Instantaneous monitoring of heart beat dynamics during anesthesia and sedation

Valenza, Gaetano; Akeju, Oluwaseun; Pavone, Kara J.; Citi, Luca; Hartnack, Katharine E.; Sampson, Aaron L.; Purdon, Patrick L.; Brown, Emery N.; Barbieri, Riccardo

doi:10.1186/s40244-014-0013-2

Cited by 17 publications

(12 citation statements)

References 87 publications

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“…We will also study pulse amplitudes in more detail, taking into account that they depend both on stimulus amplitude and physiologic background state. Now that we have verified the presence of point process structure, we can study dynamics over time, applying history dependent inverse Gaussian models like those developed for heart rate variability (37)(38)(39)(40)(41). We will also study EDA in other contexts, such as during sleep, with pain, and under general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Point Process Temporal Structure Characterizes Electrodermal Activity

Subramanian

Barbieri

Brown

2020

Preprint

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Electrodermal activity (EDA) is a read-out of the body's sympathetic nervous system measured as sweatinduced changes in the electrical conductance properties of the skin. There is growing interest in using EDA to track physiological conditions such as stress levels, sleep quality and emotional states. Standardized EDA data analysis methods are readily available. However, none considers two established physiological features of EDA: 1) sympathetically mediated pulsatile changes in skin sweat measured as EDA resemble an integrate-and-fire process; 2) inter-pulse interval times vary depending upon the local physiological state of the skin. Based on the anatomy and physiology that underlie feature 1, we postulate that inverse Gaussian probability models would accurately describe EDA inter-pulse intervals. Given feature 2, we postulate that under fluctuating local physiological states, the inter-pulse intervals would follow mixtures of inverse Gaussian models, that can be represented as lognormal models if the conditions favor longer intervals (heavy tails) or by gamma models if the conditions favor shorter intervals (light tails). To assess the validity of these probability models we recorded and analyzed EDA measurements in 11 healthy volunteers during 1 to 2 hours of quiet wakefulness. We assess the tail behavior of the probability models by computing their settling rates. All data series were accurately described by one or more of the models: two by inverse Gaussian models; five by lognormal models and three by gamma models. These probability models suggest a highly succinct point process framework for real-time tracking of sympatheticallymediated changes in physiological state.

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Section: Discussionmentioning

confidence: 99%

Point Process Temporal Structure Characterizes Electrodermal Activity

Subramanian

Barbieri

Brown

2020

Preprint

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“…The drug has been commonly used as the preoperative sedative, regional anesthesia adjuvant and general anesthesia adjuvant ( 6 , 7 ). It is clinically found that the drug also has an anti-inflammatory effect ( 8 – 10 ). Therefore, 141 patients receiving radical operation of colon carcinoma in Jining No.…”

Section: Introductionmentioning

confidence: 99%

Effects of dexmedetomidine on inflammatory factors, T lymphocyte subsets and expression of NF‑κB in peripheral blood mononuclear cells in patients receiving radical surgery of colon carcinoma

Wang

2018

Oncol Lett

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The effects of dexmedetomidine on inflammatory factors, T lymphocyte subsets and expression of nuclear factor-κB (NF-κB) in peripheral blood mononuclear cells in patients receiving radical surgery of colon carcinoma were investigated. A total of 141 patients receiving radical surgery of colon carcinoma from January 2014 to April 2017 were divided into two groups randomly. The patients in the treatment group were given dexmedetomidine, while the patients in the control group were treated with saline. Results showed that there were no significant differences in preoperative levels of NF-κB, sICAM-1 and IL-8 between the two groups. However, the above three indexes of the groups were all significantly increased at 0.5 and 24 h after operation, and the results showed that the control group had a higher degree of increase (P<0.05). It was also found that the changes in levels of IL-6 and CRP in patients were the same as those of the above three indexes; in other words, the degree of the increase in the control group was significantly higher than that in the treatment group after operation. Moreover, it was found that there was little difference in the preoperative Ramsay score of patients between the two groups. The scores at 0.5 and 12 h after operation in the treatment group were significantly higher than those in the control group (P<0.05). It was also found that the intraoperative and postoperative dosages of fentanyl in the treatment group were significantly less than those in the control group (P<0.05). We can conclude that the application of dexmedetomidine during anesthesia in patients receiving radical operation of colon carcinoma has a better clinical treatment effect, which can reduce the secretion of inflammatory factors, decrease the inhibition of immunity and reduce the use of fentanyl.

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“…We cannot ignore the depressant effect of pentobarbital anesthesia on reflexes, but at the same time it is important to take into account that the values of the BRS estimates are in agreement with the literature [34, 35], albeit in unconscious animals. Nonetheless, previous reports from our and other laboratories have already shown the robustness of the application of BRS models to data collected from patients under anesthesia, as well as the importance of introducing such indices to characterize the ANS performance in the surgical or ICU setting [24, 36, 37]. …”

Section: Discussionmentioning

confidence: 99%

Heart period and blood pressure characteristics in splanchnic arterial occlusion shock-induced collapse

Aletti

Gambarotta

Penn

et al. 2015

J Clin Monit Comput

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The nature of hemodynamic instability typical of circulatory shock is not well understood, but an improved interpretation of its dynamic features could help in the management of critically ill patients. The objective of this work was to introduce new metrics for the analysis of arterial blood pressure (ABP) in order to characterize the risk of catastrophic outcome in splanchnic arterial occlusion (SAO) shock. Continuous ABP (fs = 1 kHz) was measured in rats during experimental SAO shock, which induced a fatal pressure drop (FPD) in ABP. The FPD could either be slow (SFPD) or fast (FFPD), with the latter causing cardiovascular collapse. Time series of mean arterial pressure, systolic blood pressure and heart period were derived from ABP. The sample asymmetry-based algorithm Heart Rate Characteristics was adapted to compute the Heart Period Characteristics (HPC) and the Blood Pressure Characteristics (BPC). Baroreflex sensitivity (BRS) was assessed by means of a bivariate model. The approach to FPD of the animals who collapsed (FFPD) was characterized by higher BRS in the low frequency band versus SFPD animals (0.36 ± 0.15 vs. 0.19 ± 0.12 ms/mmHg, p value = 0.0196), bradycardia as indicated by the HPC (0.76 ± 0.57 vs. 1.94 ± 1.27, p value = 0.0179) and higher but unstable blood pressure as indicated by BPC (3.02 ± 2.87 vs. 1.47 ± 1.29, p value = 0.0773). The HPC and BPC indices demonstrated promise as potential clinical markers of hemodynamic instability and impending cardiovascular collapse, and this animal study suggests their test in data from intensive care patients.

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Instantaneous monitoring of heart beat dynamics during anesthesia and sedation

Cited by 17 publications

References 87 publications

Point Process Temporal Structure Characterizes Electrodermal Activity

Point Process Temporal Structure Characterizes Electrodermal Activity

Effects of dexmedetomidine on inflammatory factors, T lymphocyte subsets and expression of NF‑κB in peripheral blood mononuclear cells in patients receiving radical surgery of colon carcinoma

Heart period and blood pressure characteristics in splanchnic arterial occlusion shock-induced collapse

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