Gravenstein J S, de Vries A, Beneken J E
Department of Anesthesiology, University of Florida College of Medicine, Gainesville.
J Clin Monit. 1989 Jan;5(1):17-21. doi: 10.1007/BF01618365.
Although five minutes is the sampling interval mentioned by the American Society of Anesthesiologists for monitoring blood pressure and heart rate during anesthesia, most patients are monitored more closely by continuous auscultation and with the help of automated instruments. Yet this difference between the interval recommended and that actually used indicates that sampling intervals are not defined clearly enough. Therefore, we present three methods with which to determine sampling intervals during monitoring. To explore the feasibility of these methods we examined data gathered every 7.5 seconds during three typical, noncatastrophic physiologic perturbations induced in an anesthetized dog. We chose hypercapnia secondary to rebreathing, hypotension secondary to deep anesthesia, and hypoxemia secondary to a low concentration of inspired oxygen as realistic examples of what can occur during operation and anesthesia. We studied three variables: respired carbon dioxide, femoral arterial blood pressure, and oxygen saturation of hemoglobin (pulse oximeter). The data obtained during monitoring were subjected to three methods of analysis: (1) recording of sets of data, with various starting times, at five-minute intervals only (moving grid); (2) Fourier analysis; and (3) analysis of slopes. For the data of the experiment, the Fourier analysis yielded, on average, longer sampling intervals than did the analysis of slopes.
尽管美国麻醉医师协会提到,在麻醉期间监测血压和心率的采样间隔为5分钟,但大多数患者通过持续听诊和借助自动仪器进行更密切的监测。然而,推荐的间隔与实际使用的间隔之间的这种差异表明采样间隔的定义还不够清晰。因此,我们提出三种在监测期间确定采样间隔的方法。为了探究这些方法的可行性,我们检查了在一只麻醉犬身上诱发的三种典型的、非灾难性生理扰动期间每隔7.5秒收集的数据。我们选择再呼吸继发的高碳酸血症、深度麻醉继发的低血压以及吸入低浓度氧气继发的低氧血症,作为手术和麻醉期间可能发生情况的实际例子。我们研究了三个变量:呼出二氧化碳、股动脉血压和血红蛋白氧饱和度(脉搏血氧仪)。监测期间获得的数据采用三种分析方法:(1)仅以5分钟间隔记录不同起始时间的数据集(移动网格);(2)傅里叶分析;(3)斜率分析。对于实验数据,傅里叶分析平均得出的采样间隔比斜率分析更长。