和脉搏波特征参数进行预测,最大预测误差小于5 mm Hg,满足AAMI国际电子血压计标准。将优化的脉搏波特征参数和PTT引入到连续血压预测模型当中,有助于提高血压预测模型的准确度和普适性,有助于无创连续血压检测的临床应用。
