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 journalArticleAcademicpeer-review

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)2101-2121
Number of pages21
JournalPhysiological Measurement
Volume38
Issue number12
DOIs
Publication statusPublished - 28 Nov 2017

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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