Blood pressure waveform contour analysis for assessing peripheral resistance changes in sepsis

Davidson, Shaun; Pretty, Christopher G.; Balmer, Joel; Desaive, Thomas; Chase, J. Geoffrey

doi:10.1186/s12938-018-0603-4

Cited by 3 publications

(1 citation statement)

References 39 publications

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“…On the other hand, for patients with high basal blood pressure, attention should be paid to the systolic blood pressure variety ratio. In the study by Zhang and Li (18), they found that the blood pressure variety ratio of the patient positively correlated with the severity of sepsis, and the systolic blood pressure variety ratio can affect the severity of sepsis, so timely effective measures should be taken for sepsis patients with continuously reduced systolic blood pressure (19). Blood pressure measurement was recorded in the case notes of the 74 patients mostly because they were sweating after the high temperature was lowered.…”

Section: Necessity For Non-icu Clinicians To Improve Their Awareness Of Qsofa and Its Accuracymentioning

confidence: 99%

Clinical observation and analysis on the significance of quick sequential organ failure assessment in 74 non-ICU patients with sepsis

Zhang¹,

Deng²,

Chen³

et al. 2021

Ann Palliat Med

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Section: Necessity For Non-icu Clinicians To Improve Their Awareness Of Qsofa and Its Accuracymentioning

confidence: 99%

Clinical observation and analysis on the significance of quick sequential organ failure assessment in 74 non-ICU patients with sepsis

Zhang¹,

Deng²,

Chen³

et al. 2021

Ann Palliat Med

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The role of pulse wave analysis indexes for critically ill patients: a narrative review

Carrara,

Campitelli,

Guberti

et al. 2024

Physiol. Meas.

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Objective. Arterial pulse wave analysis (PWA) is now established as a powerful tool to investigate the cardiovascular system, and several clinical studies have shown how PWA can provide valuable prognostic information over and beyond traditional cardiovascular risk factors. Typically these techniques are applied to chronic conditions, such as hypertension or aging, to monitor the slow structural changes of the vascular system which lead to important alterations of the arterial PW. However, their application to acute critical illness is not currently widespread, probably because of the high hemodynamic instability and acute dynamic alterations affecting the cardiovascular system of these patients. Approach. In this work we propose a review of the physiological and methodological basis of PWA, describing how it can be used to provide insights into arterial structure and function, cardiovascular biomechanical properties, and to derive information on wave propagation and reflection. The applicability of these techniques to acute critical illness, especially septic shock, is extensively discussed, highlighting the feasibility of their use in acute critical patients and their role in optimizing therapy administration and hemodynamic monitoring. Significance. The potential for the clinical use of these techniques lies in the ease of computation and availability of arterial blood pressure signals, as invasive arterial lines are commonly used in these patients. We hope that the concepts illustrated in the present review will soon be translated into clinical practice.

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Association between delayed invasive blood pressure monitoring and all-cause mortality in intensive care unit patients with sepsis: a retrospective cohort study

Xiao,

Shen,

Han

et al. 2024

Front. Med.

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PurposeHaemodynamic management is essential in sepsis management. Invasive blood pressure (IBP) monitoring is the gold standard for blood pressure (BP) assessment. Here, we identified the most advantageous time frame for IBP monitoring to mitigate adverse outcomes in patients with sepsis.MethodsWe included data on patients with sepsis from the Medical Information Mart for Intensive Care IV database. The primary endpoints comprised 28-and 90-day mortality rates, whereas secondary endpoints were acute kidney injury (AKI) rates and continuous renal replacement therapy (CRRT) requirement. To confirm our findings’ robustness, we performed multivariable Cox regression and logistic regression models, augmented by propensity score matching (PSM).ResultsOf 18,326 patients hospitalised for sepsis, 9,056 (49.42%) and 9,270 (50.58%) were included in the early and delayed IBP-monitoring groups, respectively. Our multivariable Cox regression models revealed 20 and 21% significant increases in 28-and 90-day mortality in the delayed IBP monitoring group, respectively [hazard ratios (95% confidence intervals) = 1.20 (1.11–1.31) and 1.21 (1.12–1.31), respectively; both p < 0.001]. Moreover, significant increases were noted in AKI, CRRT and mechanical ventilation requirement risks in the delayed IBP monitoring group [odds ratios (95% confidence intervals) = 1.44 (1.34–1.56), 1.50 (1.26–1.78) and 1.79 (1.67–1.92), respectively; both p < 0.001]. PSM further confirmed the validity of our findings. Delayed IBP monitoring prolonged intensive care unit (ICU) stay without extending vasopressor use duration.ConclusionProlonged delay in IBP monitoring (≥3 h) may increase mortality risks in ICU patients with sepsis. Nevertheless, early IBP monitoring may reduce AKI, CRRT and mechanical ventilation requirement risks and shorten ICU stay. However, these results warrant further validation through randomised controlled trials.

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Blood pressure waveform contour analysis for assessing peripheral resistance changes in sepsis

Cited by 3 publications

References 39 publications

Clinical observation and analysis on the significance of quick sequential organ failure assessment in 74 non-ICU patients with sepsis

Clinical observation and analysis on the significance of quick sequential organ failure assessment in 74 non-ICU patients with sepsis

The role of pulse wave analysis indexes for critically ill patients: a narrative review

Association between delayed invasive blood pressure monitoring and all-cause mortality in intensive care unit patients with sepsis: a retrospective cohort study

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