Photoplethysmographic characterization of vascular tone mediated changes in arterial pressure: an observational study

"To determine whether a classification based on the contour of the photoplethysmography signal (PPGc) can detect changes in systolic arterial blood pressure (SAP) and vascular tone. Episodes of normotension (SAP 90–140 mmHg), hypertension (SAP > 140 mmHg) and hypotension (SAP < 90 mmHg) w...

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Detalles Bibliográficos
Autores principales: Tusman, Gerardo, Acosta, Cecilia M., Pulletz, Sven, Böhm, Stephan H., Scandurra, Adriana, Martínez Arca, Jorge, Madorno, Matías, Suárez-Sipmann, Fernando
Formato: Artículos de Publicaciones Periódicas acceptedVersion
Lenguaje:Inglés
Publicado: 2020
Materias:
PRESION ARTERIAL
FOTOPLETISMOGRAFIA
FLUJO SANGUINEO
Acceso en línea:http://ri.itba.edu.ar/handle/123456789/2221
Aporte de:
Repositorio Institucional Instituto Tecnológico de Buenos Aires (ITBA) de Instituto Tecnológico de Buenos Aires (ITBA)
Descripción
Sumario:"To determine whether a classification based on the contour of the photoplethysmography signal (PPGc) can detect changes in systolic arterial blood pressure (SAP) and vascular tone. Episodes of normotension (SAP 90–140 mmHg), hypertension (SAP > 140 mmHg) and hypotension (SAP < 90 mmHg) were analyzed in 15 cardiac surgery patients. SAP and two surrogates of the vascular tone, systemic vascular resistance (SVR) and vascular compliance (Cvasc = stroke volume/pulse pressure) were compared with PPGc. Changes in PPG amplitude (foot-to-peak distance) and dicrotic notch position were used to define 6 classes taking class III as a normal vascular tone with a notch placed between 20 and 50% of the PPG amplitude. Class I-to-II represented vasoconstriction with notch placed > 50% in a small PPG, while class IV-to-VI described vasodilation with a notch placed < 20% in a tall PPG wave. 190 datasets were analyzed including 61 episodes of hypertension [SAP = 159 (151–170) mmHg (median 1st–3rd quartiles)], 84 of normotension, SAP = 124 (113–131) mmHg and 45 of hypotension SAP = 85(80–87) mmHg. SAP were well correlated with SVR (r = 0.78, p < 0.0001) and Cvasc (r = 0.84, p < 0.0001). The PPG-based classification correlated well with SAP (r = − 0.90, p < 0.0001), SVR (r = − 0.72, p < 0.0001) and Cvasc (r = 0.82, p < 0.0001). The PPGc misclassified 7 out of the 190 episodes, presenting good accuracy (98.4% and 97.8%), sensitivity (100% and 94.9%) and specificity (97.9% and 99.2%) for detecting episodes of hypotension and hypertension, respectively. Changes in arterial pressure and vascular tone were closely related to the proposed classification based on PPG waveform."

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