Noninvasive assessment of blood pressure in rotary blood pump recipients using a novel ultrasonic Doppler method

2019 ◽  
Vol 42 (5) ◽  
pp. 226-232
Author(s):  
Marcus Granegger ◽  
Bente Thamsen ◽  
Francesco Moscato ◽  
Thomas Schlöglhofer ◽  
Christoph Gross ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Radial Artery ◽  
Blood Pump ◽  
Arterial Line ◽  
Rotary Blood Pump ◽  
Flow Measurements ◽  
Velocity Signal ◽  
Doppler Method ◽  
Arterial Blood ◽  
The Mean

In rotary blood pump recipients with low blood pressure pulsatility, current oscillometric methods to measure blood pressure are not applicable. The aim of this study was to use ultrasonic Doppler flow measurements to determine blood pressure in this patient population noninvasively. In 28 rotary blood pump recipients, blood pressure was measured three times with the developed Doppler method and compared to the invasive arterial line (n = 15) or to the oscillometric Terumo Elemano BP monitor (n = 13). Blood velocities in the radial artery were recorded by the new Doppler sensor during cuff deflation. A sigmoid curve was fitted to a preprocessed velocity signal and the systolic and mean arterial pressures were determined. A total of 84 measurements were performed, and 17 recordings were visually excluded from further analysis due to obvious artifacts. Both the systolic and mean pressures derived by the Doppler method were in good accordance with the invasively measured pressure (3.7 ± 6.6 mmHg for the systolic and −2.1 ± 7.3 mmHg for the mean pressure). A good agreement between the oscillometric monitor and the Doppler method for the systolic (0.0 ± 6.0 mmHg) and mean (1.0 ± 5.9 mmHg) pressures was observed. In this study, a new Doppler blood pressure measurement system was developed and clinically validated. The novel sensor allows easier placement above the radial artery compared to commercial probes. An algorithm was developed which processes the Doppler signal robustly and is able to determine the systolic as well as the mean arterial blood pressure.

scholarly journals On the Pathology of the dropsy produced by obstruction of the superior and inferior venœ and the portal vein.— Preliminary communication

1907 ◽  
Vol 79 (532) ◽  
pp. 267-283 ◽  
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Portal Vein ◽  
Mean Arterial Blood Pressure ◽  
Normal Limit ◽  
The Body ◽  
Diastolic Filling ◽  
Arterial Blood ◽  
Preliminary Communication ◽  
The Mean

In August, 1903, I published a paper in the ‘Journal of Pathology’(1) in which I demonstrated a method experimentally producing uncompensated hear disease in an animal, which was compatible with life. This method consisted in diminishing the size of the pericardial sac by stitches, so that the diastolic filling of the heart was impeded. The main symptoms of this condition were dropsy and diminution in the amount of urine excreted. As the immediate result of this interference with the action of the heart, there occurred a rise of pressure throughout the whole systemic venous system extending as far back as the capillaries, and a fall of the mean arterial blood-pressure. Further, I found that the pressure in all the veins fell to the normal limit again within the space of about one hour, and that subsequently when dropsy was being produced, the vanous pressure in all parts of the body was normal, and the arterial pressure had almost recovered itself.

scholarly journals An Estimation Method of Continuous Non-Invasive Arterial Blood Pressure Waveform Using Photoplethysmography: A U-Net Architecture-Based Approach

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1867
Author(s):  
Tasbiraha Athaya ◽  
Sunwoong Choi
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Health ◽  
Estimation Method ◽  
Absolute Error ◽  
British Hypertension Society ◽  
Non Invasive ◽  
Arterial Blood ◽  
Blood Pressure Waveform ◽  
The Mean ◽  
Mimic Iii

Blood pressure (BP) monitoring has significant importance in the treatment of hypertension and different cardiovascular health diseases. As photoplethysmogram (PPG) signals can be recorded non-invasively, research has been highly conducted to measure BP using PPG recently. In this paper, we propose a U-net deep learning architecture that uses fingertip PPG signal as input to estimate arterial BP (ABP) waveform non-invasively. From this waveform, we have also measured systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). The proposed method was evaluated on a subset of 100 subjects from two publicly available databases: MIMIC and MIMIC-III. The predicted ABP waveforms correlated highly with the reference waveforms and we have obtained an average Pearson’s correlation coefficient of 0.993. The mean absolute error is 3.68 ± 4.42 mmHg for SBP, 1.97 ± 2.92 mmHg for DBP, and 2.17 ± 3.06 mmHg for MAP which satisfy the requirements of the Association for the Advancement of Medical Instrumentation (AAMI) standard and obtain grade A according to the British Hypertension Society (BHS) standard. The results show that the proposed method is an efficient process to estimate ABP waveform directly using fingertip PPG.

HAEMODYNAMIC CHANGES AND ADRENAL FUNCTION IN MAN DURING INDUCED HYPOGLYCAEMIA

1963 ◽  
Vol 44 (3) ◽  
pp. 430-442 ◽  
Author(s):  
B. Arner ◽  
P. Hedner ◽  
T. Karlefors ◽  
H. Westling
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Mean Arterial Blood Pressure ◽  
Peripheral Vascular ◽  
Adrenocortical Activity ◽  
Arterial Blood ◽  
Haemodynamic Changes ◽  
The Mean ◽  
Temporary Rise ◽  
Catechol Amines

ABSTRACT Observations were made on healthy volunteers during insulin induced hypoglycaemia (10 cases) and infusion of adrenaline (3 cases) or cortisol (1 case). In all cases a rise in the cardiac output was registered during insulin hypoglycaemia. The mean arterial blood pressure was relatively unchanged and the calculated peripheral vascular resistance decreased in all cases. A temporary rise in plasma corticosteroids was observed. After infusion of adrenaline similar circulatory changes were observed but no rise in plasma corticosteroids was found. Infusion of cortisol caused an increased plasma corticosteroid level but no circulatory changes. It is concluded that liberation of catechol amines and increased adrenocortical activity following hypoglycaemia are not necessarily interdependent.

scholarly journals THE ASSAY OF HYPERTENSIN FROM THE ARTERIAL BLOOD OF NORMOTENSIVE AND HYPERTENSIVE HUMAN BEINGS

1952 ◽  
Vol 95 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Joseph R. Kahn ◽  
Leonard T. Skeggs ◽  
Norman P. Shumway ◽  
Paul E. Wisenbaugh
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Normal Blood ◽  
Moderate Degree ◽  
Human Beings ◽  
Normal Blood Pressure ◽  
Arterial Blood ◽  
The Mean ◽  
Mean Concentration ◽  
Benign Group

Hypertensin has been assayed in the blood of patients with normal blood pressure and in those with essential hypertension in both the benign and malignant phases. 250 ml. samples of arterial blood were obtained, chemically purified, and concentrated to a volume of 1 ml. These extracts were then assayed in anesthetized rats. The concentrations of hypertensin in the blood of patients with the malignant phase of essential hypertension were found to be greatly increased. The concentrations of hypertensin found in patients with benign hypertension had a moderate degree of overlapping with those found in the normotensive group, but the mean concentration of hypertensin in the former group was twice that of the controls. Although these results are statistically significant, the amounts of hypertensin recovered in the benign group are so small that no conclusions can be drawn as to its effectiveness in producing vasoconstriction in these patients.

Vasodilation of cat cerebral arterioles by prostaglandins D2, E2, G2, and I2

1979 ◽  
Vol 237 (3) ◽  
pp. H381-H385 ◽  
Author(s):  
E. F. Ellis ◽  
E. P. Wei ◽  
H. A. Kontos
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Arterial Blood Pressure ◽  
Standard Error ◽  
Arterial Blood ◽  
Cerebral Arterioles ◽  
The Mean ◽  
Dose Dependent ◽  
The Brain

To determine the possible role that endogenously produced prostaglandins may play in the regulation of cerebral blood flow, the responses of cerebral precapillary vessels to prostaglandins (PG) D2, E2, G2, and I2 (8.1 X 10(-8) to 2.7 X 10(-5) M) were studied in cats equipped with cranial windows for direct observation of the microvasculature. Local application of PGs induced a dose-dependent dilation of large (greater than or equal to 100 microns) and small (less than 100 microns) arterioles with no effect on arterial blood pressure. The relative vasodilator potency was PGG2 greater than PGE2 greater than PGI2 greater than PGD2. With all PGs, except D2, the percent dilation of small arterioles was greater than the dilation of large arterioles. After application of prostaglandins in a concentration of 2.7 X 10(-5) M, the mean +/- standard error of the percent dilation of large and small arterioles was, respectively, 47.6 +/- 2.7 and 65.3 +/- 6.1 for G2, 34.1 +/- 2.0, and 53.6 +/- 5.5 for E2, 25.4 +/- 1.8, and 40.2 +/- 4.6 for I2, and 20.3 +/- 2.5 and 11.0 +/- 2.2 for D2. Because brain arterioles are strongly responsive to prostaglandins and the brain can synthesize prostaglandins from its large endogenous pool of prostaglandin precursor, prostaglandins may be important mediators of changes in cerebral blood flow under normal and abnormal conditions.

Vasomotor waves of arterial blood pressure after cessation of cardiopulmonary bypass in man

Perfusion ◽  
1990 ◽  
Vol 5 (4) ◽  
pp. 261-266
Author(s):  
V. Vainionpää ◽  
A. Hollme'n ◽  
J. Timisjärvi
Keyword(s):  
Blood Pressure ◽  
Cardiopulmonary Bypass ◽  
Arterial Pressure ◽  
Venous Pressure ◽  
Systemic Arterial Pressure ◽  
Heart Patients ◽  
Arterial Blood ◽  
Pulmonary Arterial ◽  
The Mean ◽  
Epicardial Pacing

The occurrence of vasomotor waves during cardiopulmonary bypass (CPB) is a recognized phenomenon. The lesser known oscillation of arterial pressure after cessation of CPB was observed in 18 open-heart patients. The duration of an oscillatory wave was 13.5±5.0 seconds, the amplitude 6.1 ±2.6mmNg and the mean arterial pressure 76.5± 10.7mmHg. Inter-and also intraindividual variations in frequency and amplitude of the oscillation, however, did occur. In 13 patients, this oscillation occurred during ventricular epicardial pacing. The oscillation continued until the end of the operation in eight patients; in others, the oscillation was of shorter duration. An oscillation of pulmonary arterial pressure (PAP) was simultaneously observed in nine patients (eight with pacemaker) and central venous pressure (CVP) oscillation in eight patients (all with pacemaker). The duration of a wave was the same as in systemic arterial pressure and the amplitudes were 1.5-3.0mmHg in PAP and 1.0-2.0mmHg in CVP. These arterial vasomotor waves, seen here after CPB, largely resemble those observed during perfusion in man and also the Mayerwaves explored in experimental animals. The pacing rhythm seems to favourthe appearance of those blood pressure oscillations.

Low Variability of Blood Pressure Predicts Abnormal Electroencephalogram in Infants with Hypoxic Ischemic Encephalopathy

2020 ◽  
Author(s):  
Abigail Flower ◽  
Daniel Vasiliu ◽  
Tianrui Zhu ◽  
Robert Andris ◽  
Maryam Abubakar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Frequency Domain ◽  
Arterial Blood Pressure ◽  
Apgar Score ◽  
Blood Pressure Variability ◽  
Hypoxic Ischemic Encephalopathy ◽  
Arterial Blood ◽  
The Mean ◽  
Minute Apgar Score ◽  
Ischemic Encephalopathy

Objective This study aimed to evaluate the role of an objective physiologic biomarker, arterial blood pressure variability, for the early identification of adverse short-term electroencephalogram (EEG) outcomes in infants with hypoxic-ischemic encephalopathy (HIE). Study Design In this multicenter observational study, we analyzed blood pressure of infants meeting these criteria: (1) neonatal encephalopathy determined by modified Sarnat exam, (2) continuous mean arterial blood pressure (MABP) data between 18 and 27 hours after birth, and (3) continuous EEG performed for at least 48 hours. Adverse outcome was defined as moderate–severe grade EEG at 48 hours. Standardized signal preprocessing was used; the power spectral density was computed without interpolation. Multivariate binary logistic regression was used to identify which MABP time and frequency domain metrics provided improved predictive power for adverse outcomes compared with standard clinical predictors (5-minute Apgar score and cord pH) using receiver operator characteristic analysis. Results Ninety-one infants met inclusion criteria. The mean gestational age was 38.4 ± 1.8 weeks, the mean birth weight was 3,260 ± 591 g, 52/91 (57%) of infants were males, the mean cord pH was 6.95 ± 0.21, and 10/91 (11%) of infants died. At 48 hours, 58% of infants had normal or mildly abnormal EEG background and 42% had moderate or severe EEG backgrounds. Clinical predictor variables (10-minute Apgar score, Sarnat stage, and cord pH) were modestly predictive of 48 hours EEG outcome with area under curve (AUC) of 0.66 to 0.68. A composite model of clinical and optimal time- and frequency-domain blood pressure variability had a substantially improved AUC of 0.86. Conclusion Time- and frequency-domain blood pressure variability biomarkers offer a substantial improvement in prediction of later adverse EEG outcomes over perinatal clinical variables in a two-center cohort of infants with HIE. Key Points

Reduced parasympathetic control of heart rate in obese dogs

1995 ◽  
Vol 269 (2) ◽  
pp. H629-H637 ◽  
Author(s):  
B. N. Van Vliet ◽  
J. E. Hall ◽  
H. L. Mizelle ◽  
J. P. Montani ◽  
M. J. Smith
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Rate Control ◽  
Saturated Fat ◽  
Pressure Control ◽  
Resting Heart Rate ◽  
Arterial Blood ◽  
Parasympathetic Control ◽  
The Mean ◽  
Affect Heart Rate

We investigated why resting heart rate is elevated in dogs fed a high saturated fat diet for 12.7 +/- 1.8 wk. Obese dogs exhibited elevated body weight (59%), blood pressure (14%), and heart rate (25%). Differences in resting heart rate (control, 58 +/- 5 beats/min; obese, 83 +/- 7 beats/min) were abolished after hexamethonium, indicating an autonomic mechanism. Hexamethonium also reduced blood pressure in obese (20 +/- 4 mmHg) but not control (9 +/- 6 mmHg) animals. Propranolol did not affect heart rate in either group, excluding a beta-adrenergic mechanism. Subsequent administration of atropine increased heart rate more in control than in obese dogs (110 +/- 9 vs. 57 +/- 11 beats/min). The sensitivity of the cardiac limb of the baroreflex (Oxford method) was reduced by 46% in the obese group, confirming impairment of the parasympathetic control of heart rate. The standard deviation of blood pressure measurements was normal when expressed as a percentage of the mean arterial blood pressure (control, 11.2 +/- 0.4%; obese, 11.2 +/- 0.5%). Our results indicate that the development of obesity in dogs fed a high saturated fat diet is accompanied by an attenuated resting and reflex parasympathetic control of heart rate.

Central effect of endothelin on blood pressure in conscious rats

1989 ◽  
Vol 256 (6) ◽  
pp. H1747-H1751 ◽  
Author(s):  
Y. Ouchi ◽  
S. Kim ◽  
A. C. Souza ◽  
S. Iijima ◽  
A. Hattori ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Conscious Rats ◽  
Arterial Blood ◽  
Norepinephrine Concentration ◽  
Artificial Cerebrospinal Fluid ◽  
Male Wistar Rats ◽  
The Mean ◽  
Dose Dependent Increase ◽  
Dose Dependent ◽  
Lateral Cerebral Ventricle

This study was conducted to investigate the effect of intracerebroventricular administration of endothelin (EDT), a novel potent vasoconstricting peptide, on blood pressure in conscious rats. The lateral cerebral ventricle of male Wistar rats was cannulated, and the femoral artery was also cannulated to measure the mean arterial blood pressure (MABP) and heart rate (HR). EDT dissolved in 10 microliters of artificial cerebrospinal fluid (ACSF) (8.25-66 pmol icv) provoked a dose-dependent increase in MABP. EDT also increased HR, although the effect of 66 pmol was variable. Intracerebroventricular ACSF did not provoke any effects on MABP and HR. Intracerebroventricular EDT also provoked contralateral rotational behavior. Pretreatment with 2 mg/kg iv phenoxybenzamine significantly suppressed the 16.5 pmol icv EDT-induced increase in MABP. Moreover, 16.5 pmol icv EDT markedly increased plasma epinephrine and norepinephrine concentration. These results indicate that EDT has a central pressor action, and the action might be mediated, at least in part, by catecholamine release to the periphery. EDT might play a role in the central control of blood pressure, although the physiological implications have not yet been determined.

A New Noninvasive Method to Measure Blood Pressure 

1999 ◽  
Vol 91 (3) ◽  
pp. 686-686 ◽  
Author(s):  
Kumar Belani ◽  
Makoto Ozaki ◽  
James Hynson ◽  
Thomas Hartmann ◽  
Hugo Reyford ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Critically Ill ◽  
Radial Artery ◽  
Pulse Rate ◽  
Critically Ill Patients ◽  
Arterial Catheter ◽  
Arterial Waveform ◽  
Measure Blood Pressure ◽  
The Mean ◽  
Radial Artery Catheter

Background Blood pressure (BP) monitoring with arterial waveform display requires an arterial cannula. We evaluated a new noninvasive device, Vasotrac (Medwave, Arden Hills, MN) that provides BP measurements approximately every 12-15 beats and displays pulse rate and a calibrated arterial waveform for each BP measurement. Methods Surgical and critically ill patients (n = 80) served as subjects for the study. BPs, pulse waveforms, and pulse rates measured via a radial artery catheter were compared with those obtained by the Vasotrac from the opposite radial artery. Data were analyzed to determine agreement between the two systems of measurement. Results Blood pressure measured noninvasively by the Vasotrac demonstrated excellent correlation (P<0.01) with BP measured via a radial arterial catheter (systolic r2 = 0.93; diastolic r2 = 0.89; mean r2 = 0.95). Differences in BP measured by the Vasotrac versus the radial arterial catheter were small. The mean+/-SD bias and precision were as follows: systolic BP 0.02+/-5.4 mm Hg and 3.9+/-3.7 mm Hg; diastolic BP -0.39+/-3.9 mm Hg and 2.7+/-2.8 mm Hg; mean BP -0.21+/-3.0 mm Hg and 2.1+/-2.2 mm Hg compared with radial artery measurements. The Vasotrac pulse rates were almost identical to those measured directly (r2 = 0.95). The Vasotrac BP waveform resembled those directly obtained radial artery pulsatile waveforms. Conclusions In surgical and critically ill patients, the Vasotrac measured BP, pulse rate, and displayed radial artery waveform, which was similar to direct radial arterial measurements. It should be a suitable device to measure BP frequently in a noninvasive fashion.

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