Xiang Haiyan, Liu Yanyong, Li Yinhua, Qin Yufei, Yu Mengsun
Institute of Aviation Medicine, Beijing, China.
Blood Press Monit. 2012 Feb;17(1):35-41. doi: 10.1097/MBP.0b013e32834f710b.
To propose a novel noninvasive beat-to-beat arterial blood pressure measurement method based on the Korotkoff sound delay time (KDT) and evaluate its accuracy in preliminary experiments.
KDT decreases as the cuff pressure P deflates, which can be described by a function KDT=f (P). Actually, KDT is a function of arterial transmural pressure. Therefore, the variation in blood pressure can be obtained by the transmural pressure, which is estimated by the KDT. Holding the cuff pressure at an approximate constant pressure between systolic pressure and diastolic pressure, the variation in blood pressure ΔEBP between successive heartbeats can be estimated according to KDT and f'(p), which represents the variation of KDT corresponding to unit pressure. Then the blood pressure for each heartbeat can be obtained by accumulating the ΔEBP. Invasive and noninvasive blood pressure values of six participants were measured simultaneously to evaluate the method.
The average of the correlation coefficients between the invasive mean arterial pressure (MAP) and the KDT for six participants was -0.91. The average of the correlation coefficients between the invasive MAP and the estimated mean blood pressure (EBP) was 0.92. The mean difference between EBP and MAP was 0.51 mmHg, and the SD was 2.65 mmHg. The mean blood pressure estimated by the KDT is consistent with the invasive MAP.
The beat-to-beat blood pressure estimated by KDT provides an accurate estimate of MAP in the preliminary experiments and represents a potential acceptable alternative to invasive blood pressure monitoring during laboratory studies.
提出一种基于柯氏音延迟时间(KDT)的新型逐搏无创动脉血压测量方法,并在初步实验中评估其准确性。
随着袖带压力P降低,KDT减小,这可以用函数KDT = f (P)来描述。实际上,KDT是动脉跨壁压的函数。因此,血压变化可通过跨壁压获得,跨壁压由KDT估算。将袖带压力保持在收缩压和舒张压之间的近似恒定压力,根据KDT和f'(p)(表示单位压力对应的KDT变化)可估算连续心跳之间的血压变化ΔEBP。然后通过累加ΔEBP可获得每个心跳的血压。同时测量了6名参与者的有创和无创血压值以评估该方法。
6名参与者的有创平均动脉压(MAP)与KDT之间的相关系数平均值为-0.91。有创MAP与估算平均血压(EBP)之间的相关系数平均值为0.92。EBP与MAP之间的平均差值为0.51 mmHg,标准差为2.65 mmHg。通过KDT估算的平均血压与有创MAP一致。
在初步实验中,通过KDT估算的逐搏血压能准确估算MAP,是实验室研究中有创血压监测的一种潜在可接受的替代方法。