Chou En-Fan, Cheung Shin Yu Celia, Maxwell Hailey Christine, Pham Nicholas, Khine Michelle, Rinehart Joseph
Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States.
Department of Medical Education, University of California, Irvine, Irvine, CA, United States.
Front Digit Health. 2021 Jul 22;3:696606. doi: 10.3389/fdgth.2021.696606. eCollection 2021.
We test a new wireless soft capacitance sensor (CAP) based on applanation tonometry at the radial and dorsalis pedis arteries against the gold standard, invasive arterial line (A-Line), for continuous beat to beat blood pressure (BP) measurements in the Operating Room during surgical procedures under anesthesia in 17 subjects with the mean age and body mass index (BMI) of 57. 35 ± 18.72 years and 27.36 ± 4.20 kg/m, respectively. We have identified several parameters to monitor in order to compare how well the CAP sensor tracks the entire hemodynamic waveform as compared to the A-Line. This includes waveform similarity, heart rate (HR), absolute systolic BP (SBP), diastolic BP (DBP), and temporal response to a vasopressor. Overall, the CAP sensor shows good correlations with A-Line with respect to hemodynamic shape ( > 0.89), HR (mean bias = 0.0006; SD = 0.17), absolute SBP, and DBP in a line of best fit (slope = 0.98 in SBP; 1.08 in DBP) and the mean bias derived from Bland-Altman method to be 1.92 (SD = 12.55) in SBP and 2.38 (SD = 12.19) in DBP across body habitus and age in OR patients under general anesthesia. While we do observe drifts in the system, we still obtain decent correlations with respect to the A-Line as evidenced by excellent linear fit and low mean bias across patients. When we post-process using a different calibration method to account for the drift, the mean bias and SD improve dramatically to -1.85 and 7.19 DBP as well as 1.43 and 7.43 SBP, respectively, indicating a promising potential for improvement when we integrate strategies to account for movement identified by our integrated accelerometer data.
我们在17名平均年龄和体重指数（BMI）分别为57.35±18.72岁和27.36±4.20kg/m²的受试者身上，于麻醉下的手术过程中，在手术室里，将一种基于压平眼压计的新型无线软电容传感器（CAP）与金标准——有创动脉导管（A-Line）进行对比，以连续逐搏测量血压（BP）。我们确定了几个要监测的参数，以便比较CAP传感器与A-Line相比追踪整个血流动力学波形的效果。这包括波形相似性、心率（HR）、绝对收缩压（SBP）、舒张压（DBP）以及对血管升压药的时间反应。总体而言，CAP传感器在血流动力学形状（>0.89）、HR（平均偏差=0.0006；标准差=0.17）、绝对SBP和DBP方面与A-Line显示出良好的相关性，在最佳拟合线上（SBP斜率=0.98；DBP斜率=1.08），并且通过布兰德-奥特曼方法得出的平均偏差在全身麻醉下的手术室患者中，SBP为1.92（标准差=12.55），DBP为2.38（标准差=12.19）。虽然我们确实观察到系统存在漂移，但正如患者之间出色的线性拟合和低平均偏差所证明的那样，我们仍获得了与A-Line相当不错的相关性。当我们使用不同的校准方法进行后处理以考虑漂移时，平均偏差和标准差显著改善，DBP分别为-1.85和7.19，SBP分别为1.43和7.43，这表明当我们整合策略以考虑由我们的集成加速度计数据识别出的运动时，有很大的改进潜力。
