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术中逐拍脉搏传输时间 (PTT) 通过非侵入性压电/压容式周边传感器监测可以预测高危手术患者有创血压的变化。

Intraoperative Beat-to-Beat Pulse Transit Time (PTT) Monitoring via Non-Invasive Piezoelectric/Piezocapacitive Peripheral Sensors Can Predict Changes in Invasively Acquired Blood Pressure in High-Risk Surgical Patients.

机构信息

Department of Anesthesiology and Intensive Care Medicine, Hindenburgdamm 30, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, 12203 Berlin, Germany.

Berlin Institute of Health at Charité, Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.

出版信息

Sensors (Basel). 2023 Mar 21;23(6):3304. doi: 10.3390/s23063304.

DOI:10.3390/s23063304
PMID:36992016
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10059272/
Abstract

BACKGROUND

Non-invasive tracking of beat-to-beat pulse transit time (PTT) via piezoelectric/piezocapacitive sensors (PES/PCS) may expand perioperative hemodynamic monitoring. This study evaluated the ability for PTT via PES/PCS to correlate with systolic, diastolic, and mean invasive blood pressure (SBP, DBP, and MAP, respectively) and to detect SBP fluctuations.

METHODS

PES/PCS and IBP measurements were performed in 20 patients undergoing abdominal, urological, and cardiac surgery. A Pearson's correlation analysis (r) between 1/PTT and IBP was performed. The predictive ability of 1/PTT with changes in SBP was determined by area under the curve (reported as AUC, sensitivity, specificity).

RESULTS

Significant correlations between 1/PTT and SBP were found for PES (r = 0.64) and PCS (r = 0.55) ( < 0.01), as well as MAP/DBP for PES (r = 0.6/0.55) and PCS (r = 0.5/0.45) ( < 0.05). A 7% decrease in 1/PTT predicted a 30% SBP decrease (0.82, 0.76, 0.76), while a 5.6% increase predicted a 30% SBP increase (0.75, 0.7, 0.68). A 6.6% decrease in 1/PTT detected a 30% SBP decrease (0.81, 0.72, 0.8), while a 4.8% 1/PTT increase detected a 30% SBP increase (0.73, 0.64, 0.68).

CONCLUSIONS

Non-invasive beat-to-beat PTT via PES/PCS demonstrated significant correlations with IBP and detected significant changes in SBP. Thus, PES/PCS as a novel sensor technology may augment intraoperative hemodynamic monitoring during major surgery.

摘要

背景

通过压电/压电容传感器(PES/PCS)无创跟踪逐搏脉搏传输时间(PTT)可能会扩展围手术期血流动力学监测。本研究评估了 PTT 通过 PES/PCS 与收缩压、舒张压和平均有创血压(SBP、DBP 和 MAP,分别)相关的能力,并检测 SBP 波动。

方法

对 20 例接受腹部、泌尿科和心脏手术的患者进行 PES/PCS 和 IBP 测量。进行了 1/PTT 和 IBP 之间的皮尔逊相关分析(r)。通过曲线下面积(以 AUC、灵敏度、特异性报告)确定 1/PTT 随 SBP 变化的预测能力。

结果

PES(r = 0.64)和 PCS(r = 0.55)(<0.01)以及 MAP/DBP 与 PES(r = 0.6/0.55)和 PCS(r = 0.5/0.45)(<0.05)之间均发现 1/PTT 与 SBP 之间存在显著相关性。1/PTT 降低 7%可预测 SBP 降低 30%(0.82、0.76、0.76),而增加 5.6%可预测 SBP 增加 30%(0.75、0.7、0.68)。1/PTT 降低 6.6%可检测到 SBP 降低 30%(0.81、0.72、0.8),而 1/PTT 增加 4.8%可检测到 SBP 增加 30%(0.73、0.64、0.68)。

结论

通过 PES/PCS 的无创逐搏 PTT 与 IBP 显示出显著相关性,并检测到 SBP 的显著变化。因此,PES/PCS 作为一种新型传感器技术,可能会增强重大手术期间的术中血流动力学监测。

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