Health Sciences North Research Institute, Sudbury, ON, Canada.
Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.
PLoS One. 2022 Mar 23;17(3):e0265711. doi: 10.1371/journal.pone.0265711. eCollection 2022.
We describe the temporal concordance of 3 hemodynamic monitors.
Healthy volunteers performed preload changes while simultaneously wearing a non-invasive, pulse-contour stroke volume (SV) monitor, a bioreactance SV monitor and a wireless, wearable Doppler ultrasound patch over the common carotid artery. The sensitivity and specificity for detecting preload change over 3 temporal windows (early, middle and late) was assessed.
40 preload changes were recorded in total (20 increase, 20 decrease). Immediately, the wearable Doppler had high sensitivity (100%) and specificity (100%) for detecting preload change with an area under the receiver operator curve (AUROC) of 0.98 for both velocity time integral (VTI, 10.5% threshold) and corrected flow time (FTc, 2.5% threshold). The sensitivity, specificity and AUROC for non-invasive pulse contour were equally good (9% SV threshold). For bioreactance, a 13% SV threshold immediately detected preload change with a sensitivity, specificity and AUROC of 60%, 95% and 0.75, respectively. After two SV outputs following preload change, the sensitivity, specificity and AUROC of bioreactance improved to 70%, 90% and 0.85, respectively.
Carotid Doppler ultrasound and non-invasive pulse contour detected rapid hemodynamic change with equal accuracy; bioreactance improved over time. Algorithm-lag should be considered when interpreting clinical studies.
我们描述了 3 种血流动力学监测仪的时间一致性。
健康志愿者在同时佩戴无创、脉搏轮廓式每搏输出量（SV）监测仪、生物电抗式 SV 监测仪和无线可穿戴颈动脉多普勒超声贴片的情况下进行前负荷变化。评估了在 3 个时间窗口（早期、中期和晚期）检测前负荷变化的敏感性和特异性。
总共记录了 40 次前负荷变化（20 次增加，20 次减少）。立即，可穿戴多普勒超声对检测前负荷变化具有很高的敏感性（100%）和特异性（100%），其速度时间积分（VTI，10.5%阈值）和校正流量时间（FTc，2.5%阈值）的接收者操作特征曲线（AUROC）均为 0.98。无创脉搏轮廓的敏感性、特异性和 AUROC 同样良好（9%SV 阈值）。对于生物电抗，13%SV 阈值立即检测到前负荷变化，其敏感性、特异性和 AUROC 分别为 60%、95%和 0.75。在前负荷变化后两个 SV 输出后，生物电抗的敏感性、特异性和 AUROC 分别提高到 70%、90%和 0.85。
颈动脉多普勒超声和无创脉搏轮廓以相同的准确性检测快速血流动力学变化；生物电抗随时间改善。在解释临床研究时应考虑算法滞后。
