On algorithms for calculating arterial pulse pressure variation during major surgery

Shaoxiong Sun; Wouter H. Peeters; Rick Bezemer; Xi Long; Igor Paulussen; Ronald M. Aarts; Gerrit J. Noordergraaf

doi:10.1088/1361-6579/aa95a4

On algorithms for calculating arterial pulse pressure variation during major surgery

Shaoxiong Sun, Wouter H. Peeters, Rick Bezemer, Xi Long, Igor Paulussen, Ronald M. Aarts, Gerrit J. Noordergraaf

Research output: Contribution to journal › Article › Academic › peer-review

6 Citations (Scopus)

65 Downloads (Pure)

Abstract

Objective: Arterial pulse pressure variation (PPV) is widely used for predicting fluid responsiveness and supporting fluid management in the operating room and intensive care unit. Available PPV algorithms have been typically validated for fluid responsiveness during episodes of hemodynamic stability. Yet, little is known about the performance of PPV algorithms during surgery, where fast changes of the blood pressure may affect the robustness of the presented PPV value. This work provides a comprehensive understanding of how various existing algorithmic designs affect the robustness of the presented PPV value during surgery, and proposes additional processing for the pulse pressure signal before calculating PPV. Approach: We recorded arterial blood pressure waveforms from 23 patients undergoing major abdominal surgery. To evaluate the performance, we designed three clinically relevant metrics. Main results and Significance: The results show that all algorithms performed well during episodes of hemodynamic stability. Moreover, it is demonstrated that the proposed processing helps improve the robustness of PPV during the entire course of surgery.

Original language	English
Pages (from-to)	2101-2121
Number of pages	21
Journal	Physiological Measurement
Volume	38
Issue number	12
DOIs	https://doi.org/10.1088/1361-6579/aa95a4
Publication status	Published - 28 Nov 2017

Funding

This work was financially supported by China Scholarship Council (CSC). This work was conducted as part of a collaborative PhD research program, called the Healthcare Flagship, in which the Eindhoven University of Technology, Royal Philips, the Maxima Medical Center Veldhoven, the Catharina Hospital Eindhoven, and the Kempenhaeghe Sleep Center Heeze join forces to create impactful innovations in healthcare. The authors wish to express their gratitude to Arthur Bouwman for providing clinical insights and reviewing the manuscript. The authors wish to extend their gratitude to Jan-Willem Bikker for his advice on statistical analysis.

Keywords

adaptive peak filter
baseline extraction
fluid responsiveness
major surgery
pulse pressure variation
Blood Pressure
Abdomen/surgery
Humans
Monitoring, Physiologic/methods
Respiration, Artificial
Blood Pressure Determination/methods
Algorithms
Electrocardiography

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10.1088/1361-6579/aa95a4

publisher versionFinal published version, 2.23 MBLicence: TAVERNE

Cite this

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title = "On algorithms for calculating arterial pulse pressure variation during major surgery",

abstract = "Objective: Arterial pulse pressure variation (PPV) is widely used for predicting fluid responsiveness and supporting fluid management in the operating room and intensive care unit. Available PPV algorithms have been typically validated for fluid responsiveness during episodes of hemodynamic stability. Yet, little is known about the performance of PPV algorithms during surgery, where fast changes of the blood pressure may affect the robustness of the presented PPV value. This work provides a comprehensive understanding of how various existing algorithmic designs affect the robustness of the presented PPV value during surgery, and proposes additional processing for the pulse pressure signal before calculating PPV. Approach: We recorded arterial blood pressure waveforms from 23 patients undergoing major abdominal surgery. To evaluate the performance, we designed three clinically relevant metrics. Main results and Significance: The results show that all algorithms performed well during episodes of hemodynamic stability. Moreover, it is demonstrated that the proposed processing helps improve the robustness of PPV during the entire course of surgery.",

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AU - Peeters, Wouter H.

AU - Bezemer, Rick

AU - Long, Xi

AU - Paulussen, Igor

AU - Aarts, Ronald M.

AU - Noordergraaf, Gerrit J.

PY - 2017/11/28

Y1 - 2017/11/28

N2 - Objective: Arterial pulse pressure variation (PPV) is widely used for predicting fluid responsiveness and supporting fluid management in the operating room and intensive care unit. Available PPV algorithms have been typically validated for fluid responsiveness during episodes of hemodynamic stability. Yet, little is known about the performance of PPV algorithms during surgery, where fast changes of the blood pressure may affect the robustness of the presented PPV value. This work provides a comprehensive understanding of how various existing algorithmic designs affect the robustness of the presented PPV value during surgery, and proposes additional processing for the pulse pressure signal before calculating PPV. Approach: We recorded arterial blood pressure waveforms from 23 patients undergoing major abdominal surgery. To evaluate the performance, we designed three clinically relevant metrics. Main results and Significance: The results show that all algorithms performed well during episodes of hemodynamic stability. Moreover, it is demonstrated that the proposed processing helps improve the robustness of PPV during the entire course of surgery.

AB - Objective: Arterial pulse pressure variation (PPV) is widely used for predicting fluid responsiveness and supporting fluid management in the operating room and intensive care unit. Available PPV algorithms have been typically validated for fluid responsiveness during episodes of hemodynamic stability. Yet, little is known about the performance of PPV algorithms during surgery, where fast changes of the blood pressure may affect the robustness of the presented PPV value. This work provides a comprehensive understanding of how various existing algorithmic designs affect the robustness of the presented PPV value during surgery, and proposes additional processing for the pulse pressure signal before calculating PPV. Approach: We recorded arterial blood pressure waveforms from 23 patients undergoing major abdominal surgery. To evaluate the performance, we designed three clinically relevant metrics. Main results and Significance: The results show that all algorithms performed well during episodes of hemodynamic stability. Moreover, it is demonstrated that the proposed processing helps improve the robustness of PPV during the entire course of surgery.

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KW - Monitoring, Physiologic/methods

KW - Respiration, Artificial

KW - Blood Pressure Determination/methods

KW - Algorithms

KW - Electrocardiography

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On algorithms for calculating arterial pulse pressure variation during major surgery

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