Crimmins-Pierce Lauren D, Bonvillain Gabriel P, Henry Kaylee R, Hayat Md Abul, Villafranca Adria Abella, Stephens Sam E, Jensen Hanna K, Sanford Joseph A, Wu Jingxian, Sexton Kevin W, Jensen Morten O
Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA.
Department of Electrical Engineering, University of Arkansas, Fayetteville, AR, USA.
Cardiovasc Eng Technol. 2022 Dec;13(6):886-898. doi: 10.1007/s13239-022-00624-4. Epub 2022 May 11.
Peripheral venous pressure (PVP) waveform analysis is a novel, minimally invasive, and inexpensive method of measuring intravascular volume changes. A porcine cohort was studied to determine how venous and arterial pressure waveforms change due to inhaled and infused anesthetics and acute hemorrhage.
Venous and arterial pressure waveforms were continuously collected, while each pig was under general anesthesia, by inserting Millar catheters into a neighboring peripheral artery and vein. The anesthetic was varied from inhaled to infused, then the pig underwent a controlled hemorrhage. Pearson correlation coefficients between the power of the venous and arterial pressure waveforms at each pig's heart rate frequency were calculated for each variation in the anesthetic, as well as before and after hemorrhage. An analysis of variance (ANOVA) test was computed to determine the significance in changes of the venous pressure waveform means caused by each variation.
The Pearson correlation coefficients between venous and arterial waveforms decreased as anesthetic dosage increased. In an opposing fashion, the correlation coefficients increased as hemorrhage occurred.
Anesthetics and hemorrhage alter venous pressure waveforms in distinctly different ways, making it critical for researchers and clinicians to consider these confounding variables when utilizing pressure waveforms. Further work needs to be done to determine how best to integrate PVP waveforms into clinical decision-making.
外周静脉压（PVP）波形分析是一种测量血管内容量变化的新颖、微创且廉价的方法。对一组猪进行研究，以确定静脉和动脉压力波形如何因吸入和输注麻醉剂以及急性出血而发生变化。
在每头猪全身麻醉期间，通过将Millar导管插入相邻的外周动脉和静脉，连续收集静脉和动脉压力波形。麻醉方式从吸入改为输注，然后猪经历控制性出血。针对麻醉的每种变化以及出血前后，计算每头猪心率频率下静脉和动脉压力波形功率之间的Pearson相关系数。进行方差分析（ANOVA）测试，以确定每种变化引起的静脉压力波形均值变化的显著性。
随着麻醉剂量增加，静脉和动脉波形之间的Pearson相关系数降低。相反，随着出血发生，相关系数增加。
麻醉剂和出血以截然不同的方式改变静脉压力波形，这使得研究人员和临床医生在利用压力波形时考虑这些混杂变量至关重要。需要进一步开展工作，以确定如何最好地将PVP波形纳入临床决策。
