Tube-load model: A clinically applicable pulse contour analysis method for estimation of cardiac stroke volume

Arterial wave reflection; Hemodynamic monitoring; Intensive care; Pulse contour analysis; Stroke volume; Tube-load model; Mammals; Hemodynamic instability; Load models; Pulse transit time; Pulse-contour analysis; States change; Stroke volumes; Hemodynamics; cisatracurium; diazepam; Escherichia coli endotoxin; sodium chloride; sufentanil; thiobarbital; tiletamine plus zolazepam; anesthesia; animal experiment; animal tissue; aorta; aortic flow; aortic valve; arterial pressure; Article; blood vessel tone; cardiovascular system; continuous infusion; controlled study; critically ill patient; femoral artery; heart function; heart left ventricle pressure; heart left ventricle volume; heart output; heart stroke volume; hemodynamic monitoring; hemodynamic parameters; human; intensive care; ischemia; limit of agreement; measurement accuracy; nonhuman; Pietrain pig; positive end expiratory pressure ventilation; pulse contour analysis; pulse rate; pulse transit time; sedation; septic shock; signal processing; superior cava vein; systolic time interval; venous return; animal; artery; heart rate; hemodynamics; pig; pulse wave; Animals; Arteries; Cardiac Output; Heart Rate; Humans; Pulse Wave Analysis; Stroke Volume; Swine

Abstract :

[en] Background and Objectives: Accurate, reproducible, and reliable real-time clinical measurement of stroke volume (SV) is challenging. To accurately estimate arterial mechanics and SV by pulse contour analysis, accounting for wave reflection, such as by a tube-load model, is potentially important. This study tests for the first time whether a dynamically identified tube-load model, given a single peripheral arterial input signal and pulse transit time (PTT), provides accurate SV estimates during hemodynamic instability. Methods: The model is tested for 5 pigs during hemodynamic interventions, using either an aortic flow probe or admittance catheter for a validation SV measure. Performance is assessed using Bland-Altman and polar plot analysis for a series of long-term state-change and short-term dynamic events. Results:The overall median bias and limits of agreement (2.5th, 97.5th percentile) from Bland-Altman analysis were -10% [-49, 36], and -1% [-28,20] for state-change and dynamic events, respectively. The angular limit of agreement (maximum of 2.5th, 97.5th percentile) from polar-plot analysis for state-change and dynamic interventions was 35.6∘, and 35.2∘, respectively. Conclusion: SV estimation agreement and trending performance was reasonable given the severity of the interventions. This simple yet robust method has potential to track SV within acceptable limits during hemodynamic instability in critically ill patients, provided a sufficiently accurate PTT measure. © 2021 Elsevier B.V.

Disciplines :

Anesthesia & intensive care

Author, co-author :

Smith, R.; Department of Mechanical Engineering, University of Canterbury, New Zealand

Murphy, L.; Department of Mechanical Engineering, University of Canterbury, New Zealand

Pretty, C.G.; Department of Mechanical Engineering, University of Canterbury, New Zealand

Desaive, Thomas ; Université de Liège - ULiège > Département d'astrophysique, géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles

Shaw, G.M.; Christchurch Hospital Intensive Care Unit, New Zealand

Chase, J.G.; Department of Mechanical Engineering, University of Canterbury, New Zealand

Language :

English

Title :

Tube-load model: A clinically applicable pulse contour analysis method for estimation of cardiac stroke volume

Publication date :

2021

Journal title :

Computer Methods and Programs in Biomedicine

ISSN :

0169-2607

eISSN :

1872-7565

Publisher :

Elsevier Ireland Ltd

Volume :

204

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 05 December 2023

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