Document Detail

Automatic algorithm for monitoring systolic pressure variation and difference in pulse pressure.
MedLine Citation:
PMID:  19448207     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Difference in pulse pressure (dPP) reliably predicts fluid responsiveness in patients. We have developed a respiratory variation (RV) monitoring device (RV monitor), which continuously records both airway pressure and arterial blood pressure (ABP). We compared the RV monitor measurements with manual dPP measurements. METHODS: ABP and airway pressure (PAW) from 24 patients were recorded. Data were fed to the RV monitor to calculate dPP and systolic pressure variation in two different ways: (a) considering both ABP and PAW (RV algorithm) and (b) ABP only (RV(slim) algorithm). Additionally, ABP and PAW were recorded intraoperatively in 10-min intervals for later calculation of dPP by manual assessment. Interobserver variability was determined. Manual dPP assessments were used for comparison with automated measurements. To estimate the importance of the PAW signal, RV(slim) measurements were compared with RV measurements. RESULTS: For the 24 patients, 174 measurements (6-10 per patient) were recorded. Six observers assessed dPP manually in the first 8 patients (10-min interval, 53 measurements); no interobserver variability occurred using a computer-assisted method. Bland-Altman analysis showed acceptable bias and limits of agreement of the 2 automated methods compared with the manual method (RV: -0.33% +/- 8.72% and RV(slim): -1.74% +/- 7.97%). The difference between RV measurements and RV(slim) measurements is small (bias -1.05%, limits of agreement 5.67%). CONCLUSIONS: Measurements of the automated device are comparable with measurements obtained by human observers, who use a computer-assisted method. The importance of the PAW signal is questionable.
Gunther Pestel; Kimiko Fukui; Volker Hartwich; Peter M Schumacher; Andreas Vogt; Luzius B Hiltebrand; Andrea Kurz; Yoshihisa Fujita; Daniel Inderbitzin; Daniel Leibundgut
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  108     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-18     Completed Date:  2009-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1823-9     Citation Subset:  AIM; IM    
Department of Anesthesiology, Johannes Gutenberg-University, Mainz, Germany.
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MeSH Terms
Abdomen / surgery
Airway Resistance / physiology
Blood Pressure / physiology*
Blood Volume / physiology
Data Interpretation, Statistical
Middle Aged
Monitoring, Intraoperative / methods*
Observer Variation
Reference Standards
Reproducibility of Results
Respiratory Mechanics / physiology

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

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