Narus S, Egbert T, Lee T K, Lu J, Westenskow D
Department of Anesthesiology, University of Utah Medical Center, Salt Lake City 84132, USA.
J Clin Monit. 1995 Sep;11(5):289-97. doi: 10.1007/BF01616986.
Our objective was to overcome the limitations of linear models of oscillometric blood pressure determination by using a nonlinear technique to model the relationship between the oscillometric envelope and systolic and diastolic blood pressures, and then to use that technique for near-continuous arterial pressure monitoring at the supraorbital artery.
An adhesive pressure pad and transducer were used to collect oscillometric data from the supraorbital artery of 85 subjects. These data were then used to train an artificial neural network (ANN) to report diastolic or systolic pressure. Arterial pressure measurements defined by brachial artery auscultation were used as a reference. ANN results were compared with those obtained using a standard oscillometric algorithm that determined pressures based on fixed percentages of the maximum oscillometric amplitude.
The ANN produced better estimates of reference blood pressures than the standard oscillometric algorithm. Mean difference between target and actual output for the ANN was 0.50 +/- 5.73 mm Hg for systolic pressures, compared to the mean difference of the standard algorithm of 2.78 +/- 19.38 mm Hg. For diastolic pressures, the ANN had a mean difference of 0.04 +/- 4.70 mm Hg, while the mean difference of the standard algorithm was -0.34 +/- 9.75 mm Hg.
The ANN produced a better model of the relationship between the oscillometric envelope and reference systolic and diastolic pressures than did the standard oscillometric algorithm. Noninvasive blood pressure measured from the supraorbital artery agreed with pressure measured by auscultation in the brachial artery, and may sometimes be more clinically useful than an arm cuff device.
我们的目标是通过使用非线性技术对示波包络与收缩压和舒张压之间的关系进行建模,从而克服示波法测定血压的线性模型的局限性,然后将该技术用于眶上动脉的近连续动脉压监测。
使用粘性压力垫和换能器从85名受试者的眶上动脉收集示波数据。然后使用这些数据训练人工神经网络(ANN)以报告舒张压或收缩压。将肱动脉听诊确定的动脉压测量值用作参考值。将人工神经网络的结果与使用基于最大示波幅度固定百分比确定压力的标准示波算法获得的结果进行比较。
与标准示波算法相比,人工神经网络对参考血压的估计更好。人工神经网络收缩压目标输出与实际输出的平均差值为0.50±5.73毫米汞柱,而标准算法的平均差值为2.78±19.38毫米汞柱。对于舒张压,人工神经网络的平均差值为0.04±4.70毫米汞柱,而标准算法的平均差值为-0.34±9.75毫米汞柱。
与标准示波算法相比,人工神经网络对示波包络与参考收缩压和舒张压之间的关系建立了更好的模型。从眶上动脉测量的无创血压与肱动脉听诊测量的血压一致,并且在临床上有时可能比臂袖带装置更有用。