Department of Pediatrics, Children's Hospital of Michigan/Wayne State University, Detroit, MI.
Department of Mechanical Engineering, Wayne State University, Detroit, MI.
Pediatr Crit Care Med. 2019 Sep;20(9):809-816. doi: 10.1097/PCC.0000000000001997.
To develop a novel device to predict systolic and diastolic blood pressure based on measured heart sound signals and evaluate its accuracy in comparison to intra-arterial blood pressure readings.
Prospective, observational pilot study.
PICU.
Critically ill children (0-18 yr) undergoing continuous blood pressure monitoring via radial artery intra-arterial catheters were enrolled in the study after informed consent. The study included medical, cardiac, and surgical PICU patients.
Along with intra-arterial blood pressure, patient's heart sounds were recorded simultaneously by a highly sensitive sensor taped to the chest. Additional hardware included a data acquisition unit and laptop computer. Subsequently, advanced signal processing technologies were used to minimize random interfering signals and extract and separate S1 and S2 signals. A computerized model was then developed using artificial neural network systems to estimate blood pressure from the extracted heart sound analysis.
We found a statistically significant correlation for systolic (r = 0.964; R = 0.928) and diastolic (r = 0.935; R = 0.868) blood pressure readings (n = 491) estimated by the novel heart-sound signal-based method and those recorded by intra-arterial catheters. The mean difference of the individually paired determinations of the blood pressure between the heart-sound-based method and intra-arterial catheters was 0.6 ± 7 mm Hg for systolic blood pressure and -0.06 ± 5 mm Hg for diastolic blood pressure, which was within the recommended range of 5 ± 8 mm Hg for any new blood pressure devices.
Our findings provide proof of concept that the heart-sound signal-based method can provide accurate, noninvasive blood pressure monitoring.
开发一种新的设备，通过测量心音信号预测收缩压和舒张压，并评估其与动脉内血压读数相比的准确性。
前瞻性、观察性试点研究。
PICU。
接受桡动脉内动脉导管持续血压监测的危重症儿童（0-18 岁），在知情同意后入组研究。研究包括内科、心脏和外科 PICU 患者。
与动脉内血压同时，通过贴在胸部的高灵敏度传感器同步记录患者的心音。额外的硬件包括数据采集单元和笔记本电脑。随后，使用先进的信号处理技术来最小化随机干扰信号，并提取和分离 S1 和 S2 信号。然后使用人工神经网络系统开发计算机模型，从提取的心音分析中估计血压。
我们发现，通过新的心音信号为基础的方法估计的收缩压（r = 0.964；R = 0.928）和舒张压（r = 0.935；R = 0.868）与通过动脉内导管记录的收缩压和舒张压有统计学显著相关性（n = 491）。基于心音信号的方法和动脉内导管之间的个体配对血压测定的平均差异为收缩压为 0.6 ± 7 mmHg，舒张压为 -0.06 ± 5 mmHg，这在任何新的血压设备的 5 ± 8 mmHg 推荐范围内。
我们的研究结果提供了概念验证，表明心音信号为基础的方法可以提供准确、无创的血压监测。
