Investigation of photoplethysmogram morphology for the detection of hypovolemic states

Abstract

Medics and first responders to emergencies are often faced with monitoring and assessing victims with very limited resources. Therefore, there is an inherent need for a real-time ambulatory monitoring capability that is portable and low power. This is particularly important for physiological monitoring of life-threatening conditions such as internal hemorrhaging. We propose the use of photoplethysmogram (PPG) morphology as an indicator of hypovolemic states and study its correlation with blood pressure. In this paper, we compared the PPG morphology with pulse transit time (PTT), which has been investigated for clinical and ambulatory applications. The indicators were tested on data obtained from experiments using lower body negative pressure (LBNP) as a model to simulate hemorrhage in humans. The results of this study indicate that PPG morphology is associated with pulse pressure (systolic minus diastolic blood pressure) and is therefore a promising feature for detection and real-time tracking of hypovolemic states.

Identifying Life-Threatening Shock in the Older Injured Patient: An Analysis of the National Trauma Data Bank

“…Some of these systems use a combination of sensors or changes in HR variability to determine when a person is in the early stages of hemorrhagic shock. [23][24][25][26] The results of early studies are promising, but these systems are not widely available. Until they do become available, TVS will continue to be the main way that patients at risk for dying from hemorrhagic shock are identified.…”

Modeling of arterial stiffness using variations of pulse transit time

“…Pressure pulse velocity is determined by elastic and geometric properties of arterial wall. It can be expressed by the Bramwell-Hill equation [2] V ΔP PWV = ρ ΔV (1) where V is blood volume, ΔV and Δp are the changes of blood volume and pressure, and ρ is the density (of blood). This relation enables the study of compliance (arterial elasticity) by measuring the PWV.…”

“…It is generally accepted that they can provide valuable information about the cardiovascular system [1]. PTT is measured using electrocardiogram (ECG) and (PPG) [2]. The pulse pressure waveform is getting from the left ventricle blood ejection into the aorta.…”

Standard Terminologies for Photoplethysmogram Signals

“…In 2008, Cox et al [ 13 ] used the PPG terminology when they proposed the use of photoplethysmogram (PPG) morphology as an indicator of hypovolemic states and its correlation with blood pressure.…”