Pulse transit time as a measure of respiratory effort under noninvasive ventilation

Contal, Olivier; Carnevale, Claudio; Borel, Jean‐Christian; Sabil, AbdelKébir; Tamisier, Renaud; Lévy, Patrick; Janssens, Jean–Paul; Pépin, Jean‐Louis

doi:10.1183/09031936.00193911

Cited by 23 publications

(13 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The result of present study about the coupled frequency between PTT and respiratory signal further verified this. Besides, PTT has been used as a measure of respiratory effort [46], because PTT is inversely proportional to BP, and BP falls with inspiration with the rise in PTT. This can also be observed from time series of PP, PTT and respiratory signal as depicted in Fig.…”

Section: A Effect Of Respiration and Vasomotor Tone On Bpmentioning

confidence: 99%

Continuous Cuffless Blood Pressure Estimation Using Pulse Transit Time and Photoplethysmogram Intensity Ratio

Ding

Zhang

Liu

et al. 2016

IEEE Trans. Biomed. Eng.

276

167

View full text Add to dashboard Cite

Pulse transit time (PTT) has attracted much interest for cuffless blood pressure (BP) measurement. However, its limited accuracy is one of the main problems preventing its widespread acceptance. Arterial BP oscillates mainly at high frequency (HF) because of respiratory activity, and at low frequency (LF) because of vasomotor tone. Prior studies suggested that PTT can track BP variation in HF range, but was inadequate to follow the LF variation, which is probably the main reason for its unsatisfactory accuracy. This paper presents a new indicator, the photoplethysmogram intensity ratio (PIR), which can be affected by changes in the arterial diameter, and, thus, trace the LF variation of BP. Spectral analysis of BP, PTT, PIR, and respiratory signal confirmed that PTT was related to BP in HF at the respiratory frequency, while PIR was associated with BP in LF range. We, therefore, develop a novel BP estimation algorithm by using both PTT and PIR. The proposed algorithm was validated on 27 healthy subjects with continuous Finapres BP as reference. The results showed that the mean ± standard deviation (SD) for the estimated systolic, diastolic, and mean BP with the proposed method against reference were -0.37 ±5.21, -0.08 ±4.06, -0.18 ±4.13 mmHg, and mean absolute difference (MAD) were 4.09, 3.18, 3.18 mmHg, respectively. Furthermore, the proposed method outperformed the two most cited PTT algorithms for about 2 mmHg in SD and MAD. These results demonstrated that the proposed BP model using PIR and PTT can estimate continuous BP with improved accuracy.

show abstract

Section: A Effect Of Respiration and Vasomotor Tone On Bpmentioning

confidence: 99%

Continuous Cuffless Blood Pressure Estimation Using Pulse Transit Time and Photoplethysmogram Intensity Ratio

Ding

Zhang

Liu

et al. 2016

IEEE Trans. Biomed. Eng.

276

167

View full text Add to dashboard Cite

show abstract

“…This analysis can be readily obtained from signals obtained during a standard polysomnography, such as the device pressure signal, flow signal, abdominal and thoracic belts, and saturation levels, and can provide sufficient and specific information for the detection of deviceassociated sleep-disordered events ( Table 2) (81,88). Capnography (to detect hypoventilation), pulse transit time (a surrogate marker of inspiratory muscle effort), and device-specific software (which can include measures of parameters such as rate, leaks, minute ventilation, tidal volume, percent of patient-triggered breaths) may provide additional important information (40,88,99,100).…”

Section: Identification Of Sleep-disordered Breathing Triggered By Nomentioning

confidence: 99%

Sleep-disordered Breathing in Neuromuscular Disease

Aboussouan

2015

Am J Respir Crit Care Med

150

View full text Add to dashboard Cite

Sleep-disordered breathing in neuromuscular diseases is due to an exaggerated reduction in lung volumes during supine sleep, a compromised physiologic adaptation to sleep, and specific features of the diseases that may promote upper airway collapse or heart failure. The normal decrease in the rib cage contribution to the tidal volume during phasic REM sleep becomes a critical vulnerability, resulting in saw-tooth oxygen desaturation possibly representing the earliest manifestation of respiratory muscle weakness. Hypoventilation can occur in REM sleep and progress into non-REM sleep, with continuous desaturation and hypercarbia. Specific characteristics of neuromuscular disorders, such as pharyngeal neuropathy or weakness, macroglossia, bulbar manifestations, or low lung volumes, predispose patients to the development of obstructive events. Central sleep-disordered breathing can occur with associated cardiomyopathy (e.g., dystrophies) or from instability in the control of breathing due to diaphragm weakness. Mitigating factors such as recruitment of accessory respiratory muscles, reduction in REM sleep, and loss of normal REM atonia in some individuals may partially protect against sleep-disordered breathing. Noninvasive ventilation, a standard-of-care management option for sleep-disordered breathing, can itself trigger specific sleep-disordered breathing events including air leaks, patient-ventilator asynchrony, central sleep apnea, and glottic closure. These events increase arousals, reduce adherence, and impair sleep architecture. Polysomnography plays an important role in addressing pitfalls in the diagnosis of sleep-disordered breathing in neuromuscular diseases, identifying sleep-disordered breathing triggered by noninvasive ventilation, and optimizing noninvasive ventilation settings.

show abstract

“…In recent years the use of portable monitoring (PM) has becoming an increasingly accepted cost-effective alternative approach (Blackman et al, 2010;Collop, 2008;Collop et al, 2007;Kuna, 2010;Masa et al, 2011;McNicholas and L evy, 2011), but suffers from a major drawback: the lack of a reliable sign of arousals, resulting in underestimation of respiratory events (Adler et al, 2013). To overcome this weakness, a number of studies have focused on the identification of surrogate markers of cortical arousals (Adler et al, 2013;Argod et al, 2000;Azarbarzin et al, 2014;Catcheside et al, 2002;Contal et al, 2013;Delessert et al, 2010;Haba-Rubio et al, 2005a;Pitson et al, 1994;Sforza et al, 2007;Tauman et al, 2004;Zacharia et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Arousal responses to respiratory events during sleep: the role of pulse wave amplitude

Bosi

Milioli

Riccardi

et al. 2017

Journal of Sleep Research

View full text Add to dashboard Cite

The study aims at assessing the changes in electroencephalography (as measured by the A-phases of cyclic alternating pattern) and autonomic activity (based on pulse wave amplitude) at the recovery of airway patency in patients with obstructive sleep apnea syndrome. Analysis of polysomnographic recordings from 20 male individuals with obstructive sleep apnea syndrome was carried out in total sleep time, non-rapid eye movement and rapid eye movement sleep. Scoring quantified the combined occurrence (time range of 4 s before and 4 s after respiratory recovery) or separate occurrence of A-phases (cortical activation), and pulse wave amplitude drops (below 30%) to apneas, hypopneas or flow limitation events. A dual response (A-phase associated with a pulse wave amplitude drop) was the most frequent response (71.8% in total sleep time) for all types of respiratory events, with a progressive reduction from apneas to hypopneas and flow limitation events. The highly significant correlation in total sleep time (r = 0.9351; P < 0.0001) between respiratory events combined with A-phases and respiratory events combined with pulse wave amplitude drops was confirmed both in non-rapid eye movement (r = 0.9622; P < 0.0001) and rapid eye movement sleep (r = 0.7162; P < 0.0006). In conclusion, a dual cortical and autonomic activation is the most common manifestation at the recovery of airway patency. The significant correlation between A-phases and relevant pulse wave amplitude drops suggests a possible role of pulse wave amplitude as a marker of cerebral response to respiratory events.

show abstract

Pulse transit time as a measure of respiratory effort under noninvasive ventilation

Cited by 23 publications

References 26 publications

Continuous Cuffless Blood Pressure Estimation Using Pulse Transit Time and Photoplethysmogram Intensity Ratio

Continuous Cuffless Blood Pressure Estimation Using Pulse Transit Time and Photoplethysmogram Intensity Ratio

Sleep-disordered Breathing in Neuromuscular Disease

Arousal responses to respiratory events during sleep: the role of pulse wave amplitude

Contact Info

Product

Resources

About