Variations in Arterial Blood Pressure and Photoplethysmography During Mechanical Ventilation

Natalini, Giuseppe; Rosanò, Antonio; Franceschetti, Maria Elena; Facchetti, Paola; Bernardini, Achille

doi:10.1213/01.ane.0000202380.22997.24

Cited by 75 publications

(51 citation statements)

References 23 publications

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“…It is well known that the PPG waveform is influenced by both positive pressure ventilation [8] and the peripheral venous pulsations [1,9]. In the case of positive pressure ventilation, we hypothesize that the effect on the PPG waveform is mediated by volume changes in the venous compartment.…”

Section: Measuring Venous Oxygen Saturation Via Physiological Sourcesmentioning

confidence: 79%

Measuring venous oxygenation using the photoplethysmograph waveform

Walton

Kyriacou

Silverman

et al. 2010

J Clin Monit Comput

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This is the accepted version of the paper.This version of the publication may differ from the final published version. ABSTRACT. Objective. We investigate the hypothesis that the photoplethysmograph (PPG) waveform can be analyzed to infer regional venous oxygen saturation. Methods. Fundamental to the successful isolation of the venous saturation is the identification of PPG characteristics that are unique to the peripheral venous system. Two such characteristics have been identified. First, the peripheral venous waveform tends to reflect atrial contraction. Second, ventilation tends to move venous blood preferentially due to the low pressure and high compliance of the venous system. Red (660 nm) and IR (940 nm) PPG waveforms were collected from 10 cardiac surgery patients using an esophageal PPG probe. These waveforms were analyzed using algorithms written in Mathematica. Four time-domain saturation algorithms (ArtSat, VenSat, ArtInstSat, VenInstSat) and four frequency-domain saturation algorithms (RespDC, RespAC, Cardiac, and Harmonic) were applied to the data set. Results. Three of the algorithms for calculating venous saturation (VenSat, VenInstSat, and RespDC) demonstrate significant difference from ArtSat (the conventional time-domain algorithm for measuring arterial saturation) using the Wilcoxon signed-rank test with Bonferroni correction (p < 0.0071). Conclusions. This work introduces new algorithms for PPG analysis. Three algorithms (VenSat, VenInstSat, and RespDC) succeed in detecting lower saturation blood. The next step is to confirm the accuracy of the measurement by comparing them to a gold standard (i.e., venous blood gas). Permanent repository linkKEY WORDS. pulse oximeter, waveform analysis, plethysmograph, non-invasive monitoring, venous oxygen saturation.

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Section: Measuring Venous Oxygen Saturation Via Physiological Sourcesmentioning

confidence: 79%

Measuring venous oxygenation using the photoplethysmograph waveform

Walton

Kyriacou

Silverman

et al. 2010

J Clin Monit Comput

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“…A similar effect has been noted on the PPG waveform [19] but is usually overlooked owing to filtering and autoscaling of the waveform on clinical monitoring systems. The unfiltered PPG waveform is modulated by a slowly varying wave, synchronous with the respiratory cycle.…”

Section: Effect Of Respiration On the Photoplethysmographic Waveformmentioning

confidence: 53%

Pulse oximetry and photoplethysmographic waveform analysis of the esophagus and bowel

Phillips

Kyriacou

Jones

et al. 2008

Current Opinion in Anaesthesiology

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“…Plethysomgraphic variability has been shown to predict fluid responsiveness in cardiac [30], general surgical [37] and intensive care patients [28], and goal directed fluid administration protocols directed by PVI have been shown effective at reducing morbidity and length of stay [27] [30] [38]. For dialysis-dependent patients, it is possible that the plethysmographic signal being used to calculate PVI may not be usable.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Non-Invasive Goal Directed Fluid Administration on Graft Function in Deceased Donor Renal Transplantation: A Pilot Study

Whiteley¹,

Taylor²,

Jr³

et al. 2016

OJOTS

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Background: Non-invasive goal directed fluid therapy during deceased donor renal transplant (CRT) may reduce the incidence of delayed graft function. Plethysmograph Variability Index (PVI) has been shown to predict fluid responsiveness during surgery. This pilot study evaluated the feasibility of goal directed fluid administration protocol based upon PVI studying the incidence of delayed graft function (DGF) in renal transplant recipients. Methods: Twenty patients underwent primary CRT. The Control group received intravenous fluid (IVF) at a calculated constant rate. The Treatment group received a baseline IVF infusion throughout the surgery. PVI values greater than 13% were treated with 250 ml boluses of IVF. Primary end point was DGF; total IVF administration and urinary biomarker NGAL levels were secondary endpoints. Results: Treatment group at every time point received significantly less IVF. There was no significant difference in incidence of DGF between the groups. 2 patients in the Control group and 6 in the Treatment group developed DGF. NGAL was not associated with the group assignment or total IVF given (p < 0.2). Conclusions: The effectiveness of goal directed fluid therapy with non-invasive dynamic parameters has not been validated in renal transplant surgery and larger prospective studies are needed to determine its utility in renal transplantation.

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Variations in Arterial Blood Pressure and Photoplethysmography During Mechanical Ventilation

Cited by 75 publications

References 23 publications

Measuring venous oxygenation using the photoplethysmograph waveform

Measuring venous oxygenation using the photoplethysmograph waveform

Pulse oximetry and photoplethysmographic waveform analysis of the esophagus and bowel

The Effect of Non-Invasive Goal Directed Fluid Administration on Graft Function in Deceased Donor Renal Transplantation: A Pilot Study

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