Wippermann C F, Schranz D, Huth R G
University Children's Hospital, Johannes Gutenberg University Mainz, Germany.
J Clin Monit. 1995 Sep;11(5):324-8. doi: 10.1007/BF01616991.
Pulse arrival time (PAT), which is the interval between the R wave of the electrocardiogram (ECG) and the arrival of the pulse wave peripherally, has been reported to be suitable for use as an indirect measure of blood pressure change. The purpose of this study was to evaluate, in critically ill infants and children, the degree to which 1/PAT covaries with systolic, diastolic, and mean blood pressure, as well as heart rate.
A laboratory device was used to calculate PAT in real time from the ECG and the plethysmographic curve of pulse oximetry used for routine monitoring. Calculated PAT and corresponding blood pressures and heart rate were stored on hard disk. A total of 15 critically ill patients, aged 6 days to 16 years, weighing 3 to 80 kg, were studied.
In all patients, one period of 11,000 to 36,000 beats could be evaluated. Mean correlation coefficients were best for systolic blood pressure (r = 0.73), followed by mean blood pressure (r = 0.68) and diastolic blood pressure (r = 0.61), and, finally, heart rate (r = 0.52). In 7 patients, the correlation coefficient for systolic blood pressure was > 0.9; but, in 4 patients, it was < 0.5.
We conclude that the correlation between 1/PAT and systolic blood pressure is not strong enough to serve as a marker for blood pressure changes in critically ill infants and children. This may be due to changes of the preejection period, which is part of the PAT.
脉搏波传导时间（PAT）是心电图（ECG）的R波与外周脉搏波到达之间的间隔时间，据报道它适合用作血压变化的间接测量指标。本研究的目的是评估在危重症婴幼儿和儿童中，1/PAT与收缩压、舒张压、平均血压以及心率的共变程度。
使用一种实验室设备根据用于常规监测的心电图和脉搏血氧饱和度仪的容积描记曲线实时计算PAT。计算出的PAT以及相应的血压和心率存储在硬盘上。共研究了15例危重症患者，年龄6天至16岁，体重3至80千克。
在所有患者中，可以评估11,000至36,000次心跳的一个时间段。平均相关系数对收缩压最佳（r = 0.73），其次是平均血压（r = 0.68）和舒张压（r = 0.61），最后是心率（r = 0.52）。在7例患者中，收缩压的相关系数> 0.9；但在4例患者中，该系数< 0.5。
我们得出结论，1/PAT与收缩压之间的相关性不够强，不足以作为危重症婴幼儿和儿童血压变化的标志物。这可能是由于射血前期（PAT的一部分）的变化所致。
