Comparison between Respiratory Variations in Pulse Oximetry Plethysmographic Waveform Amplitude and Arterial Pulse Pressure during Major Abdominal Surgery

Hengy, Baptiste; Gazon, Mathieu; Schmitt, Z.; Benyoub, Karima; Bonnet, A.; Viale, J. P.; Aubrun, Frédéric

doi:10.1097/aln.0b013e3182700901

Cited by 22 publications

(30 citation statements)

References 34 publications

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“…Future research to design algorithms incurring less delay could further aid the clinical utility of PPG-derived PAV as a non-invasive measure of PPV. The original agreement between finger-derived PAV and ABP-derived PPV found in this work (3.2 ± 5.1%) was better than that reported by Hengy et al [13] (5.2 ± 8.4%). This may be attributed to be the fact that PPV values changed marginally for some patients in our dataset.…”

Section: Discussioncontrasting

confidence: 54%

“…In addition to BV, we also studied the influence of the PPV, the ratio of the respiration rate and the heart rate, and perfusion index on the agreement between PPV and PAV, as these were found or assumed to have an impact in previous work [13,14,20]. In this work, PI was calculated as ratio between the pulsatile (AC) component and the slowlychanging (DC) component.…”

Section: Discussionmentioning

confidence: 99%

“…In line with PPV, the pulse amplitude variation (PAV) of the PPG signal serves the same function. Although some studies show good correlations between PPV and PAV [10][11][12], the others report poor results especially those investigating their relationship over a long period of time [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Finger and forehead photoplethysmography-derived pulse-pressure variation and the benefits of baseline correction

Sun

Peeters

Bezemer

et al. 2018

J Clin Monit Comput

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To non-invasively predict fluid responsiveness, respiration-induced pulse amplitude variation (PAV) in the photoplethysmographic (PPG) signal has been proposed as an alternative to pulse pressure variation (PPV) in the arterial blood pressure (ABP) signal. However, it is still unclear how the performance of the PPG-derived PAV is site-dependent during surgery. The aim of this study is to compare finger-and forehead-PPG derived PAV in their ability to approach the value and trend of ABP-derived PPV. Furthermore, this study investigates four potential confounding factors, (1) baseline variation, (2) PPV, (3) ratio of respiration and heart rate, and (4) perfusion index, which might affect the agreement between PPV and PAV. In this work, ABP, finger PPG, and forehead PPG were continuously recorded in 29 patients undergoing major surgery in the operating room. A total of 91.2 h data were used for analysis, from which PAV and PPV were calculated and compared. We analyzed the impact of the four factors using a multiple linear regression (MLR) analysis. The results show that compared with the ABP-derived PPV, finger-derived PAV had an agreement of 3.2 ± 5.1%, whereas forehead-PAV had an agreement of 12.0 ± 9.1%. From the MLR analysis, we found that baseline variation was a factor significantly affecting the agreement between PPV and PAV. After correcting for respiration-induced baseline variation, the agreements for finger-and foreheadderived PAV were improved to reach an agreement of − 1.2 ± 3.8% and 3.3 ± 4.8%, respectively. To conclude, finger-derived PAV showed better agreement with ABP-derived PPV compared to forehead-derived PAV. Baseline variation was a factor that significantly affected the agreement between PPV and PAV. By correcting for the baseline variation, improved agreements were obtained for both the finger and forehead, and the difference between these two agreements was diminished. The tracking abilities for both finger-and forehead-derived PAV still warrant improvement for wide use in clinical practice. Overall, our results show that baseline-corrected finger-and forehead-derived PAV may provide a non-invasive alternative for PPV.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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Finger and forehead photoplethysmography-derived pulse-pressure variation and the benefits of baseline correction

Sun

Peeters

Bezemer

et al. 2018

J Clin Monit Comput

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“…[82][83][84][85] Despite the growing body of data suggesting that PVI is capable of predicting fluid responsiveness, there does not seem to be strong agreement between PVI and PPV. [86][87][88][89][90] The reasons for this paradox (excellent predictor of fluid responsiveness yet not in agreement with arterial-derived metrics) are not clear but may be related to the dependence of PVI on perfusion. 91 While the Masimo device may not be as effective as its more invasive counterparts during periods of malperfusion, it has three major advantages -relative low cost in comparison with its competitors, the ubiquity of pulse oximetry (which of course is a Canadian Anesthesiologists' Society basic monitoring standard), 92 and ease of use.…”

Section: Technological Assessmentmentioning

confidence: 99%

Inter-device differences in monitoring for goal-directed fluid therapy

Thiele

Bartels

Gan

2014

Can J Anesth/J Can Anesth

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“…While some studies have shown a meaningful correlation between the two, 52,53 the majority of studies comparing arterial and PPG respiratory variation point to a relatively weak correlation. [54][55][56][57][58] Solus-Biguenet et al, for instance, found a weak correlation of 0.29. 54 Nevertheless, despite this weak correlation, the majority of fluid responsiveness studies suggest that the respiratory variation in the PPG tracing is predictive of the hemodynamic response to fluid loading, [59][60][61][62][63] although this finding is not universal.…”

Section: Fluid Responsivenessmentioning

confidence: 99%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

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Purpose Photoplethysmography permits continuous measurement of heart rate and peripheral oxygen saturation and has been widely used to inform clinical decisions. Recently, a myriad of noninvasive hemodynamic monitoring devices using this same technology have been increasingly available. This narrative review aims to summarize the principles that form the basis for the function of these devices as well as to comment on trials evaluating their accuracy and clinical application. Principal findings Advanced monitoring devices extend photoplethysmography technology beyond measuring oxygen concentration and heart rate. Quantification of respiratory variation of the photoplethysmographic waveform reflects respiratory variation of the arterial pressure waveform and can be used to gauge volume responsiveness. Both the volume-clamp and physiocal techniques are extensions of conventional photoplethysmography and permit continuous measurement of finger arterial blood pressure. Finger arterial pressure waveforms can subsequently inform estimations of cardiac output. Conclusions Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes. RésuméObjectif La photopléthysmographie permet la mesure continue de la fréquence cardiaque et de la saturation en oxygène périphérique, et elle est largement utilisée pour les prises de décisions cliniques. Depuis peu, un très grand nombre de dispositifs non invasifs de surveillance hémodynamique utilisant la même technologie envahit le marché. Cette synthèse narrative vise à résumer les principes à la base du fonctionnement de ces dispositifs et à commenter les essais évaluant leur exactitude ainsi que leurs applications cliniques. Constatations principales Les dispositifs de surveillance avancée étendent la technologie de photopléthysmographie au-delà de la mesure de la concentration en oxygène et de la fréquence cardiaque. La quantification de la variation respiratoire du tracé photopléthysmographique reflète la variation respiratoire du tracé de pression artérielle et peut servir à jauger la réactivité au volume. Les deux techniques de compression volumique (volume-clamp) au doigt et la technique physiocal sont des prolongements de Author contributions Karsten Bartels wrote approximately 50% of the manuscript and critically edited the remainder. Robert H. Thiele wrote approximately 50% of the manuscript and critically edited the remainder.

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Comparison between Respiratory Variations in Pulse Oximetry Plethysmographic Waveform Amplitude and Arterial Pulse Pressure during Major Abdominal Surgery

Cited by 22 publications

References 34 publications

Finger and forehead photoplethysmography-derived pulse-pressure variation and the benefits of baseline correction

Finger and forehead photoplethysmography-derived pulse-pressure variation and the benefits of baseline correction

Inter-device differences in monitoring for goal-directed fluid therapy

Advances in photoplethysmography: beyond arterial oxygen saturation

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