Document Detail


Arterial-pulse oximetry loops: a new method of monitoring vascular tone.
MedLine Citation:
PMID:  9269615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We report the off-line calculation of the vascular compliance of the finger and suggest the continuous on-line use of this methodology as an aid to monitoring the peripheral vascular resistance. This method consists of the simultaneous analysis of the waveform signals from the pulse oximeter monitors and the arterial pressure as indicators of "volume" and pressure respectively to continuously calculate the vascular "compliance" (volume change per unit pressure change). This should be seen as a "relative compliance" as the pulse plethysmograph signal is not calibrated. This new methodology allows for continuous monitoring of peripheral vascular compliance as a beat-to-beat indicator of peripheral vascular resistance. The vaso-constrictors, phenylephrine and ephedrine, were shown to decrease the compliance as predicted. METHODS: The arterial pressure and pulse oximeter waveforms were obtained during routine anesthetic care. The waveforms were collected with a computer data-acquisition system and then analyzed "off-line" as an indirect indicator of total vascular tone. Demographic and clinical information including drug administration were recorded. RESULTS: A case report is presented using this new form of analysis. Vascular compliance changes induced by phenylephrine and ephedrine were studied. A dose response curve of peripheral vascular compliance to phenylephrine was generated from these data. CONCLUSIONS: By plotting the pulse oximeter waveforms versus the arterial waveforms, multiple volume versus pressure (relative compliance) loops were obtained. Analysis of these loops may assist in the monitoring of vascular compliance.
Authors:
K H Shelley; W B Murray; D Chang
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical monitoring     Volume:  13     ISSN:  0748-1977     ISO Abbreviation:  J Clin Monit     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-10-16     Completed Date:  1997-10-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8506707     Medline TA:  J Clin Monit     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  223-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Pennsylvania State University, College of Medicine, Hershey 17033, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / administration & dosage,  therapeutic use
Anesthesia, Intravenous
Arteries
Blood Pressure / physiology
Blood Volume / physiology
Calibration
Cephalometry
Dose-Response Relationship, Drug
Ephedrine / administration & dosage,  therapeutic use
Female
Fingers / blood supply
Forecasting
Heart Rate
Humans
Hypotension / drug therapy,  etiology
Intraoperative Complications / drug therapy
Meningioma / surgery
Middle Aged
Monitoring, Physiologic / instrumentation,  methods*
Online Systems
Oximetry / instrumentation,  methods*
Phenylephrine / administration & dosage,  therapeutic use
Plethysmography
Signal Processing, Computer-Assisted
Vascular Resistance / drug effects,  physiology*
Vasoconstrictor Agents / administration & dosage,  therapeutic use
Vasomotor System / drug effects,  physiology
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 0/Vasoconstrictor Agents; 299-42-3/Ephedrine; 59-42-7/Phenylephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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