Beat-to-Beat Tracking of Systolic Blood Pressure Using Noninvasive Pulse Transit Time During Anesthesia Induction in Hypertensive Patients

Kim, Sung Hoon; Song, Jae-Kwan; Park, Jihyun; Kim, Jungwon; Park, Yong-Seok; Hwang, Gyu‐Sam

doi:10.1213/ane.0b013e318270a6d9

Cited by 51 publications

(54 citation statements)

References 31 publications

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“…Some of the changes such as peak to peak amplitude, rise time, width, slope, PTT and pulse rate recover within 5-10 min of tooth extraction. Our results show the decreased PTT and increased pulse amplitude after the injection of local anesthesia, which are closely agree with the results reported by Kim et al [15]. The pulse wave is influenced by sympathetic activity, vascular stiffness and other factors that influence the local perfusion.…”

Section: Discussionsupporting

confidence: 93%

“…An acute rise in BP causes vascular tone to increase and hence the arterial wall becomes stiffer which causes PTT to reduce. Kim et al [15] have shown the increased PTT with reduced systolic blood pressure during anesthesia induction in hypertensive patients during kidney transplant surgery and also reported that PTT variability may show potential as a useful noninvasive index of SBP. The PTT has clinically significant association with systolic hypertension at a given time and also enables prediction of changes in BP over a short period [13].…”

Section: Introductionmentioning

confidence: 97%

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Monitoring cardiovascular changes due to local anesthesia during and after tooth extraction using pulse wave analysis

Veerabhadrappa

Vyas

Anand

et al. 2015

Biomedical Signal Processing and Control

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 97%

Monitoring cardiovascular changes due to local anesthesia during and after tooth extraction using pulse wave analysis

Veerabhadrappa

Vyas

Anand

et al. 2015

Biomedical Signal Processing and Control

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“…BP changes can be recorded by monitoring changes in PTT. 25 A sudden increase in BP increases the vascular tone, which results in an increase of arterial wall rigidity and shorter PTT. 26 Although there was a higher number of PTT drops in WUS, the difference was not statistically significant.…”

Section: Figure 2-desaturationmentioning

confidence: 99%

Association of Sleep Disordered Breathing with Wake-Up Acute Ischemic Stroke: A Full Polysomnographic Study

Šiarnik

Kollár

Čarnická

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Sleep disordered breathing (SDB) is a frequent comorbidity in stroke patients. SDB is one of the independent risk factors for ischemic stroke. Conversely, stroke may contribute to SDB onset or aggravate premorbid SDB. Multiple mechanisms underlying SDB might be responsible for the development of stroke. The aim of this study was to compare polysomnographic, clinical, and laboratory characteristics of wake-up (WUS) and non-wake-up acute ischemic strokes (NWUS). Methods: We prospectively enrolled 88 patients with acute ischemic stroke. Clinical characteristics of the population were recorded on admission, and blood samples were obtained in the fasting condition following morning. SDB was assessed using standard overnight polysomnography in the acute phase of the stroke. Results: WUS were present in 16 patients (18.2%), and NWUS in 72 patients (81.8%). In WUS compared to NWUS, we observed significantly higher values of apnea-hypopnea index (24.8 vs. I NTRO DUCTI O NA recent population-based study has shown that wake-up strokes (WUS) comprise 14% of all ischemic strokes. The same study concludes, that WUS do not differ from non-wake up strokes (NWUS) in clinical features, risk factors, or outcome.1 There is a diurnal variation in the onset of stroke. Sleep tends to promote ischemic stroke, and there is a higher frequency of strokes occurring in the morning.2,3 Sleep disordered breathing (SDB) is present in up to 72% of stroke patients and is one of the independent risk factors for stroke. 4,5 However, stroke may also aggravate premorbid SDB or even contribute to SDB onset. 6 Multiple mechanisms might link SDB with the onset of cerebral ischemia during the sleep, including coagulation changes, hemodynamic changes, blood pressure (BP) surges, inflammatory overactivity, increased arterial stiffness, increased sympathetic tone, paradoxical embolization, or the development of cardiac arrhythmias. 7-11Currently, WUS patients are excluded from revascularization therapy; therefore, a thorough search for predictors and risk factors of WUS is desirable. The aim of this study was to compare polysomnographic, clinical, and laboratory characteristics of WUS and NWUS with mild-to-moderate severity. SCIENTIFIC INVESTIGATIONS Association of Sleep M ETHO DSThe study population consists of patients hospitalized in the stroke unit of the 1 st Department of Neurology, Comenius University Bratislava from January 2011 to December 2014 with the BRIEF SUMMARY Current Knowledge/Study Rationale: Currently, wake-up stroke patients are excluded from revascularization therapy, so a precise search for predictors and risk factors of wake-up strokes is desirable. The aim of this study was to compare polysomnographic, clinical, and laboratory characteristics of wake-up strokes and non-wake-up strokes with mild-to-moderate severity. Study Impact: We emphasize the importance of significantly higher frequency of moderate-to-severe sleep apnea syndrome among the wake-up stroke population, as this population is indicated for positive...

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“…36 More recently, oximeter-based PTT has been used to obtain accurate measurements of changes in blood pressure that occur during induction of general anesthesia as well as to achieve rapid detection of the onset of hypotension in patients undergoing spinal anesthesia for Cesarean delivery. 37,38 While more validation studies are needed, the near instantaneous response time shown in both of these studies is encouraging. 33,34 In aggregate, these data suggest that PTT, at least over short time periods, provides useful information for immediate detection of hemodynamic changes that might be missed if only an oscillometric cuff method is used for periodic blood pressure assessments.…”

Section: Physiology Of the Ppgmentioning

confidence: 84%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

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Purpose Photoplethysmography permits continuous measurement of heart rate and peripheral oxygen saturation and has been widely used to inform clinical decisions. Recently, a myriad of noninvasive hemodynamic monitoring devices using this same technology have been increasingly available. This narrative review aims to summarize the principles that form the basis for the function of these devices as well as to comment on trials evaluating their accuracy and clinical application. Principal findings Advanced monitoring devices extend photoplethysmography technology beyond measuring oxygen concentration and heart rate. Quantification of respiratory variation of the photoplethysmographic waveform reflects respiratory variation of the arterial pressure waveform and can be used to gauge volume responsiveness. Both the volume-clamp and physiocal techniques are extensions of conventional photoplethysmography and permit continuous measurement of finger arterial blood pressure. Finger arterial pressure waveforms can subsequently inform estimations of cardiac output. Conclusions Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes. RésuméObjectif La photopléthysmographie permet la mesure continue de la fréquence cardiaque et de la saturation en oxygène périphérique, et elle est largement utilisée pour les prises de décisions cliniques. Depuis peu, un très grand nombre de dispositifs non invasifs de surveillance hémodynamique utilisant la même technologie envahit le marché. Cette synthèse narrative vise à résumer les principes à la base du fonctionnement de ces dispositifs et à commenter les essais évaluant leur exactitude ainsi que leurs applications cliniques. Constatations principales Les dispositifs de surveillance avancée étendent la technologie de photopléthysmographie au-delà de la mesure de la concentration en oxygène et de la fréquence cardiaque. La quantification de la variation respiratoire du tracé photopléthysmographique reflète la variation respiratoire du tracé de pression artérielle et peut servir à jauger la réactivité au volume. Les deux techniques de compression volumique (volume-clamp) au doigt et la technique physiocal sont des prolongements de Author contributions Karsten Bartels wrote approximately 50% of the manuscript and critically edited the remainder. Robert H. Thiele wrote approximately 50% of the manuscript and critically edited the remainder.

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Beat-to-Beat Tracking of Systolic Blood Pressure Using Noninvasive Pulse Transit Time During Anesthesia Induction in Hypertensive Patients

Cited by 51 publications

References 31 publications

Monitoring cardiovascular changes due to local anesthesia during and after tooth extraction using pulse wave analysis

Monitoring cardiovascular changes due to local anesthesia during and after tooth extraction using pulse wave analysis

Association of Sleep Disordered Breathing with Wake-Up Acute Ischemic Stroke: A Full Polysomnographic Study

Advances in photoplethysmography: beyond arterial oxygen saturation

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