This article is a review of 25 publications on ambulatory blood pressure monitoring(ABPM) and the importance of its results in everyday clinical practice. These studies, published in 2008-2011, were selected from the ...This article is a review of 25 publications on ambulatory blood pressure monitoring(ABPM) and the importance of its results in everyday clinical practice. These studies, published in 2008-2011, were selected from the Scopus database, but are also available in Pubmed. They were prepared by researchers from around the world, concerned with the problems of proper control of blood pressure(BP), and of abnormalities in the circadian pattern of BP in patients with arterial hypertension, diabetes mellitus or renal failure. In the first part of this article, I analyse publications focused on some nuances in the methodology of ABPM and recommend ways to avoid some traps, related not only to the individual patient but also to the device used and the technical staff. The next section is devoted to the advantages of ABPM as a diagnostic tool which enables clinicians to learn about patients' BP during sleep, and emphasizes the practical implications of this information for so-called chronotherapy. This section also presents some new studies on the prognostic value of ABPM in patients with cardiovascular(CV) risk. Some recent articles on the results of various methods of pharmacological treatment of arterial hypertension in different agegroups are then described. The observations presented in this article may be helpful not only for researchers interested in the chronobiology of the CV system, but also for general practitioners using ABPM.展开更多
Objective: The objective is to investigate the incidence and consequences of arterial line occlusion during invasive blood pressure monitoring in the form of questionnaire survey. Methods: The questionnaires were rand...Objective: The objective is to investigate the incidence and consequences of arterial line occlusion during invasive blood pressure monitoring in the form of questionnaire survey. Methods: The questionnaires were randomly distributed to the anesthesiologists who participated the 22<sup>nd</sup> annual meeting of Chinese society of anesthesiology. The main contents of this survey included the arterial line managing status, the incidence of arterial line occlusion, the effects of arterial line occlusion on the anesthesiologists’ therapy and consequences caused by arterial line occlusion. Results: Totally 294 questionnaires were collected, in which 261 questionnaires were valid. In all respondents, 28.3% expressed that they could not flush arterial line on time, and 95.4% had experienced flushing arterial line only or sometimes or occasionally when the arterial waveform was not normal. Furthermore, 93.9% had experienced partial occlusion of the arterial line, and 79.3% had experienced complete occlusion. According to the serious recall of the respondents, the incidence of partial arterial line occlusion was 17.7% ± 22.0%, and the incidence of complete arterial line occlusion was 3.6% ± 8.1%. For all the respondents, 89.7% had experienced suspecting arterial line occlusion while real hypotension occurred, 65.1% had experienced not treating hypotension timely due to this suspicion, and 31% had experienced serious consequences caused by this suspicion. Conclusion: The incidence of arterial line occlusion is high during invasive blood pressure monitoring, which is a threat to the patients’ safety. So, intensive attention should be paid to the arterial line management.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
文摘This article is a review of 25 publications on ambulatory blood pressure monitoring(ABPM) and the importance of its results in everyday clinical practice. These studies, published in 2008-2011, were selected from the Scopus database, but are also available in Pubmed. They were prepared by researchers from around the world, concerned with the problems of proper control of blood pressure(BP), and of abnormalities in the circadian pattern of BP in patients with arterial hypertension, diabetes mellitus or renal failure. In the first part of this article, I analyse publications focused on some nuances in the methodology of ABPM and recommend ways to avoid some traps, related not only to the individual patient but also to the device used and the technical staff. The next section is devoted to the advantages of ABPM as a diagnostic tool which enables clinicians to learn about patients' BP during sleep, and emphasizes the practical implications of this information for so-called chronotherapy. This section also presents some new studies on the prognostic value of ABPM in patients with cardiovascular(CV) risk. Some recent articles on the results of various methods of pharmacological treatment of arterial hypertension in different agegroups are then described. The observations presented in this article may be helpful not only for researchers interested in the chronobiology of the CV system, but also for general practitioners using ABPM.
文摘Objective: The objective is to investigate the incidence and consequences of arterial line occlusion during invasive blood pressure monitoring in the form of questionnaire survey. Methods: The questionnaires were randomly distributed to the anesthesiologists who participated the 22<sup>nd</sup> annual meeting of Chinese society of anesthesiology. The main contents of this survey included the arterial line managing status, the incidence of arterial line occlusion, the effects of arterial line occlusion on the anesthesiologists’ therapy and consequences caused by arterial line occlusion. Results: Totally 294 questionnaires were collected, in which 261 questionnaires were valid. In all respondents, 28.3% expressed that they could not flush arterial line on time, and 95.4% had experienced flushing arterial line only or sometimes or occasionally when the arterial waveform was not normal. Furthermore, 93.9% had experienced partial occlusion of the arterial line, and 79.3% had experienced complete occlusion. According to the serious recall of the respondents, the incidence of partial arterial line occlusion was 17.7% ± 22.0%, and the incidence of complete arterial line occlusion was 3.6% ± 8.1%. For all the respondents, 89.7% had experienced suspecting arterial line occlusion while real hypotension occurred, 65.1% had experienced not treating hypotension timely due to this suspicion, and 31% had experienced serious consequences caused by this suspicion. Conclusion: The incidence of arterial line occlusion is high during invasive blood pressure monitoring, which is a threat to the patients’ safety. So, intensive attention should be paid to the arterial line management.
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。
