An improved artifact removal algorithm for continuous cardiac output and blood pressure recordings

Tronstad, Christian; Omenås, Ivar Nagelgaard; Rosseland, Leiv Arne

doi:10.1109/embc.2015.7319751

Cited by 5 publications

(5 citation statements)

References 3 publications

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“…Artefacts were reduced using a previously published method for detecting and removing outliers in continuous BP and CO recordings [12]. Data points for statistical analysis were constructed with 1-min intervals by averaging data over the first 10 s of each minute.…”

Section: Discussionmentioning

confidence: 99%

Accuracy and trending abilities of finger plethysmographic blood pressure and cardiac output compared to invasive measurements during caesarean delivery in healthy women: an observational study

2020

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Background In women presenting for caesarean section under spinal anesthesia, continuous measurement of circulatory aspects, such as blood pressure and cardiac output, is often needed. At present, invasive techniques are used almost exclusively. Reliable non-invasive monitoring would be welcome, as it could be safer, less uncomfortable, and quick and easy to apply. We aimed to evaluate whether a non-invasive, finger plethysmographic device, the ccNexFin monitor, can replace invasively measured blood pressure in the radial artery, and whether cardiac output measurements from this device can be used interchangeably with measurements from the mini-invasive LiDCO monitor currently in use at our institution. Methods Simultaneous invasive measurements were compared to ccNexFin in 23 healthy women during elective caesarean section under spinal anesthesia. We used Bland Altman statistics to assess agreement, and polar plot methodology to judge trending abilities with pre-defined limits. Results Mean arterial and systolic pressures showed biases (invasive – ccNexFin) of − 4.3 and 12.2 mmHg, with limits of agreement of − 15.9 – 7.4 and − 11.1 – 35.6, respectively. The ccNexFin trending abilities were within the suggested limits for mean pressure but insufficient for systolic pressure compared to invasive measurements. Cardiac output had a small bias of 0.2 L/min, but wide limits of agreement of − 2.6 – 3.0. The ccNexFin trending abilities compared to the invasive estimated values (LiDCO) were unsatisfactory. Conclusions We consider the ccNexFin monitor to have sufficient accuracy in measuring mean arterial pressure. The limits of agreement for systolic measurements were wider, and the trending ability compared to invasive measurements was outside the recommended limit. The ccNexFin is not reliable for cardiac output measurements or trend in pregnant women for caesarean delivery under spinal anesthesia. Trial registration Registered May 23, 2013, at ClinicalTrials.gov under number NCT01861132.

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Section: Discussionmentioning

confidence: 99%

Accuracy and trending abilities of finger plethysmographic blood pressure and cardiac output compared to invasive measurements during caesarean delivery in healthy women: an observational study

2020

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“…PerioPerative Medicine pasma et al data, as used in this paper. [15][16][17][18][19] More advanced methods exist (e.g., models or machine learning algorithms that identify artifacts); although, the downfall of these more advanced methods is that they require a training set to train an algorithm, of which obtaining is labor intensive. When artifacts are identified and subsequently removed, there are several options that can be used to fill in the gaps.…”

Section: Systematic Searchmentioning

confidence: 99%

“…procedures should be new (no procedures on the same patient in the previous yr) and have sufficient (at least 15) invasive blood pressure measurements available after time of induction. 2,3,[15][16][17][18][19][20][21][22][23][24][25][26][27] Copyright © 2020, the American Society of Anesthesiologists, Inc. Unauthorized reproduction of this article is prohibited.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Artifact Processing Methods Influence on Intraoperative Hypotension Quantification and Outcome Effect Estimates

et al. 2020

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Background Physiologic data that is automatically collected during anesthesia is widely used for medical record keeping and clinical research. These data contain artifacts, which are not relevant in clinical care, but may influence research results. The aim of this study was to explore the effect of different methods of filtering and processing artifacts in anesthesiology data on study findings in order to demonstrate the importance of proper artifact filtering. Methods The authors performed a systematic literature search to identify artifact filtering methods. Subsequently, these methods were applied to the data of anesthesia procedures with invasive blood pressure monitoring. Different hypotension measures were calculated (i.e., presence, duration, maximum deviation below threshold, and area under threshold) across different definitions (i.e., thresholds for mean arterial pressure of 50, 60, 65, 70 mmHg). These were then used to estimate the association with postoperative myocardial injury. Results After screening 3,585 papers, the authors included 38 papers that reported artifact filtering methods. The authors applied eight of these methods to the data of 2,988 anesthesia procedures. The occurrence of hypotension (defined with a threshold of 50 mmHg) varied from 24% with a median filter of seven measurements to 55% without an artifact filtering method, and between 76 and 90% with a threshold of 65 mmHg. Standardized odds ratios for presence of hypotension ranged from 1.16 (95% CI, 1.07 to 1.26) to 1.24 (1.14 to 1.34) when hypotension was defined with a threshold of 50 mmHg. Similar variations in standardized odds ratios were found when applying methods to other hypotension measures and definitions. Conclusions The method of artifact filtering can have substantial effects on estimates of hypotension prevalence. The effect on the association between intraoperative hypotension and postoperative myocardial injury was relatively small. Nevertheless, the authors recommend that researchers carefully consider artifacts handling and report the methodology used. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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“…Artefacts were reduced using a previously published method for detecting and removing outliers in continuous blood pressure and cardiac output recordings [12]. Data points for statistical analysis were constructed with one-minute intervals, by averaging data over the first 10 seconds of each minute.…”

Section: Statisticsmentioning

confidence: 99%

Accuracy and trending abilities of finger plethysmographic blood pressure and cardiac output compared with invasive measurements during caesarean delivery in healthy women. An observational study.

Omenås¹,

Tronstad²,

Rosseland³

2020

Preprint

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Background: In women presenting for caesarean section under spinal anaesthesia, continuous measurement of circulatory aspects, such as blood pressure and cardiac output, is often needed. At present, invasive techniques are used almost exclusively. Reliable non-invasive monitors would be welcome, as they could be safer and less uncomfortable, while easy and quick to apply. We aimed to evaluate whether a non-invasive, finger plethysmographic device, the ccNexFin monitor, can replace invasively measured blood pressure in the radial artery, and whether cardiac output measurements from this device can be used interchangeably with measurements from the mini-invasive LiDCO monitor, currently in use at our institution. Methods: Simultaneous invasive measurements were compared with ccNexFin in 23 healthy women during elective caesarean section under spinal anaesthesia. We used Bland Altman statistics for assessing agreement, and polar plot methodology for judging trending abilities with pre-defined limits. Results: Mean arterial and systolic pressures showed biases (invasive – ccNexFin) of -4.3 and 12.2 mmHg, with limits of agreement of -15.9 – 7.4 and -11.1 – 35.6, respectively. The ccNexFin trending abilities were within suggested limits for mean pressure, but insufficient for systolic pressure compared with invasive measurements. Cardiac output had a small bias of 0.2 L/min, but wide limits of agreement of -2.6 – 3.0. The ccNexFin trending abilities compared with the invasive estimated values (LiDCO) were unsatisfactory. Conclusions: We consider the ccNexFin monitor to have sufficient accuracy in measuring mean arterial pressures. The limits of agreement for systolic measurements were wider, and the trending ability, compared with invasive measurements, was outside the recommended limit. The ccNexFin is not reliable for cardiac output measurements or trend in pregnant women for caesarean delivery under spinal anaesthesia.

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An improved artifact removal algorithm for continuous cardiac output and blood pressure recordings

Cited by 5 publications

References 3 publications

Accuracy and trending abilities of finger plethysmographic blood pressure and cardiac output compared to invasive measurements during caesarean delivery in healthy women: an observational study

Accuracy and trending abilities of finger plethysmographic blood pressure and cardiac output compared to invasive measurements during caesarean delivery in healthy women: an observational study

Artifact Processing Methods Influence on Intraoperative Hypotension Quantification and Outcome Effect Estimates

Accuracy and trending abilities of finger plethysmographic blood pressure and cardiac output compared with invasive measurements during caesarean delivery in healthy women. An observational study.

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