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Photoplethysmographic characterization of vascular tone mediated changes in arterial pressure: an observational study
Hosp Privado Comunidad Mar Del Plata, Dept Anesthesiol, 7600 Mar Plata, Buenos Aires, DF, Argentina.
Hosp Privado Comunidad Mar Del Plata, Dept Anesthesiol, 7600 Mar Plata, Buenos Aires, DF, Argentina.
Klinikum Osnabrueck, Dept Anesthesiol & Intens Care Med, Osnabruck, Germany.
Rostock Univ, Med Ctr, Dept Anesthesiol & Intens Care Med, Rostock, Germany.
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2019 (English)In: Journal of clinical monitoring and computing, ISSN 1387-1307, E-ISSN 1573-2614, Vol. 33, no 5, p. 815-824Article in journal (Refereed) Published
Abstract [en]

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. Clinical Trial Registration NTC02854852.

Place, publisher, year, edition, pages
SPRINGER HEIDELBERG , 2019. Vol. 33, no 5, p. 815-824
Keywords [en]
Arterial pressure, Photoplethysmography, Vasodilation, Vasoconstriction, Vascular tone
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-394047DOI: 10.1007/s10877-018-0235-zISI: 000482910800010PubMedID: 30554338OAI: oai:DiVA.org:uu-394047DiVA, id: diva2:1357704
Available from: 2019-10-04 Created: 2019-10-04 Last updated: 2019-10-04Bibliographically approved

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Suarez-Sipmann, Fernando

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