Invasive blood pressure measurement is used in patients with unstable haemodynamics. The demand of the accuracy of these measurements is high. The reliability of the reproduced signal strongly depends on the measurement system's dynamic characteristic-its resonance frequency and damping factor. These characteristics were examined with the frequency response method, which is valuable for second and higher order systems. Most of the pressure measuring systems in use in clinical practice have low damping factor (0.1-0.2), which causes high overshoot in systolic pressure values (up to 13%), since putting all the measuring components in a chain reduces the dynamic properties of a single component and the resonance frequency drops drastically from over 100 Hz to even below 10 Hz. One of the solutions to increase the damping ratio is to insert a damping device R.O.S.E. parallel to the tubing. The resonance frequency remains the same, the damping factor increases to around 0.5. Systems with higher damping factors (0.5-0.7) have lower overshoot (1-2%), therefore the blood pressure measurements are more accurate.
In critically ill patients haemodynamic parameters are being routinely monitored. All of the fluctuations in blood pressures cannot be visualised since on most monitors the time window is too short and trend curves do not have a sufficient time resolution. Therefore, frequency analysis was applied to an 800-second window. Systemic artery pressure, central venous pressure and pulmonary artery pressure curves of 6 patients were sampled with a frequency of 40 Hz. The signals were transformed into the frequency domain by the Fast Fourier Transform method. Bispectral analysis was applied to determine the origin of higher frequencies. There were three main frequencies present: heart stroke rate, respiratory frequency and a slow frequency (< 0.05 Hz), which was equal to the used infusion rate (2-10 ml/h) of vaso-active drugs. Continuous infusion of short-acting vaso-active drugs delivered by pulsatile diaphragm pumps to produce slow significant fluctuations in especially the arterial blood pressures (range: 5-40 mmHg). The periodicity of these slow fluctuations is not visualised during routine monitoring, so the observer may misinterpret the cause of changes in blood pressure and make inappropriate clinical decisions. A solution for detection of such slow waves is Fast Fourier Transform combined with bispectral analysis.
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